From the Guidelines
Ipratropium bromide commonly causes dry mouth and drying of respiratory secretions as side effects, as reported in the most recent study 1. This anticholinergic bronchodilator may also cause other side effects, including:
- Increased wheezing in some individuals, as noted in a study from 2007 1
- Tachycardia, palpitations, or paradoxical bronchospasm, although these are rare, as mentioned in a 2023 study 1
- If ipratropium spray accidentally contacts the eyes, it can cause temporary blurring of vision or eye pain, as described in the same 2023 study 1 These side effects occur because ipratropium works by blocking acetylcholine receptors, which affects not only the airways but also other body systems. Most side effects are mild and diminish with continued use. Patients should report severe side effects like chest pain, severe dizziness, eye pain, or difficulty urinating to their healthcare provider immediately. Proper inhaler technique can help minimize side effects, particularly those affecting the mouth and throat. It is essential to note that the most recent and highest quality study 1 provides the most reliable information on the side effects of ipratropium bromide. Other studies, such as those from 2007 1 and 2009 1, may provide additional information, but their findings should be considered in the context of the more recent evidence. Overall, the side effects of ipratropium bromide should be carefully considered and monitored to ensure the best possible outcomes for patients.
From the FDA Drug Label
ADVERSE REACTIONS Adverse reaction information concerning ipratropium bromide inhalation solution is derived from 12-week active-controlled clinical trials. Additional information is derived from foreign post-marketing experience and the published literature All adverse events, regardless of drug relationship, reported by three percent or more patients in the 12-week controlled clinical trials appear in the table below. Additional adverse reactions reported in less than three percent of the patients treated with ipratropium bromide include tachycardia, palpitations, eye pain, urinary retention, urinary tract infection and urticaria Cases of precipitation or worsening of narrow-angle glaucoma and acute eye pain have been reported. Lower respiratory adverse reactions (bronchitis, dyspnea and bronchospasm) were the most common events leading to discontinuation of ipratropium bromide therapy in the 12-week trials Headache, mouth dryness and aggravation of COPD symptoms are more common when the total daily dose of ipratropium bromide equals or exceeds 2,000 mcg. Allergic-type reactions such as skin rash, angioedema of tongue, lips and face, urticaria, laryngospasm and anaphylactic reaction have been reported. Many of the patients had a history of allergies to other drugs and/or foods WARNINGS ... Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm and oropharyngeal edema.
The side effects of Ipratropium bromide (Inhalation bronchodilator) include:
- Res Respiratory System Disorders (Lower):
- Bronchitis
- Dyspnea
- Bronchospasm
- Body as a Whole-General Disorders:
- Headache
- Pain
- Influenza-like symptoms
- Cardiovascular Disorders:
- Hypertension/ hypertension Aggravated
- Central & Peripheral Nervous System:
- Dizziness
- Insomnia
- Tremor
- Nervousness
- Gastrointestinal System Disorders:
- Mouth Dryness
- Nausea
- Constipation
- Musculo-skeletal System Disorders:
- Arthritis
- Respiratory System Disorders (Upper):
- Upper Respiratory Tract Infection
- Pharyngitis
- Rhinitis
- Sinusitis
- Allergic-type reactions:
From the Research
Side Effects of Ipratropium Bromide
The side effects of Ipratropium bromide, an inhalation bronchodilator, are as follows:
- Cough 3
- Nausea 3
- Palpitations 3
- Dry mouth 3, 4
- Nervousness 3
- Gastrointestinal distress 3
- Dizziness 3
- Acute urinary retention, particularly in older patients with benign prostatic hyperplasia 5
- Respiratory system disorders, which were the most common adverse events reported in studies 4
Comparison with Other Bronchodilators
Ipratropium bromide has been compared to other bronchodilators, such as tiotropium bromide, in terms of its safety profile and efficacy. While tiotropium bromide has a longer duration of action and allows for once-daily dosing, its safety profile is similar to that of ipratropium bromide, except for a higher incidence of xerostomia (dry mouth) 6.
Pharmacology and Toxicology
Ipratropium bromide acts primarily on large- and intermediate-size airways, and its peak pharmacologic effects occur prior to any detectable plasma drug concentrations. The drug does not exhibit the toxic effects of atropine, even at high doses, and is well-tolerated by most patients 7.