From the Guidelines
Ipratropium nasal spray is a viable treatment option for postnasal drip, particularly when caused by allergic or non-allergic rhinitis, as it has been shown to be effective in reducing rhinorrhea 1. The typical prescription strength is 0.03% or 0.06%, with dosing usually at 2 sprays in each nostril 2-3 times daily. Ipratropium works by blocking acetylcholine receptors in the nasal passages, which reduces mucus production from the nasal glands 1. This mechanism directly addresses excessive secretions that contribute to postnasal drip.
Some key points to consider when using ipratropium nasal spray for postnasal drip include:
- The concomitant use of ipratropium bromide nasal spray and antihistamines may provide increased efficacy over either drug alone without any increase in adverse events 1.
- The combined use of ipratropium bromide nasal spray 0.03% and an intranasal corticosteroid is more effective than administration of either drug alone in the treatment of rhinorrhea 1.
- Side effects are generally mild and may include nasal dryness, irritation, or nosebleeds 1.
- For best results, clear your nasal passages before use and avoid spraying directly onto the nasal septum.
- If postnasal drip persists after 3-4 weeks of consistent use, consult a healthcare provider as you may need additional or alternative treatments.
From the FDA Drug Label
Ipratropium bromide nasal solution, 0. 03% does not relieve nasal congestion, sneezing, or postnasal drip associated with allergic or nonallergic perennial rhinitis. Ipratropium bromide 0.03% does not relieve nasal congestion, sneezing, or postnasal drip associated with allergic or nonallergic perennial rhinitis. There was no effect of ipratropium bromide 0. 03% on degree of nasal congestion, sneezing, or postnasal drip.
Ipratropium nasal spray is not effective for postnasal drip. The drug label explicitly states that it does not relieve postnasal drip associated with allergic or nonallergic perennial rhinitis 2, 2, 2.
From the Research
Efficacy of Ipratropium Nasal Spray for Postnasal Drip
- Ipratropium bromide nasal spray has been studied for its effectiveness in reducing nasal hypersecretion and postnasal drip in patients with perennial allergic rhinitis and non-allergic rhinitis 3, 4, 5, 6.
- According to a study published in 1995, ipratropium bromide nasal spray 0.06% was effective in controlling rhinorrhea, congestion, postnasal drip, and sneezing in patients with perennial allergic rhinitis 3.
- However, another study published in 1992 found that while ipratropium bromide aqueous nasal spray decreased the duration and severity of rhinorrhea, it did not have a statistically significant effect on postnasal drip, congestion, or sneezing 4.
- A 1994 study on non-allergic rhinitis found that ipratropium bromide nasal spray reduced the mean severity and duration of rhinorrhea, and also improved quality of life, but had a modest reduction effect on nasal congestion, sneezing, and postnasal drip 5.
- A 2023 systematic review and meta-analysis found that ipratropium bromide nasal spray was effective in reducing rhinorrhea and improving quality of life in non-allergic rhinitis patients, but did not specifically address postnasal drip 6.
- A 2024 review on postnasal drip discussed the lack of understanding of its pathophysiology and the need for effective treatment strategies, but did not mention ipratropium bromide nasal spray as a treatment option 7.