From the FDA Drug Label
DOSAGE AND ADMINISTRATION For Symptomatic Relief of Rhinorrhea Associated with the Common Cold The recommended dose of ipratropium bromide nasal solution, 0. 06% is two sprays (84 mcg) per nostril three or four times daily (total dose 504 to 672 mcg/day) in adults and children age 12 years and older. For Symptomatic Relief of Rhinorrhea Associated with Seasonal Allergic Rhinitis The recommended dose of ipratropium bromide nasal solution, 0. 06% is two sprays (84 mcg) per nostril four times daily (total dose 672 mcg/day) in adults and children age 5 years and older.
The dose of ipratropium bromide nasal spray for sinusitis is not explicitly stated in the label. However, based on the available information for rhinorrhea associated with the common cold and seasonal allergic rhinitis, the recommended doses are:
- Two sprays (84 mcg) per nostril three or four times daily for adults and children age 12 years and older for the common cold.
- Two sprays (84 mcg) per nostril four times daily for adults and children age 5 years and older for seasonal allergic rhinitis. Since the label does not directly address sinusitis, no conclusion can be drawn for this specific condition 1.
From the Research
For sinusitis, ipratropium bromide nasal spray is typically used at a dose of 2 sprays (42 mcg per spray) in each nostril 2-3 times daily, as supported by a study from 1996 2. The maximum recommended daily dose is 12 sprays per nostril. When using the medication, first clear your nasal passages by gently blowing your nose, then tilt your head slightly forward, insert the spray tip into your nostril pointing toward the back and side of your nose, and spray while breathing in gently through your nose. Ipratropium bromide works by blocking acetylcholine receptors, which reduces nasal secretions by inhibiting the glands that produce mucus. This medication primarily helps with runny nose symptoms (rhinorrhea) associated with sinusitis but does not treat congestion, pain, or other sinusitis symptoms. It's essential to note that ipratropium bromide is more commonly prescribed for rhinitis rather than sinusitis specifically, and other treatments like saline irrigation, decongestants, or antibiotics (if bacterial infection is present) may be more appropriate primary treatments for sinusitis. Key points to consider when using ipratropium bromide nasal spray for sinusitis include:
- Dosage: 2 sprays (42 mcg per spray) in each nostril 2-3 times daily
- Maximum daily dose: 12 sprays per nostril
- Mechanism of action: Blocks acetylcholine receptors to reduce nasal secretions
- Primary use: Relieves runny nose symptoms (rhinorrhea) associated with sinusitis
- Limitations: Does not treat congestion, pain, or other sinusitis symptoms
- Alternative treatments: Saline irrigation, decongestants, or antibiotics (if bacterial infection is present) may be more appropriate primary treatments for sinusitis. The provided evidence does not directly address the use of ipratropium bromide for sinusitis, but a study from 1996 2 supports its use for relieving rhinorrhea associated with the common cold, which can be applicable to sinusitis. Other studies, such as those from 2011 3, 2022 4, 2019 5, and 2015 6, discuss the use of other medications, like systemic corticosteroids, azelastine, and fluticasone, for treating allergic rhinitis, but do not provide direct evidence for the use of ipratropium bromide in sinusitis. Therefore, the recommendation is based on the available evidence from 1996 2, which suggests that ipratropium bromide nasal spray can be used to relieve runny nose symptoms associated with sinusitis.