Description
Ipratropium (I-pra-TROE-pee-um)
is a bronchodilator (medicine that opens
up narrowed breathing passages). It is taken by inhalation to help control
the symptoms of lung diseases, such as asthma, chronic bronchitis, and emphysema.
Ipratropium helps decrease coughing, wheezing, shortness of breath, and troubled
breathing by increasing the flow of air into the lungs.
When ipratropium inhalation is used to treat acute, severe attacks of asthma,
bronchitis, or emphysema, it is used only in combination with other bronchodilators.
Ipratropium is available only with your doctor's prescription, in the following
dosage forms:
Inhalation
-
Inhalation aerosol (U.S. and Canada)
-
Inhalation solution (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,
the risks of using the medicine must be
weighed against the good it will do. This is a decision you and your doctor
will make. For ipratropium, the following should be considered:
Allergies--Tell your doctor if you have ever had any unusual or
allergic reaction
to ipratropium, atropine, belladonna, hyoscyamine, or scopolamine, or to other
inhalation aerosol medicines. Also tell your health care professional if you
are allergic to soya lecithin or related food substances such as soybeans
and peanuts.
Pregnancy--Ipratropium has not been studied in pregnant women.
However, it has not
been shown to cause birth defects or other problems in animal studies.
Breast-feeding--It is not known whether ipratropium passes
into the breast milk. Although
most medicines pass into breast milk in small amounts, many of them may be
used safely while breast-feeding. Mothers who are using this medicine and
who wish to breast-feed should discuss this with their doctor.
Children--This medicine has been tested in children and,
in effective doses, has
not been shown to cause different side effects or problems in children than
it does in adults.
Older adults--Ipratropium inhalation has been tested in patients
65 years of age or older.
This medicine is not expected to cause different side effects or problems
in older people than it does in younger adults.
Other medicines--Although certain medicines should not be used
together at all, in other
cases two different medicines may be used together even if an interaction
might occur. In these cases, your doctor may want to change the dose, or other
precautions may be necessary. When you are taking ipratropium, it is especially
important that your health care professional know if you are taking any other
prescription or nonprescription (over-the-counter [OTC]) medicine.
Other medical problems--The presence of other medical
problems may affect the use of ipratropium.
Make sure you tell your doctor if you have any other medical problem, especially:
-
Difficult urination--Ipratropium may make the
condition worse
-
Glaucoma--Ipratropium may make the
condition worse if it gets into the eyes
Proper Use of This Medicine
Ipratropium is used to help control the symptoms of
lung diseases, such as chronic bronchitis, emphysema, and asthma. However,
for treatment of bronchospasm or asthma attacks that have already started,
ipratropium is used only in combination with other bronchodilators
.
It is very important that you use ipratropium only as directed. Do not
use more of it and do not use it more often than your doctor ordered. To do
so may increase the chance of side effects.
Keep the spray or solution away from the eyes
because this medicine may cause irritation or blurred vision. Closing your
eyes while you are inhaling ipratropium may keep the medicine from getting
into your eyes. Rinsing your eyes with cool water may help if any medicine
does get into your eyes.
Ipratropium usually comes with patient directions. Read them carefully
before using this medicine.
If you are taking this medicine every day to help control your symptoms,
it must be taken at regularly spaced times as ordered by your doctor.
Dosing--The dose of ipratropium will be different for
different patients.
Follow your doctor's orders or the
directions on the label
.
The following information includes only the average doses of ipratropium.
If your dose is different, do not change it
unless your
doctor tells you to do so.
-
For symptoms of chronic
obstructive pulmonary disease, such as chronic bronchitis or emphysema:
-
For
inhalation aerosol
dosage
form:
-
Adults and children 12 years of age and
older--2 to 4 inhalations (puffs) three or four times a day, at regularly
spaced times. Some patients may need up to 6 to 8 puffs three times a day.
-
For
inhalation solution
dosage form:
-
Adults and children 12 years of age and older--250
to 500 mcg used in a nebulizer three or four times a day, every six to eight
hours.
-
For symptoms of asthma:
-
For
inhalation aerosol
dosage form:
-
Adults
and children 12 years of age and older--1 to 4 inhalations (puffs) four
times a day, at regularly spaced times, as needed.
-
Children up to 12 years of age--1 or 2 inhalations (puffs) three
or four times a day, at regularly spaced times, as needed.
-
For
inhalation solution
dosage form:
-
Adults and children 12 years of age and older--500
mcg used in a nebulizer three or four times a day, every six to eight hours,
as needed.
-
Children 5 to 12 years of age--125 to 250 mcg used in a nebulizer
three or four times a day, every four to six hours as needed.
-
Children up to 5 years of age--Use and dose must be determined
by your doctor.
Missed dose--If you use ipratropium inhalation regularly and
you miss a dose of this medicine, use it as soon as possible. Then use any
remaining doses for that day at regularly spaced times.
Storage--To store this medicine:
-
Keep out of the reach of children.
-
Store away from heat.
-
Store the solution form of this medicine away from direct light.
Store the aerosol form of this medicine away from direct sunlight.
-
Keep the medicine from freezing.
-
Store any opened bottles of the solution form of this medicine in
the refrigerator.
-
Do not puncture, break, or burn the aerosol container, even if it
is empty.
-
Do not keep outdated medicine or medicine no longer needed. Be sure
that any discarded medicine is out of the reach of children.
For patients using
ipratropium inhalation aerosol
:
-
If you do not understand the directions or you are
not sure how to use the inhaler, ask your health care professional to show
you how to use it. Also, ask your health care professional to check regularly
how you use the inhaler to make sure you are using it properly.
-
When you use the inhaler for the first time, or if you have not used
it for a while, the inhaler may not give the right amount of medicine with
the first puff. Therefore, before using the inhaler, test or prime it.
-
To test or prime the inhaler
:
-
Insert the canister firmly into the clean mouthpiece according to
the manufacturer's instructions. Check to make sure it is placed properly
into the mouthpiece.
-
Take the cap off the mouthpiece and shake the inhaler three or four
times.
-
Hold the inhaler away from you at arm's length and press the top
of the canister, spraying the medicine once into the air. The inhaler will
now be ready to give the right amount of medicine when you use it.
-
To use the inhaler
:
-
Using your thumb and one or two fingers, hold the inhaler upright,
with the mouthpiece end down and pointing toward you.
-
Take the cap off the mouthpiece. Check the mouthpiece to make sure
it is clear. Then, gently shake the inhaler three or four times.
-
Breathe out slowly to the end of a normal breath.
-
Use the inhalation method recommended by your doctor:
-
Open-mouth method--Place the mouthpiece about 1 or 2 inches
(2 fingerwidths) in front of your widely opened mouth. Make sure the inhaler
is aimed into your mouth so the spray does not hit the roof of your mouth
or your tongue.
-
Closed-mouth method--Place the mouthpiece in your mouth between
your teeth and over your tongue with your lips closed tightly around it. Make
sure your tongue or teeth are not blocking the opening.
-
Start to breathe in slowly and deeply through your mouth. At the
same time, press the top of the canister once to get one puff of medicine.
Continue to breathe in slowly for 5 to 10 seconds. Count the seconds while
breathing in. It is important to press the canister and breathe in slowly
at the same time so the medicine gets into your lungs. This step may be difficult
at first. If you are using the closed-mouth method and you see a fine mist
coming from your mouth or nose, the inhaler is not being used correctly.
-
Hold your breath as long as you can up to 10 seconds. This gives
the medicine time to settle into your airways and lungs.
-
Take the mouthpiece away from your mouth and breathe out slowly.
-
If your doctor has told you to inhale more than one puff of medicine
at each dose, gently shake the inhaler again, and take the second puff following
exactly the same steps you used for the first puff. Press the canister one
time for each puff of medicine.
-
When you are finished, wipe off the mouthpiece and replace the cap.
-
Your doctor may want you to use a spacer device or holding chamber
with the inhaler. A spacer helps get the medicine into the lungs and reduces
the amount of medicine that stays in your mouth and throat.
-
To use a spacer device with the inhaler
:
-
Attach the spacer to the inhaler according to the manufacturer's
directions. There are different types of spacers available, but the method
of breathing remains the same with most spacers.
-
Gently shake the inhaler and spacer three or four times.
-
Hold the mouthpiece of the spacer away from your mouth and breathe
out slowly to the end of a normal breath.
-
Place the mouthpiece into your mouth between your teeth and over
your tongue with your lips closed around it.
-
Press the top of the canister once to release one puff of medicine
into the spacer. Within 1 or 2 seconds, start to breathe in slowly and deeply
through your mouth for 5 to 10 seconds. Count the seconds while inhaling.
Do not breathe in through your nose.
-
Hold your breath as long as you can up to 10 seconds.
-
Take the mouthpiece away from your mouth and breathe out slowly.
-
If your doctor has told you to take more than one puff of medicine
at each dose, gently shake the inhaler and spacer again and take the next
puff, following exactly the same steps you used for the first puff. Do not
put more than one puff of medicine into the spacer at a time.
-
When you are finished, remove the spacer device from the inhaler
and replace the cap.
-
Clean the inhaler, mouthpiece, and spacer at least twice a week.
-
To clean the inhaler
:
-
Remove the canister from the inhaler and set aside.
-
Wash the mouthpiece, cap, and the spacer with warm, soapy water.
Then, rinse well with warm, running water.
-
Shake off the excess water and let the inhaler parts air dry completely
before putting the inhaler back together.
-
The ipratropium canister provides about 200 inhalations. You should
keep a record of the number of inhalations you use so you will know when the
canister is almost empty. This canister, unlike other aerosol canisters, cannot
be floated in water to test its fullness.
For patients using
ipratropium inhalation solution
:
-
Use this medicine only in a power-operated
nebulizer with an adequate flow rate and equipped with a face mask or mouthpiece.
Your doctor will tell you which nebulizer to use. Make sure you understand
exactly how to use it. If you have any questions about this, check with your
doctor.
-
To prepare the medicine for use in the nebulizer
:
-
If you are using the
single-dose vial of ipratropium
:
-
Break
away one vial by pulling it firmly from the strip.
-
Twist off the top to open the vial. Use the contents of the vial
as soon as possible after opening it.
-
Squeeze the contents of the vial into the cup of the nebulizer. If
your doctor has told you to use less than a full vial of solution, use a syringe
to withdraw the correct amount of solution from the vial and add it to the
nebulizer cup. Be sure to throw away the syringe after one use.
-
If you are using the multiple-dose bottle of
ipratropium
:
-
Use a syringe to withdraw
the correct amount of solution from the bottle and add it to the nebulizer
cup. Do not use the same syringe more than once.
-
If you have been told to dilute the ipratropium inhalation solution
in the nebulizer cup with the sodium chloride solution provided, use a new
syringe to add the sodium chloride solution to the cup as directed by your
health care professional.
-
If your doctor told you to use another inhalation solution with the
ipratropium inhalation solution, add that solution also to the nebulizer cup.
-
To use the nebulizer
:
-
Gently shake the nebulizer cup to mix the solutions well.
-
Connect the nebulizer tube to the air or oxygen pump and begin the
treatment. Adjust the mask, if you are using one, to prevent mist from getting
into your eyes.
-
Use the method of breathing your doctor told you to use to take the
treatment. One way is to breathe slowly and deeply through the mask or mouthpiece.
Another way is to breathe in and out normally with the mouthpiece in your
mouth, taking a deep breath every 1 or 2 minutes. Continue to breathe in the
medicine as instructed until no more mist is formed in the nebulizer cup
or until you hear a sputtering (spitting or popping) sound.
-
When you have finished, replace the caps on the solutions. Store
the bottles of solution in the refrigerator until the next treatment.
-
Clean the nebulizer according to the manufacturer's directions.
Side Effects of This Medicine
Along with its needed effects,
a medicine may cause some unwanted effects.
Although not all of these side effects may occur, if they do occur they may
require medical attention.
Check with your doctor as soon as possible
if any of the following side
effects occur:
Rare
Constipation (continuing) or lower abdominal pain or bloating; increased wheezing, tightness in chest, or difficulty
in breathing; severe eye pain; skin rash or hives; swelling of face, lips, or eyelids
Other side effects may occur that usually do not need medical attention.
These side effects may go away during treatment as your body adjusts to the
medicine. However, check with your doctor if any of the following side effects
continue or are bothersome:
Other side effects not
listed above may also occur in some patients. If you notice any other effects,
check with your doctor.
