Apoven

Generic Name: ipratropium
Product Name: Apoven

Indication: What Apoven is used for

Ipratropium is a medicine which can be used to prevent or to treat the narrowing of the airways associated with asthma.

Ipratropium can also be used to relieve any reversible airways blockage associated with problems such as repeated infections affecting the airways.

Your doctor may have prescribed ipratropium for another reason. Ask your doctor if you have any questions about why ipratropium has been prescribed for you.

This medicine is available only with a doctor’s prescription.

There is no evidence that ipratropium is addictive.

Action: How Apoven works

Ipratropium works by opening up the narrowed airways to assist breathing.

Apoven contains ipratropium as the active ingredient. Apoven also contains sodium chloride BP and water for injections.

Apoven does not contain preservatives, gluten, lactose, sucrose, tartrazine or any other azo dyes.

Dose advice: How to use Apoven

Before you use Apoven

When you must not use it

Do not use ipratropium if:

• You have an allergy to atropine, ipratropium, other asthma medicines or any of the ingredients listed here. Some of the symptoms of an allergic reaction may include skin rash, itching, difficulty breathing, wheezing, asthma attack, swelling of the lips, face, tongue or throat, low blood pressure or collapse;
• The packaging is torn or shows signs of tampering;
• The expiry date on the pack has passed. If you use this medicine after the expiry date has passed, it may not work as well or it may make you feel sick.

If you are not sure whether you should start using ipratropium, talk to your doctor.

Before you start to use it

You must tell your doctor:

• If you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes;
• If you have or have ever had any other health problems/medical conditions, including:
  • Glaucoma, high pressure in the eye;
  • Difficulty in passing urine;
  • Constipation, inability to open bowels;
  • Cystic fibrosis;
• If you are pregnant or intend to become pregnant. Your doctor will discuss the risks and benefits of using ipratropium during pregnancy;
• If you are breastfeeding or plan to breastfeed. Your doctor will discuss the risks and benefits of using ipratropium when breastfeeding.

If you have not told your doctor about any of the above, tell them before you begin using ipratropium.

Taking other medicines

Tell your doctor if you are taking/using any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop.

How to use Apoven

How much to use

Apoven is to be used under the direction of a doctor. Your doctor will recommend a suitable dose for you.

How to use it

Apoven is to be delivered from an efficient device, called a nebuliser, which produces a fine mist to breathe in.

Opening instructions for the single dose units

Twist a single unit downwards to remove from the strip. Flick the single dose unit so that the solution flows to the bottom. Hold the base of the single dose unit and break the seal with a quick twisting action. Snap off the top. Squeeze the contents of the single dose unit into the nebuliser bowl.

The ipratropium solution must not enter the eyes, be injected or swallowed.

How long to use it

Your doctor will decide how long you will need to use Apoven.

If you use too much (overdose)

Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26), or go to casualty at your nearest hospital, if you think that you or anyone else may have used too much or swallowed any of the Apoven single dose units. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention. Keep telephone numbers of these places/services handy.

If you use too much Apoven you may have:

• Dry mouth;
• Fast heart rate;
• Difficulty in passing urine;
• Constipation, inability to open bowels;
• Eyesight difficulty;
• Red, painful eyes with brow-ache or headache and possibly followed by nausea or vomiting.

While you are using Apoven

Things you must do

If the symptoms of your asthma do not improve within a few days, or if they become worse, tell your doctor.

If you become pregnant while you are using ipratropium tell your doctor.

If you are about to start taking/using any new medicine, tell your doctor and pharmacist that you are using ipratropium.

Tell all the doctors, dentists and pharmacists who are treating you that you are using ipratropium.

Things you must not do

Do not give ipratropium to anyone else, even if they have the same condition as you.

Do not use ipratropium to treat any other complaints unless your doctor tells you to.

Things to be careful of

Be careful driving or operating machinery until you know how ipratropium affects you. Ipratropium generally does not cause any problems with your ability to drive a car or operate machinery.

After using Apoven

Storage

Apoven will generally be stored in the pharmacy or in a hospital ward.

If stored at home, keep your Apoven single dose units in their original packs until it is time to use them. If you take the Apoven single dose units out of the pack it may not keep well.

Keep it in a cool dry place, protected from light where the temperature stays below 25°C.

Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Schedule of Apoven

Apoven is a Schedule 4 (prescription only) medicine.

Side effects of Apoven

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using ipratropium. Like other medicines, ipratropium can cause some side effects. If they occur, most are likely to be minor and temporary. However, some may be serious and need medical attention.

Ask your doctor or pharmacist to answer any questions you may have.

While using it

Tell your doctor if you notice any of the following and they worry you:

• Mouth/ throat irritation;
• Cough;
• Headache;
• Nausea;
• Indigestion;
• Constipation.

These are all mild side effects of ipratropium.

Tell your doctor immediately or go to casualty at your nearest hospital if you notice any of the following:

• Difficulty in passing urine;
• Red, painful eyes with brow-ache or headache and possibly followed by nausea or vomiting;
• Eye pain;
• Dilated pupils of the eyes;
• Shortness of breath or difficulty breathing;
• Swelling with fluid in the tissues;
• Skin rash, may be itchy;
• Changes in the way your heart beats e.g. if you notice it beating faster or the beats are irregular.

These are all serious side effects of ipratropium. You may need urgent medical attention.

Other side effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

For further information talk to your doctor.

References

1. Apoven Consumer Medicine Information (CMI). Baulkham Hills, NSW: Douglas Pharmaceuticals Australia Ltd. September 2002. [PDF]