Select a medication above to begin.
Atrovent HFA
ipratropium bromide inhaled
Adult Dosing .
Dosage forms: MDI: 17 mcg per actuation
COPD, maintenance tx
- [2 puffs inhaled qid]
- Max: 12 puffs/day
asthma exacerbation, mod-severe (off-label)
- [8 puffs inhaled q20min prn up to 3h]
- Info: for adjunct tx; no proven additional benefit once hospitalized
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: MDI: 17 mcg per actuation
asthma exacerbation, mod-severe (off-label)
- [<6 yo]
- Dose: 2 puffs inhaled q20min x3 doses; Info: for adjunct tx; no proven additional benefit once hospitalized
- [6-12 yo]
- Dose: 4-8 puffs inhaled q20min prn up to 3h; Info: for adjunct tx; no proven additional benefit once hospitalized
- [13 yo and older]
- Dose: 8 puffs inhaled q20min prn up to 3h; Info: for adjunct tx; no proven additional benefit once hospitalized
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to atropine
- caution: glaucoma, angle-closure
- caution: prostatic hypertrophy
- caution: bladder neck obstruction
Drug Interactions .
Overview
ipratropium inhaled
anticholinergic inhaled
- anticholinergic effects
- tachycardia
Contraindicated
- potassium chloride
- potassium citrate
Avoid/Use Alternative
- aclidinium inhaled
- amantadine
- atropine ophthalmic
- botulinum toxin
- chlophedianol
- clozapine
- cyclopentolate ophthalmic
- darifenacin
- dexbrompheniramine
- dexchlorpheniramine
- doxepin topical
- dronabinol
- fesoterodine
- flavoxate
- fluphenazine
- glucagon
- glycopyrrolate
- glycopyrronium topical
- ipratropium nasal
- molindone
- orphenadrine
- pramlintide
- pyrilamine
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- revefenacin inhaled
- scopolamine
- sofpironium topical
- thiothixene
- tolterodine
- trihexyphenidyl
- tropicamide ophthalmic
- trospium
Monitor/Modify Tx
- cannabis
- clomipramine
- phenylephrine ophthalmic
Caution Advised
- alfentanil
- alosetron
- amitriptyline
- amoxapine
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- asenapine
- atropine
- barium
- belladonna alkaloids
- benztropine
- bethanechol
- brexpiprazole
- brompheniramine
- buprenorphine
- butorphanol
- carbinoxamine
- cariprazine
- cevimeline
- chlorpheniramine
- chlorpromazine
- cisapride
- clemastine
- clidinium
- codeine
- cyclobenzaprine
- cyproheptadine
- desipramine
- dicyclomine
- difenoxin
- dihydrocodeine
- dimenhydrinate
- diphenhydramine
- diphenoxylate
- disopyramide
- domperidone
- donepezil
- doxepin
- doxylamine
- erenumab
- erythromycin
- fentanyl
- galantamine
- gepotidacin
- glycopyrrolate inhaled
- haloperidol
- homatropine
- hydrocodone
- hydromorphone
- hydroxyzine
- hyoscyamine
- iloperidone
- imipramine
- isocarboxazid
- levorphanol
- loperamide
- loxapine
- lumateperone
- lurasidone
- meclizine
- meperidine
- methadone
- methscopolamine
- metoclopramide
- mexiletine
- mirabegron
- mirtazapine
- morphine
- nalbuphine
- neostigmine
- nortriptyline
- olanzapine
- oliceridine
- oxybutynin
- oxycodone
- oxymorphone
- paliperidone
- pentazocine
- perphenazine
- phenelzine
- pheniramine
- pilocarpine
- pilocarpine ophthalmic
- pimozide
- potassium acid phosphate
- potassium gluconate
- potassium phosphate
- prochlorperazine
- promethazine
- protriptyline
- quetiapine
- remifentanil
- risperidone
- solifenacin
- sufentanil
- tapentadol
- thioridazine
- topiramate
- tramadol
- tranylcypromine
- trifluoperazine
- trimipramine
- triprolidine
- umeclidinium inhaled
- vibegron
- ziprasidone
- zonisamide
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- bronchospasm, paradoxical
- glaucoma, angle-closure
Common Reactions
- bronchitis
- dyspnea
- nausea
- xerostomia
- influenza-like sx
- sinusitis
- dizziness
- dyspepsia
- UTI
- back pain
- urinary hesitancy
- urinary retention
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
Atrovent confused with: Advair Diskus; albuterol; Alupent; Azmacort; Combivent; Flovent; Natru-Vent; Serevent
ipratropium confused with: tiotropium
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; risk of fetal harm not expected based on limited human data
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on minimal systemic absorption in breastfeeding pts
Pharmacology .
Metabolism: hydrolysis; CYP450: none; Info: minimal systemic absorption
Excretion: feces primarily; Half-life: 2h
Subclass: Muscarinic Antagonists, Inhaled Short-Acting (SAMAs)
Mechanism of Action
antagonizes acetylcholine receptors, producing bronchodilation
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.