From the Guidelines
Atrovent (Ipratropium bromide) is used to treat respiratory conditions like chronic obstructive pulmonary disease (COPD) and asthma by working as a bronchodilator to relax and open the airways, with a typical dose for adults being 2 inhalations (36 mcg) four times daily or 500 mcg administered 3-4 times daily via nebulizer solution, as supported by studies such as 1 and 1. The medication begins working within 15-30 minutes and its effects last for 4-6 hours, making it a suitable option for patients with certain heart conditions due to its lack of typical side effects like jitteriness or increased heart rate. According to 1, a recent meta-analysis indicated a reduced number of hospital admissions associated with treatment with ipratropium bromide, particularly in patients with severe exacerbations, highlighting its effectiveness in managing acute asthma exacerbations. Some key points to consider when using Atrovent include:
- Proper inhaler technique is essential for maximum effectiveness, including exhaling fully before inhaling the medication and holding your breath for 10 seconds afterward.
- Patients should use the medication regularly as prescribed rather than only when symptoms occur, and not exceed the recommended dosage.
- Common side effects include dry mouth, cough, headache, and throat irritation, as noted in studies such as 1, which also discussed the long-term effects of ipratropium bromide therapy in stable patients with chronic bronchitis. Overall, the use of Atrovent (Ipratropium bromide) is recommended for patients with COPD and asthma, given its effectiveness in improving breathing and reducing hospital admissions, as supported by the most recent and highest quality studies, such as 1.
From the FDA Drug Label
INDICATIONS AND USAGE Ipratropium bromide inhalation solution administered either alone or with other bronchodilators, especially beta adrenergics, is indicated as a bronchodilator for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease, including chronic bronchitis and emphysema. The use of Atrovent (Ipratropium bromide) is for the maintenance treatment of bronchospasm associated with:
- Chronic obstructive pulmonary disease (COPD)
- Chronic bronchitis
- Emphysema 2
From the Research
Use of Atrovent (Ipratropium bromide)
- Atrovent (Ipratropium bromide) is used to treat obstructive lung diseases, including chronic obstructive pulmonary disease (COPD) and asthma 3, 4, 5.
- It works by interrupting vagally mediated bronchoconstriction, inhibiting the cyclic guanosine 3',5'-monophosphate system at parasympathetic nerve endings 3.
- Ipratropium bromide is poorly absorbed after oral and inhaled administration, but diffuses rapidly into tissue after intravenous or intramuscular administration 3.
- The bronchodilatory effect of ipratropium bromide is comparable to, and may be superior to, that of beta-sympathomimetic agents in stable chronic obstructive pulmonary disease 3, 4.
Therapeutic Efficacy
- Ipratropium bromide has been shown to be effective in patients with COPD, with a duration of action of 4 to 6 hours 3, 4, 5.
- It may be useful as adjunctive therapy in asthma, particularly in patients who do not respond fully to beta 2-adrenoceptor agonist drugs 3, 5.
- Combination therapy with other bronchodilating drugs, such as beta 2-adrenoceptor agonists or theophylline, may be beneficial in patients with COPD or asthma 3, 4, 5.
Clinical Use
- Ipratropium bromide is commonly used in the treatment of acute exacerbations of COPD and asthma, with almost 90% of patients receiving it during hospital admission 6.
- However, its use in chronic asthma is limited, and it should not be used as single-drug therapy in acute asthmatic exacerbations 3, 5, 6.
- The usual dosage is two inhalations (36 micrograms) four times daily, with a maximum of 12 doses per day 3.