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  • Atrovent
    / Boehringer Ingelheim


    Active Ingredient

    Status in Israel
    RX

    Presentation and Status in Health Basket

    Presentation Basket Yarpa Pharmasoft

    Inhaler

    200 doses

    full basket chart 59982 1906

    Related information


    Dosage

    The dosage should be adapted to the individual requirements of the patient; patients should also be kept under medical supervision during treatment. It is advisable not to greatly exceed the recommended daily dose during both acute and maintenance treatment. If therapy does not produce a significant improvement or if the patient’s condition worsens, medical advice must be sought in order to determine a new regimen of therapy. In the case of acute or rapidly worsening dyspnea, a doctor should be consulted immediately. The recommended dosage is as follows:
    Adults: Usually 1 or 2 puffs four times daily, although some patients may need up to 4 puffs at a time to obtain maximum benefit during early treatment. However, the total number of inhalations should not exceed 12 in 24 hours.
    Children: 6-12 years: Usually 1 or 2 puffs three times daily. In order to ensure that the inhaler is used correctly, administration should be supervised by an adult.         


    Indications

    For the relief of symptoms of reversible bronchospasm associated with asthma, chronic bronchitis and emphysema.


    Contra-Indications

    Hypersensitivity to the drug, to atropine and its derivatives. Hypersensitivity to any other ingredient of the preparation.


    Special Precautions

    When using the new formulation of Ipratropium bromide CFC free for the first time, some patients may notice that the taste is slightly different from that of the CFC (chlorofluorocarbon) containing formulation. Patients should be made aware of this when changing from one formulation to the other. They should also be told that the formulations have been shown to be interchangeable for all practical purposes and that the difference in taste has no consequences in terms of the safety or the efficacy of the new formulation. Ipratropium bromide is not indicated for the initial treatment of acute episodes of bronchospasm where rapid response is required.If dyspnoea suddenly worsens during inhalation of the product (paradoxical bronchospasm), treatment should be stopped immediately and the treatment plan reviewed.
    Note: Immediate hypersensitivity reactions may occur after administration of Ipratropium bromide inhaler, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, oropharyngeal edema, and anaphylaxis. Ipratropium bromide inhaler should be used with caution in patients predisposed to narrow-angle glaucoma, or with pre-exisiting outflow tract obstructions (e.g, prostatic hyperplasia or bladder-neck obstruction). Patients should be advised that temporary blurring of vision may result if the inhaler is sprayed into the eyes. Patients should be reminded that Ipratropium bromide inhaler is not intended for occasional use, but rather, in order to be maximally effective, must be used consistently as prescribed throughout the course of therapy.
    Ocular complications: There have been isolated reports of ocular complications (i.e. mydriasis, increased intraocular pressure, angle-closure glaucoma, eye pain) when aerosolized ipratropium bromide either alone or in combination with an adrenergic beta2 -agonist, has escaped into the eyes. Thus patients must be instructed in the correct administration of Ipratropium bromide inhaler. Eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema may be signs of acute angle-closure glaucoma. Should any combination of these symptoms develop, treatment with miotic drops should be initiated and specialist advice sought immediately. Patients with cystic fibrosis may be more prone to gastrointestinal motility disturbances. The patient should be instructed to seek medical advice should a reduced response become apparent.
    See prescribing information for full details.


    Side Effects

    Headache, dizziness, Cough, irritation in the throat, Dry mouth, disturbed gastrointestinal motility, nausea.
    See prescribing information for full details.


    Drug interactions

    Additive effect has been reported when ipratropium bromide is used in patients treated with beta2-adrenergic stimulants and xanthine preparations. The therapeutic and adverse effects of Ipratropium bromide may become more pronounced if other anticholinergic medications, such as those containing pirenzepine, are given concomitantly.


    Pregnancy and Lactation

    Pregnancy: The safety of ipratropium during human pregnancy has not been established. The benefits of using ipratropium bromide during a confirmed or suspected pregnancy must be weighed against possible hazards to the unborn child.
    Lactation: It is not known whether ipratropium is secreted into breast milk. Although lipid-insoluble quaternary cations pass into breast milk, it is unlikely that ipratropium bromide would reach the infant to an important extent, when administered by inhalation. However, because many drugs are secreted into breast milk, caution should be exercised when ipratropium bromide is administered to nursing mothers.
    See prescribing information for full details.


    Overdose

    No symptoms specific to overdose have been encountered to date. In view of the wide therapeutic range and topical route of administration of ipratropium bromide inhalation, however, no serious anticholinergic symptoms are to be expected. Mild systemic anticholinergic effects such as dry mouth, ocular accommodation disturbances and increase in heart rate are possible.


    Important notes

    Pharmaceutical Precautions: Store below 30°C and protect from heat and direct sunlight. The vials should not be punctured or incinerated even when apparently empty.
    Warning: Pressure container. Do not puncture, break, or incinerate even when empty.

     


    Manufacturer
    Boehringer Ingelheim Pharma KG, Germany
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