IPRATROPIUM bromide nebuliser solution

Therapeutic action

• Bronchodilator, anticholinergic drug

Indications

• Severe asthma attack, in combination with salbutamol

Forms and strengths

• Solution for inhalation, in unit dose vial of 0.25 mg in 1 ml (0.25 mg/ml) and 0.5 mg in 2 ml (0.25 mg/ml), to be administered via a nebuliser

Dosage and duration

• Child under 5 years: 0.25 mg (1 ml) per nebulisation every 20 minutes for the first hour
• Child 5 years and over and adult: 0.5 mg (2 ml) per nebulisation every 20 minutes for the first hour

Contra-indications, adverse effects, precautions

• May cause:
  • throat irritation, headache, cough, vomiting;
  • anticholinergic effects: dryness of the mouth, constipation, dilation of the pupils, blurred vision, urinary retention, tachycardia.
• Administer with caution to older patients and patients with closed-angle glaucoma, urethro-prostatic disorders, urinary retention.
• Avoid or monitor combination with drugs known to have anticholinergic effects: tricyclic antidepressants (e.g. amitriptyline), first generation H-1 antihistamines (e.g. hydroxyzine, promethazine), biperiden, antispasmodics (e.g. atropine, hyoscine butylbromide), antipsychotics (e.g. chlorpromazine, haloperidol), etc. (increased risk of adverse effects).
• Pregnancy: no contra-indication
• Breast-feeding: no contra-indication

Remarks

• Volumes of nebuliser solution to be administered are insufficient to obtain efficient nebulisation in most nebulisers: add ipratropium to salbutamol and then 0.9% sodium chloride to obtain a total volume of 5 ml in the reservoir of the nebuliser. Stop the nebulisation when the reservoir is empty (after around 10 to 15 minutes).

Storage