Anticholinergic bronchodilator

ACP: Severe bronchospasm in asthma and chronic obstructive pulmonary disease

Known hypersensitivity to ipratropium or any formulation components

Inhaled:

• Onset: 1-3 minutes
• Peak: 1.5-2 hours
• Duration: 4-6 hours

Adverse effects are similar to other anticholinergics and can include atrial arrhythmias, blurred vision.  Coughing is common.  Paradoxical bronchospasm can occur during the use of inhaled bronchodilators; this is not the same thing as an inadequate response to treatment. 

Very high doses of ipratropium (up to 1.2 mg) have been given to volunteers without the development of serious systemic side effects. 

• Ipratropium is intended to act synergistically with salbutamol as part of a management plan for bronchospasm. It is not indicated for episodes of acute bronchospasm as monotherapy.
• Avoid spraying ipratropium into the eyes of patients with narrow-angle glaucoma.