Generic Name: ipratropium bromide
Product Name: Ipravent
Indication: What Ipravent is used for
Ipravent is used to relieve the symptoms of lung disease such as asthma or chronic obstructive bronchitis. It may be used in other conditions where breathing is difficult, such as after surgery or during assisted ventilation.
Ipravent may be used for the management of other conditions that are not mentioned above. Your doctor will be able to tell you about the specific condition for which you have been prescribed Ipravent. Ask your doctor if you have any questions about why it has been prescribed for you.
This medicine is available only with a doctor’s prescription.
Action: How Ipravent works
Ipravent belongs to a group of medicines known as anticholinergic bronchodilators. Anticholinergic bronchodilators work by relaxing the bronchial tubes (air passages) that carry air in and out of your lungs. This makes breathing less difficult.
Ipratropium bromide allows bronchodilation by inhibiting cholinergic bronchomotor tone and consequently, vagal reflexes mediating bronchoconstriction are blocked.
It contains the active ingredient ipratropium bromide monohydrate and the inactive ingredients sodium chloride and water for injections.
Ipravent does not contain preservatives.
Dose advice: How to use Ipravent
Before you use it
When you must not use it
Do not use Ipravent if you have an allergy to ipratropium bromide or any of the ingredients listed here. If you are not sure if this applies to you, check with your doctor.
Ipravent should not be given to a newborn baby.
Do not use it after the expiry date (EXP) printed on the pack. If you use it after the expiry date has passed, it may not work as well. Do not use it if the packaging is torn or shows signs of tampering.
Before you start to use it
Tell your doctor if
- You have any allergies to:
- Any other medicine, especially atropine or other anticholinergic drugs;
- Any other substances, such as foods, preservatives or dyes;
- You are pregnant or intend to become pregnant;
- You are breast-feeding or planning to breast-feed;
- You have, or have had, the following medical conditions:
- An eye condition called ‘glaucoma’ (condition in which the pressure within the eye is raised);
- Difficulty passing urine;
- Chronic constipation;
- Cystic fibrosis.
If you have not told your doctor about any of the above, tell them before you use Ipravent.
Interactions with other medicines
Tell your doctor if you are using any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may have an effect on Ipravent. These include:
- Other anticholinergic medications e.g. Atrovent, Buscopan, Spiriva;
- Beta adrenergics e.g. Betaloc, Visken, Nyogel;
- Xanthine e.g. Nuelin;
- Beta mimetics e.g. Bricanyl.
These medicines may be affected by Ipravent or may affect how well it works. You may need to use different amounts of your medicines, or take different medicines. Your doctor will advise you.
Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking Ipravent.
How to use it
Ipravent is intended for inhalation with suitable nebulising equipment and must not be swallowed.
How much to use
Your doctor will decide what dose and how long you will receive Ipravent. However, the usual dose of Ipravent is 250 to 500 mcg diluted to 2 to 3 mL with normal saline and nebulised until the entire volume of solution is inhaled, every six hours.
How to use it
Ipravent is used only in a power-operated nebuliser, which can be obtained from your local pharmacy.
You will also need a mask or mouthpiece, which is used with the nebuliser so that your prescribed dose can be inhaled. The time taken to deliver a given volume of solution will depend on the equipment used, but most nebulisers will deliver 1 mL of solution over 3 minutes and 2 mL over 8-10 minutes. Make sure you understand how to use the nebuliser.
Do not allow Ipravent to come in contact with the eyes.
It is important to ensure that the nebuliser mask is correctly fitted over the mouth and nose to prevent the mist from contacting the eyes.
If you forget to use it
If you forget your dose, inhale it as soon as you remember. If you remember when it is almost time for your next dose, inhale only your usual dose at that time.
Do not try to make up for missed doses by taking more than one dose at a time. This may increase the chance of getting an unwanted side effect.
If you have trouble remembering when to take your medicine, ask your pharmacist for hints.
If you inhale too much (overdose)
Accidental overdose by inhalation is unlikely. However, if you do inhale too much ipratropium bromide, you may experience some of the effects listed under “Side effects” below.
Immediately telephone your doctor, or the Poisons Information Centre (telephone 13 11 26) or go to Accident and Emergency at your nearest hospital, if you think you or anyone else may have inhaled too much Ipravent solution. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention. Keep these telephone numbers handy.
While you are using it
Things you must do
Contact your doctor immediately if you experience eye pain or discomfort, or any disturbances with your sight (blurred vision, visual halos or coloured images) during or after using Ipravent. This is because there have been rare reports of narrow-angle glaucoma with the use of Ipravent products.
Tell your doctor if you need to use Ipravent more frequently than prescribed or if you need to inhale more Ipravent than prescribed to relieve your symptoms. In these situations, your dose or treatment may need to be changed.
Tell your doctor or pharmacist if you begin taking any other medicine while you are using Ipravent.
Things to be careful of
Be careful driving or operating machinery until you know how Ipravent affects you. When used as recommended, and when there are no side effects, Ipravent is not known to have any effect on the ability to drive or operate machinery.
After using it
Ipravent should be kept in the original container until it is time to use it.
Ipravent is sensitive to light and the ampoules should, therefore, be stored in the carton or protected from light.
Keep the medicine in a cool dry place where the temperature stays below 25°C, and protect from light. Use once only and discard any unused portion.
Do not store it or any other medicine in the bathroom, near a sink, or on a window-sill. Do not leave it in the car. Heat and damp 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.
If your doctor tells you to stop using Ipravent or the solution has passed its expiry date, ask your pharmacist what to do with any that is left over.
Schedule of Ipravent
Ipravent is a Schedule 4 – prescription only medicine.
Side effects of Ipravent
All medicines may have some unwanted side effects. Sometimes they are serious, but most of the time they are not. Your doctor has weighed the risks of using this medicine against the benefits they expect it will have for you.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
Tell your doctor, nurse or pharmacist as soon as possible if you do not feel well while you are using Ipravent. It helps most people with breathing problems, but it may have unwanted side effects in a few people.
Tell your doctor if you notice any of the following and they worry you:
- Throat irritation;
- Nausea and/or vomiting;
- Change in bowel movements e.g. constipation, diarrhoea;
- Dry mouth.
These are mild side effects of the medicine, and usually short-lived.
Tell your doctor immediately if you notice any of the following:
- Changes to your heart beat;
- Difficulty passing urine;
- Problems with your eyes e.g. red eyes, eye pain or discomfort, sight disturbances (blurred vision, visual halos or coloured images).
If any of the following happens, stop taking Ipravent and tell your doctor immediately or go to Accident and Emergency at your nearest hospital:
- Worsening of breathing problems (induced by the inhalation process);
- An allergic reaction to Ipravent, the signs of which may include skin rash, itching, swelling of face, lips and tongue, swelling of the throat area or difficulty breathing.
These may be serious side effects of Ipravent. You may need urgent medical attention. Serious side effects are uncommon.
Tell your doctor if you notice anything else that is making you feel unwell. Other side effects not listed above may occur in some people.
For further information talk to your doctor.