What is the dosing for Ipratropium (Inhalation Bronchodilator) nasal 0.03% solution?

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From the FDA Drug Label

The recommended dose of ipratropium bromide solution, 0.03% is two sprays (21 mcg) per nostril two or three times daily (total dose 168 to 252 mcg/day) for the symptomatic relief of rhinorrhea associated with allergic and nonallergic perennial rhinitis in adults and children age 6 years and older. The recommended dosing for Ipratropium Nasal 0.03% is:

  • 2 sprays per nostril
  • 2-3 times daily
  • Total dose: 168-252 mcg/day 1

From the Research

Ipratropium nasal spray 0.03% should be dosed as 2 sprays in each nostril 2-3 times daily for adults and children 6 years and older, with each spray delivering 21 mcg of ipratropium bromide, as this dosing regimen has been shown to be effective in reducing rhinorrhea symptoms in patients with allergic and nonallergic perennial rhinitis 2.

Key Considerations

  • The dosing frequency and duration of treatment may vary depending on the specific condition being treated, such as rhinorrhea associated with the common cold or perennial rhinitis.
  • Patients should be advised to clear their nasal passages before administering the spray, and to tilt their head slightly forward to ensure proper delivery of the medication.
  • Common side effects of ipratropium nasal spray include nasal dryness, headache, and epistaxis, and patients should be monitored for these adverse effects.

Mechanism of Action

  • Ipratropium works as an anticholinergic agent by blocking muscarinic receptors in the nasal mucosa, reducing watery nasal secretions by inhibiting glandular secretions 3.
  • This mechanism of action makes ipratropium nasal spray an effective treatment option for patients with rhinorrhea symptoms, particularly those with nonallergic rhinitis.

Clinical Evidence

  • Studies have shown that ipratropium nasal spray is effective in reducing rhinorrhea symptoms in patients with allergic and nonallergic perennial rhinitis, with some studies suggesting that it may be used in combination with other medications, such as nasal steroids, for optimal symptom relief 4, 5.
  • The most recent and highest quality study on this topic, published in 2019, supports the use of ipratropium nasal spray as a treatment option for patients with rhinorrhea symptoms, particularly those with nonallergic rhinitis 4.

References

Research

Ipratropium bromide nasal spray 0.03% and beclomethasone nasal spray alone and in combination for the treatment of rhinorrhea in perennial rhinitis.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 1999

Research

Management of rhinitis: allergic and non-allergic.

Allergy, asthma & immunology research, 2011

Research

Allergic and nonallergic rhinitis.

Allergy and asthma proceedings, 2019

Research

Rhinitis.

Primary care, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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