Properties
What is it?
Atrovent Manufacturer: Austria Active Ingredient: Ipratropium Bromide Clinical-Pharmacological Group: Bronchodilator Dosage Form: Inhalation Solution 0.025%: 20 ml vial with dropper. 1 ml Ipratropium Bromide Excipients: 250 mcg Benzalkonium Chloride, Disodium Edetate, Sodium Chloride. Pharmacological Properties: Atrovent is a quaternary ammonium compound with anticholinergic (parasympatholytic) properties. Atrovent inhibits acetylcholine stimulation of vagal nerve endings caused by various factors. Bronchodilation with Atrovent is based on the drug's local rather than systemic anticholinergic effect. A controlled 90-day clinical study in patients with bronchospasm caused by chronic obstructive pulmonary diseases (chronic bronchitis, pulmonary emphysema) showed improvement in external respiration function indicators 15 minutes after Atrovent administration, with maximum effect observed 1-2 hours later, lasting for 6 hours. The study found that Atrovent does not negatively affect mucus secretion, mucociliary clearance, and gas exchange. Atrovent's bronchodilating effect in the treatment of acute bronchospasm caused by bronchial asthma has been confirmed by clinical studies in adults and children up to 6 years of age. In most cases, Atrovent was prescribed in combination with inhaled beta-agonists. There is limited data on the effectiveness of Atrovent in treating bronchospasm caused by viral bronchiolitis and bronchopulmonary dysplasia in newborns and infants. Indications: Atrovent inhalation solution is used as a bronchodilator for maintenance effect in chronic obstructive pulmonary disease, including chronic bronchitis and pulmonary emphysema. It can be combined with other inhaled beta-agonists for the treatment of acute bronchospasm caused by chronic obstructive pulmonary diseases, including chronic bronchitis and bronchial asthma. Dosage and Administration: (20 drops = 1 ml, 1 drop = 0.0125 mg anhydrous ipratropium bromide). Dosage regimen: Individual. Patients are under medical supervision during treatment. Maintenance therapy: Adults (including elderly) and children over 12 years of age: 2.0 ml (40 drops = 0.5 mg) 3-4 times daily. Children aged 6 to 12 years: 1.0 ml (20 drops = 0.25 mg) 3-4 times daily. Children under 6 years of age: 0.4-1.0 ml (8-20 drops = 0.1-0.25 mg) 3-4 times daily. Acute bronchospasm: Adults (including elderly) and children over 12 years of age: 2.0 ml (40 drops = 0.5 mg); repeated use may be necessary until the patient's condition stabilizes. The interval between inhalations is determined by the doctor. Atrovent can be used simultaneously with inhaled beta-agonists. Children aged 6 to 12 years: 1.0 ml (20 drops = 0.25 mg); repeated use may be necessary until the patient's condition stabilizes. The interval between inhalations is determined by the doctor. Atrovent can be used simultaneously with beta-agonists. Children under 6 years of age: 0.4-1.00 ml (8-20 drops = 0.1-0.25 mg); repeated use may be necessary until the patient's condition stabilizes. The interval between inhalations is determined by the doctor. Atrovent can be used simultaneously with inhaled beta-agonists. The recommended dose is diluted with physiological saline to a final volume of 3-4 ml. This is placed in a nebulizer and inhaled until the dose is finished. The drug should be diluted immediately before each inhalation. Any remaining dose should not be used later. The dose of the drug depends on the method of inhalation and the quality of the nebulizer. The duration of inhalation depends on the volume of the diluted solution. Daily doses exceeding 2 mg in adults and children over 12 years of age, or 1 mg in children under 12 years of age, should be administered under medical supervision. Increasing the recommended dose is not allowed, neither during the treatment of acute bronchitis nor during maintenance therapy. If inhalation is ineffective or the patient's condition worsens, consult a doctor. If shortness of breath develops and progresses rapidly, inform your doctor. Atrovent inhalation solution can be used with various commercially available nebulizers. When using a centralized oxygen system, the recommended flow rate is 6-8 L/min. Atrovent can be used simultaneously with the following secretolytic agents: Mucosolvan inhalation solution, Bisolvon inhalation solution, and Berotec inhalation solution. Atrovent should not be administered simultaneously with Cromoglicate Disodium inhalation solution, as precipitation may occur. Side Effects: Headache, nausea, dry mouth in most cases. Due to Atrovent's low systemic absorption, side effects related to systemic anticholinergic action, such as tachycardia, arrhythmia, accommodation disorders, gastrointestinal motility disorders, and urinary retention, are transient. In patients with urinary tract obstruction, the risk of urinary retention increases. As with other inhalation therapies, including bronchodilators, cough is sometimes observed. Bronchospastic reactions are rare. There are reports of allergic reactions, including rash, angioneurotic edema of the tongue, face, lips, urticaria, laryngeal spasm, and anaphylactic reactions. Ophthalmology - there are isolated reports of side effects affecting the eyes, such as mydriasis, increased intraocular pressure, narrow-angle glaucoma, eye pain, and aerosol contact with the eye. Eye pain or discomfort, blurred vision, floaters, accompanied by conjunctival and corneal hyperemia are symptoms of narrow-angle glaucoma, for which the patient should consult an ophthalmologist. Patients should use the inhaler correctly. Inhalation solution should not come into contact with the eyes. Nebulizers with a mouthpiece for the mouth are used for inhalation. If a nebulizer mask is used, it should be of appropriate size. Patients prone to glaucoma should be warned to avoid aerosol contact with the eyes. Contraindications: Hypersensitivity to the components of the drug. Pregnancy and Lactation: The safety of Atrovent during pregnancy has not been studied. It may be prescribed if the expected benefit to the mother outweighs the potential risk to the fetus. There is no data on the transfer of Atrovent into breast milk; however, lipid-insoluble quaternary amines reach breast milk, and it is unlikely that Atrovent will significantly affect the infant when used by inhalation. Since many drugs are excreted in breast milk, Atrovent should be used with caution during lactation. Special Instructions: Atrovent 0.025% inhalation solution contains the antibacterial preservative benzalkonium chloride and the stabilizer disodium edetate. Clinical studies have shown that these components can cause narrowing of the bronchial lumen in some patients. The drug should be used with caution in patients prone to narrow-angle glaucoma, as well as in patients with benign prostatic hyperplasia and urethral obstruction. Patients with cystic fibrosis may experience gastrointestinal motility disorders. Rarely, immediate hypersensitivity reactions, including urticaria, rash, bronchospasm, laryngeal edema, and anaphylaxis, may occur with Atrovent use. Overdose: No specific symptoms of overdose have been identified. Given the wide therapeutic range of the drug, local use of a metered-dose aerosol excludes the possibility of serious anticholinergic symptoms. Minor manifestations of systemic anticholinergic effects, such as dry mouth, accommodation disorders, and heart rhythm disturbances, may occur. Drug Interactions: Beta-adrenergic agents and xanthine derivatives enhance the bronchodilating effect of the drug. Simultaneous use of Atrovent with inhaled beta-adrenomimetic agents in patients with narrow-angle glaucoma increases the risk of acute glaucoma attack. Storage Conditions and Shelf Life: Store at a temperature not exceeding 30°C, protected from light and out of reach of children. Do not freeze. Shelf life: 5 years.