IPRATROPIUM bromide nebuliser solution

Therapeutic action

• Bronchodilator, anticholinergic drug

Indications

• Acute life-threatening 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 1 month to < 12 years: 0.25 mg per nebulisation, to be repeated every 20 to 30 minutes if necessary
• Child 12 years and over and adult: 0.5 mg per nebulisation, to be repeated every 20 to 30 minutes if necessary

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 elderly patients and patients with closed-angle glaucoma, benign prostatic hyperplasia, urinary retention.
• Avoid or monitor combination with drugs known to have anticholinergic effects: tricyclic antidepressants (amitriptyline, clomipramine), H-1 antihistamines (chlorphenamine, promethazine), antiparkinsonians (biperiden), antispasmodics (atropine, hyoscine butylbromide), neuroleptics (chlorpromazine), 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