Ipratropium Bromide

Key facts

• Ipratropium bromide (found in inhalers and nebules such as Atrovent, often combined with salbutamol) is an anticholinergic bronchodilator. It blocks a nerve signal that tightens airway muscle, helping the airways relax and stay open.
• It is used regularly, several times a day, for ongoing control of COPD and, as an add-on, asthma. It is not a fast-acting rescue inhaler for a sudden attack.
• Keep the spray or nebulized mist away from your eyes. Contact with the eye can trigger acute angle-closure glaucoma: sudden eye pain, blurred vision, and halos around lights that need emergency treatment.
• Seek urgent care for sudden eye pain or vision changes, or for breathing that keeps getting worse.

What ipratropium bromide treats

Ipratropium bromide is used for the regular, ongoing management of chronic obstructive pulmonary disease (COPD), widening the airways to ease breathlessness and reduce flare-ups. It is also used as an add-on bronchodilator in asthma alongside inhaled corticosteroids. A nasal spray form treats a runny nose caused by allergies or the common cold.

How ipratropium bromide works

Airway muscle can tighten under signals carried by the nerve chemical acetylcholine, narrowing the airway. Ipratropium bromide blocks the receptors acetylcholine acts on, so the muscle relaxes and the airway widens. Because it works on a different pathway to beta-agonists like salbutamol, the two are often used together for a stronger effect than either gives alone.

Before you take it

• Do not treat ipratropium bromide as a substitute for a fast-acting reliever inhaler during a sudden asthma attack.
• Tell your prescriber if you have glaucoma, an enlarged prostate with difficulty passing urine, or bladder neck obstruction, since anticholinergic effects can worsen these conditions.
• Tell your prescriber about allergy to atropine or related drugs, and about soya or peanut allergy if your formulation contains soya lecithin.
• Use a spacer with a metered-dose inhaler for more reliable delivery.

Side effects

Common effects: dry mouth, throat irritation, cough, headache, and a metallic or unusual taste.

Seek urgent medical care for:

• Sudden eye pain, blurred vision, halos around lights, or a red eye, which can mean the spray has triggered acute angle-closure glaucoma.
• Difficulty passing urine or a swollen, painful bladder.
• Severe or worsening breathlessness, chest tightness, or a fast or irregular heartbeat.
• Facial swelling, hives, or difficulty breathing, which can signal an allergic reaction.

Safety essentials

• Ipratropium bromide is a maintenance bronchodilator, not a rescue inhaler. Always carry a separate fast-acting reliever for sudden symptoms.
• Keep the spray well away from your eyes. If it does get into an eye, rinse with water and seek urgent medical review: acute angle-closure glaucoma is a medical emergency that can threaten your sight.
• Use caution with other anticholinergic medicines, such as some antihistamines and drugs for overactive bladder, which can add to dry mouth and confusion.
• If you use a nebulizer mask rather than a mouthpiece, fit it closely so the mist cannot reach your eyes.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.