ipratropium intranasal (Rx)

Brand and Other Names:Atrovent Nasal Spray
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray

  • 0.03%
  • 0.06%

Perennial Allergic/Nonallergic Rhinitis

Nasal spray (0.03%): 2 sprays (21 mcg/spray) per nostril q8-12hr; not to exceed 168-252 mcg/day

Seasonal allergic rhinitis: 2 sprays (0.06%) per nostril q6hr

Symptomatic relief of rhinorrhea (Common Cold)

Nasal spray (0.06%): 2 sprays (0.42 mcg/spray) per nostril q6hr; no to exceed 672 mcg/day

Seasonal Allergic Rhinitis

Nasal spray (0.06%): 2 sprays (0.42 mcg/spray) per nostril q6hr; no to exceed 672 mcg/day

Dosing Considerations

In treatment of allergic rhinitis, do not use for >3 weeks

Dosage Forms & Strengths

nasal spray

  • 0.03%
  • 0.06%

Symptomatic Relief of Rhinorrhea (Colds)

<5 years: Safety & efficacy not established

5-12 years: 2 sprays (0.06%) in each nostril q8hr

>12 years: 2 sprays (0.06%) in each nostril q6-8hr

Allergic/nonallergic rhinitis

<6 years: Safety & efficacy not established

>6 years: 2 sprays (0.03%) per nostril q8-12hr

Seasonal Allergic Rhinitis

< 5 years: Safety & efficacy not established

> 5 years: 2 sprays (0.06%) per nostril q6hr

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Adverse Effects

1-10%

Headache (9.8%)

URI (9.8%)

Epistaxis (9%)

Pharyngitis (8.1%)

Nasal dryness/irritation/congestion (5.1%)

Taste perversion (4%)

Nausea (2.2%)

Xerostomia (1-4%)

Diarrhea (2%)

Nausea (2%)

Nasal congestion (1%)

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Warnings

Contraindications

Hypersensitivity

Cautions

Use caution in patients with narrow angle glaucoma, hepatic impairment, renal impairment, and BPH or bladder neck obstruction

Contact with eye can cause burning

May cause dizziness, accomodation disorder, mydriasis and blurred vision; caution patients about performing tasks that require mental alertness, including operating a heavy machinery

Immediate hypersensitivity reactions reported; discontinue use immediately if it occurs

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Pregnancy & Lactation

Pregnancy Category: B

Lactation: Unknown whether distributed in breast milk

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Anticholinergic bronchodilator

Inhibits serous and seromucous gland secretions

Inhibits vagally mediated reflexes by antagonizing effects of acetylcholine

Pharmacokinetics

Half-life: 1.6 hr

Excretion: Urine

Absorption: < 20%

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
Atrovent HFA inhalation
-
17 mcg/actuation aerosol
ipratropium bromide nasal
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42 mcg (0.06 %) aerosol
ipratropium bromide nasal
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21 mcg (0.03 %) aerosol
ipratropium bromide nasal
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42 mcg (0.06 %) aerosol
ipratropium bromide nasal
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42 mcg (0.06 %) aerosol
ipratropium bromide nasal
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21 mcg (0.03 %) aerosol
ipratropium bromide nasal
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21 mcg (0.03 %) aerosol
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution
ipratropium bromide inhalation
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0.02 % solution

Copyright © 2010 First DataBank, Inc.

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Patient Handout

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Patient Education
ipratropium bromide nasal

IPRATROPIUM 0.06% SPRAY - NASAL

(IP-ra-TROE-pee-um)

COMMON BRAND NAME(S): Atrovent

USES: Ipratropium is used to treat a runny nose caused by the common cold or seasonal allergies. It works by reducing the amount of fluid/mucus released from inside your nose.This medication does not relieve symptoms of stuffy nose or sneezing.

HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using ipratropium and each time you get a refill. Learn how to use this spray properly. If you have any questions, ask your doctor or pharmacist.Follow the instructions for priming the spray if you are using it for the first time or if you have not used it for more than 24 hours. When priming the spray, make sure to spray away from the face so that you do not get the medication into your eyes.Gently blow your nose before using this drug. Spray this medication into the nose as directed by your doctor, usually 3 or 4 times a day in each nostril.The dosage is based on your medical condition, age, and response to treatment.Avoid getting this medication into your eyes. It may cause eye pain/irritation, temporary blurred vision, and other vision changes. If this medication does get into your eyes, flush your eyes with water for a few minutes. Tell your doctor right away if any symptoms occur.Use this medication regularly in order to get the most benefit from it. This medication works best if used at evenly spaced intervals. To help you remember, use it at the same times each day. Do not increase your dose or use this medication more often or for a longer time than directed without first consulting your doctor.If the spray gets clogged, hold the nasal tip under warm running water for about a minute. Dry the nasal tip and prime the spray again. Do not use a sharp object to clear the spray.You may start to feel better on the first day after using this medication. Tell your doctor if your condition does not improve or if it worsens.

SIDE EFFECTS: See also How to Use section.Dry/bloody nose, headache, dry mouth/throat, throat irritation, bad taste in mouth, dizziness, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: difficult/painful urination, fast/pounding heartbeat.Get medical help right away if you have any very serious side effects, including: eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night, blurred vision).A very serious allergic reaction to this product is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using ipratropium, tell your doctor or pharmacist if you are allergic to it or to tiotropium; or to atropine or other belladonna-type drugs; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of glaucoma (angle-closure type), difficulty urinating (for example, due to enlarged prostate).Although unlikely, this drug may make you dizzy or blur your vision or cause other vision changes. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially problems urinating or constipation.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature with the cap on. Do not refrigerate or freeze. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

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Adding plans allows you to:

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.