Atrovent® Inhaler (Ipratropium Bromide)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules
Atrovent Inhaler delivers 20 mcg of ipratropium bromide per actuation for the maintenance treatment of chronic obstructive pulmonary disease (COPD) and relief of acute bronchospasm. As an inhaled anticholinergic, it blocks muscarinic receptors in airway smooth muscle, producing bronchodilation within 15 minutes and lasting up to 6 hours, improving lung function and exercise tolerance.
Ipratropium Bromide – 20 mcg per metered dose
Ipratropium MDI
Anticholinergic Bronchodilator Inhaler
Atrovent HFA (US formulation)
Oxivent (generic in some markets)
Ipratropium is a muscarinic receptor antagonist that competitively inhibits acetylcholine at M₁–M₅ receptors in bronchial smooth muscle. By blocking M₃‑mediated bronchoconstriction, it reduces vagal tone, leading to sustained bronchodilation and decreased mucus secretion without systemic anticholinergic effects.
Maintenance Treatment of reversible airflow obstruction in COPD, including chronic bronchitis and emphysema

Adjunctive Therapy in asthma for patients not controlled on β₂‑agonists and inhaled corticosteroids

Relief of Acute Bronchospasm when rapid β₂‑agonists are insufficient
Population Dose Frequency Notes
Adults (COPD/Asthma) 2 inhalations (40 mcg total) per dose 4 times daily (every 6 h) Administer via metered‑dose inhaler with spacer if needed
Pediatric (Asthma) ≥12 years: same as adult; <12 years: refer specialist Safety not established in children <5 years
Elderly Same as adult; no adjustment needed May have increased sensitivity to anticholinergics
Shake inhaler well before each use.

Exhale fully, seal lips around mouthpiece.

Actuate once while inhaling slowly and deeply.

Hold breath for 5–10 seconds, then exhale.

Wait 30 seconds before a second actuation if prescribed.
Formulation: Metered‑dose inhaler (pMDI) containing ipratropium bromide solution

Strength: 20 mcg per actuation

Device: Canister plus actuator; replace after 200 actuations
Legal Status: Prescription Only Medicine
Pregnancy: Category B1 – Use only if potential benefit justifies potential risk; minimal systemic absorption.

Breastfeeding: Excreted in breast milk in low concentrations; monitor infant for dryness or feeding issues.

Renal/Hepatic Impairment: No dosage adjustment required due to low systemic bioavailability.

Elderly: Caution in those with prostatic hypertrophy or glaucoma; monitor for urinary retention and blurred vision.

Dry mouth
Bitter taste
Throat irritation
Cough
Less Common / Serious:
Urinary retention (in susceptible individuals)

Narrow‑angle glaucoma precipitated by ocular exposure

Palpitations, tachycardia

Headache, dizziness
Ocular Exposure: Avoid spraying near eyes; may cause acute glaucoma.

Urinary Retention: Use cautiously in patients with bladder outlet obstruction.

Paradoxical Bronchospasm: Discontinue immediately if occurs and provide alternative therapy.

Not for Acute Exacerbations Alone: Always have a short‑acting β₂‑agonist rescue inhaler available.
Therapeutic Class: Bronchodilator, Anticholinergic

Pharmacologic Class: Muscarinic Receptor Antagonist (SAMA)

Legal Category: Prescription Only Medicine
Other Anticholinergics (e.g., oxybutynin, tolterodine): Additive anticholinergic effects; monitor for systemic side effects.

β₂‑Agonists: Can be safely combined; provides complementary bronchodilation.

Theophylline: No direct interaction, but optimize dosing separately.

Cholinesterase Inhibitors (e.g., donepezil): May antagonize central effects; unlikely to impact inhaled ipratropium significantly.
The UPLIFT study demonstrated that maintenance ipratropium improved FEV₁ by 100–150 mL and reduced COPD exacerbations over 4 years.

Meta‑analyses confirm that adding ipratropium to β₂‑agonists provides superior bronchodilation versus monotherapy.

FAQs – Atrovent® Inhaler
Q1. How quickly does Atrovent work?
A: Onset within 15 minutes; peak effect at 1–2 hours; duration ~6 hours.

Q2. Can I use it for exercise‑induced bronchospasm?
A: It may be used prophylactically 15–30 minutes before exercise, but β₂‑agonists are preferred.

Q3. How do I know when the inhaler is empty?
A: Keep a dose counter if available or track actuations; discard after 200 doses.

Q4. Can Atrovent replace my rescue inhaler?
A: No. Continue to carry a short‑acting β₂‑agonist for acute relief.

Q5. Is spacers recommended?
A: Yes, especially in elderly or children to improve drug delivery and reduce oropharyngeal deposition.

Q6. What if I accidentally spray into my eyes?
A: Rinse eyes immediately with water; seek medical attention for blurred vision or pain.

Q7. How should I store the inhaler?
A: At room temperature (15–30 °C), away from direct heat and sunlight; do not freeze.
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