Ipratropium — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Ipratropium?
Ipratropium is a short-acting muscarinic antagonist (SAMA) bronchodilator inhaler used for COPD and acute asthma. This medication is funded by Pharmac for COPD.
What is Ipratropium Used For?
Ipratropium is used for COPD (as a maintenance bronchodilator), acute severe asthma (in combination with salbutamol in emergency settings), and acute exacerbations of COPD.
How Does Ipratropium Work?
Ipratropium blocks muscarinic receptors (M3) in bronchial smooth muscle, reducing acetylcholine-mediated bronchoconstriction and mucus secretion. Onset of action is 15–30 minutes with duration of 4–6 hours.
How to Take Ipratropium
For COPD maintenance: 2 puffs (40 mcg) via MDI three to four times daily. For acute severe asthma (hospital use): 500 mcg via nebuliser combined with salbutamol. Available as MDI (Atrovent® 20 mcg/puff) and nebuliser solution (0.025% solution). Avoid spraying near eyes (can precipitate acute glaucoma).
Common Side Effects of Ipratropium
- Dry mouth
- Constipation
- Urinary hesitancy
- Throat irritation
- Blurred vision (if inadvertently sprayed in eyes)
- Cough
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Acute angle-closure glaucoma (if accidentally sprayed in eyes)
- Acute urinary retention (in BPH)
- Paradoxical bronchospasm (rare)
- Severe allergic reactions
Drug Interactions
Ipratropium may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Other anticholinergic medicines (additive effects)
- Long-acting muscarinic antagonists (do not combine with tiotropium — additive anticholinergic toxicity)
New Zealand Prescribing Information
Ipratropium bromide (Atrovent® MDI 20 mcg/actuation; Atrovent UDVs 0.025% 2 mL nebuliser vials) is funded by Pharmac. For maintenance COPD treatment, long-acting bronchodilators (tiotropium, salmeterol) are generally preferred over ipratropium due to convenience and superior duration of action. Ipratropium remains valuable in acute exacerbations.
Frequently Asked Questions
Is ipratropium the same as tiotropium?
Both are anticholinergic bronchodilators, but ipratropium (Atrovent®) is short-acting (4–6 hours, used 3–4 times daily) while tiotropium (Spiriva®) is long-acting (24 hours, once daily). Tiotropium is generally preferred for maintenance COPD treatment.
Can ipratropium make glaucoma worse?
Yes — ipratropium spray accidentally entering the eyes can precipitate acute angle-closure glaucoma in susceptible individuals. Use a spacer device when possible, and if using a nebuliser mask, ensure it fits properly to prevent drug escaping towards the eyes.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: