Ipratropium belongs to the class of medications called bronchodilators. It is used to treat spasms in the lungs associated with COPD (Chronic Obstructive Pulmonary Disease) (COPD), including chronic Bronchitis and emphysema. It works by opening the airways to make breathing easier.

Ipratropium inhalation aerosol should not be used to treat acute breathing problems where rapid results are required. Inhalers that contain "reliever" medications with fast action (e.g., salbutamol, terbutaline) should be used for acute treatment of breathing problems.

Atrovent HFA (Ipratropium-inh) may be available under multiple brand names and/or in several different forms. Any specific brand name of Atrovent HFA (Ipratropium-inh) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Atrovent HFA (Ipratropium-inh) may not be used for all of the conditions discussed here.

Your doctor may have suggested Atrovent HFA (Ipratropium-inh) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given Atrovent HFA (Ipratropium-inh), speak to your doctor. Do not stop using Atrovent HFA (Ipratropium-inh) without consulting your doctor.

Do not give Atrovent HFA (Ipratropium-inh) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use Atrovent HFA (Ipratropium-inh) if their doctor has not prescribed it.

The recommended dosage of ipratropium inhalation aerosol is 2 metered doses 3 or 4 times daily. The most beneficial dose must be determined individually. Some people may need up to 4 metered doses at a time to obtain the best benefit when first starting treatment. The maximum daily dose should not be more than 12 metered doses, and doses must be at least 4 hours apart.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use Atrovent HFA (Ipratropium-inh) exactly as prescribed by your doctor. If you miss a dose of scheduled medication, skip the missed dose and carry on with your regular schedule. Do not double a dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Your doctor or pharmacist should instruct you on proper use of the medication. Also refer to the information pamphlet provided with the medication. Always shake the unit well before using. If you have been instructed to use 2 inhalations per dose, wait one minute between inhalations.

Store the aerosol canister at room temperature and do not place in hot water or near radiators, stoves, or other sources of heat. Protect it from light and moisture and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Atrovent HFA (Ipratropium-inh). If you are concerned about side effects, discuss the risks and benefits of Atrovent HFA (Ipratropium-inh) with your doctor.

The following side effects have been reported by at least 1% of people taking Atrovent HFA (Ipratropium-inh). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Constipation
• cough
• Diarrhea
• dizziness
• Dry Mouth
• headache
• hoarseness
• irritation of mouth or throat
• nausea
• unpleasant taste
• voice change
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision or other changes in vision
• burning eyes
• constipation (continuing) or lower abdominal pain or bloating
• difficulty urinating
• eye pain
• fast or pounding heartbeat

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain
• increased wheezing, tightness in chest, or difficulty breathing
• rapidly worsening shortness of breath
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• skin rash or Hives
• swelling of face, lips, or eyelids

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Atrovent HFA (Ipratropium-inh).

Each valve Depression actuation delivers 20 µg of ipratropium bromide. Nonmedicinal ingredients: 1,1,1,2-Tetrafluoroethane (HFA 134a)), citric acid, ethanol, nitrogen, and water. This product does not contain chlorofluorocarbons (CFCs) or soya lecithin.

Do not use Atrovent HFA (Ipratropium-inh) if you:

• are allergic to ipratropium or any ingredients of the medication
• are allergic to atropine-like medications in general

There may be an interaction between ipratropium bromide aerosol and any of the following:

• aclidinium
• amantadine
• antihistamines (e.g,. cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• atropine
• azelastine
• belladonna
• Benztropine
• beta-adrenergic medications (e.g., formoterol, salbutamol, terbutaline)
• botulinum toxin
• cannabis
• Darifenacin
• Disopyramide
• Domperidone
• Donepezil
• Flavoxate
• Galantamine
• Glucagon
• glycopyrrolate
• ketotifen
• Metoclopramide
• Mirabegron
• Moclobemide
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, orphenadrine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• Nitroglycerin
• Oxybutynin
• Phenelzine
• potassium chloride
• quinidine
• Rivastigmine
• scopolamine
• Solifenacin
• theophyllines (e.g., Aminophylline, oxytriphylline, Theophylline)
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• tiotropium
• Tolterodine
• Topiramate
• Tranylcypromine
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• umeclidinium

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Atrovent HFA (Ipratropium-inh). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Atrovent HFA (Ipratropium-inh).

Acute breathing problems: Atrovent HFA (Ipratropium-inh) is not for use as a "reliever" medication. If you get a sudden attack of breathlessness, be sure to use your "reliever" medication for rapid relief of your symptoms. It is very important that you have your "reliever" medication available with you at all times. If you persistently use more of your "reliever" medication, contact your doctor.

Eye problems: Take care to ensure that ipratropium bromide aerosol does not reach the eye. There have been reports of eye complications (e.g., tearing, increased eye pressure, Glaucoma, and eye pain) when Atrovent HFA (Ipratropium-inh) has been released into the eyes. Eye problems have occurred when the aerosol was used with the standard mouthpiece or with a spacing device. If you experience eye pain, blurred vision, or vision changes, talk to your doctor as soon as possible.

Glaucoma: Ipratropium can make symptoms of glaucoma worse. If you have glaucoma, discuss with your doctor how Atrovent HFA (Ipratropium-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Atrovent HFA (Ipratropium-inh), and whether any special monitoring is needed. You will probably need to have regular eye examinations while you are using Atrovent HFA (Ipratropium-inh).

Prostate or urinary problems: Ipratropium can make symptoms of prostate enlargement or urinary problems worse. If you have a urinary tract problem, discuss with your doctor how Atrovent HFA (Ipratropium-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Atrovent HFA (Ipratropium-inh), and whether any special monitoring is needed.

If you experience difficulty passing urine or pain when urinating, contact your doctor.

Pregnancy: Atrovent HFA (Ipratropium-inh) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using Atrovent HFA (Ipratropium-inh), contact your doctor immediately.

Breast-feeding: It is not known if ipratropium bromide passes into breast milk. If you are a breast-feeding mother and are using Atrovent HFA (Ipratropium-inh), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Atrovent HFA (Ipratropium-inh) have not been established for children less than 18 years of age.