Effectiveness of Tai Chi vs Cognitive Behavioural Therapy for Insomnia in Middle-Aged and Older Adults
November 27, 2025
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Brand Name :
Atrovent, Atrovent HFA
Synonyms :
ipratropium (Rx)
Class :
Anticholinergic Agent
Brand Name :
Atrovent, Atrovent HFA
Synonyms :
ipratropium (Rx)
Class :
Anticholinergic Agent
Dosage Forms and Strengths:
Aerosol Solution, Inhalation
17 mcg/actuation (12.9 g)
Solution, Inhalation
0.02% (2.5 ml)
Chronic Obstructive Pulmonary Disease (COPD)
Inhaler:
2
actuations
every 6 hrs
Do not exceed 12 actuations per day
Nebulizer: 2.5 mL every 6-8hours
(Off-label):
Inhaler: 8 actuation every 20min as needed for 3 hours
Nebulizer: 500 mcg every 20min three doses for 1 hour, then as needed
Dosage Forms and Strengths:
Aerosol Solution, Inhalation
17 mcg/actuation (12.9 g)
Solution, Inhalation
0.02% (2.5 ml)
(Off-label):
According to NIH asthma guidelines
Age: <5 years: 2 inhalations every 20min for 1 hour
Age: 5-12 years: 4-8 actuations every 20 min for about 3 hours as needed
Age: ≥12 years: 8 actuation every 20 min for about 3 hours as needed
Age: <5 years: 0.25 mg every 20min for 1 hour
Age: 5-12 years: 250-500 mcg every 20 min for 1 hour 3 doses, then as needed
Age: ≥12 years: 500 mcg every 20 min for 1 hour 3 doses, then as needed
ipratropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
ipratropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
ipratropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
ipratropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
ipratropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may have an increased anticholinergic effect when combined with anticholinergic agents
may have an increased anticholinergic effect when combined with anticholinergic agents
may have an increased anticholinergic effect when combined with anticholinergic agents
may have an increased anticholinergic effect when combined with anticholinergic agents
may have an increased anticholinergic effect when combined with anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may increase the CNS depressant effect of CNS Depressants
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
it increases the effect of anticholinergic agents
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may increase the CNS depressant effect of CNS Depressants
ipratropium: they may enhance the serum concentration of CYP2D6 Inhibitors
ipratropium: they may enhance the serum concentration of CYP2D6 Inhibitors
ipratropium: they may enhance the serum concentration of CYP2D6 Inhibitors
ipratropium: they may enhance the serum concentration of CYP2D6 Inhibitors
ipratropium: they may enhance the serum concentration of CYP2D6 Inhibitors
may increase the anti-cholinergic effect
may enhance the adverse/toxic effect of loxapine
hydrocodone/chlorpheniramine/pseudoephedrine
may increase the CNS depressant activity of CNS depressants
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect of anti-cholinergic agents
may increase the anticholinergic of anticholinergic agents
may increase the anticholinergic effect of Anticholinergic Agents
may increase the anticholinergic effect of Anticholinergic Agents
may have an increased risk of adverse effects when combined with ipratropium
When ipratropium is used together with profenamine, this leads to enhanced risk or seriousness of adverse events
may have an increased risk of adverse effects when combined with ipratropium
Ipratropium works by blocking muscarinic acetylcholine receptors in the bronchial smooth muscle. By preventing acetylcholine from binding, it suppresses parasympathetic stimulation that normally causes airway constriction and mucus secretion. This blockade results in relaxation of the bronchial muscles, leading to widened airways (bronchodilation) and reduced mucus production. At the cellular level, this action helps keep the airways open by preventing smooth muscle contraction triggered by acetylcholine.
Adverse drug reactions:
Frequency defined
>10%
Chronic obstructive pulmonary disease exacerbation
Bronchitis
1-10%
Dyspnea
Dizziness
Nausea
Urinary tract infection
Headache
Flulike symptoms
Back pain
Cough
Dyspepsia
Dry mouth
Frequency Not Defined
Hypotension
Palpitations
tachycardia
Dry throat
throat irritation
Constipation
Stomatitis
mouth edema
There is no blackbox warning
Contraindication
Hypersensitivity
Cautions
Pregnancy warnings:
Pregnancy Category: not assigned
Breastfeeding warnings:
The release of the drug into the human breastmilk is unknown
Pregnancy Categories:
Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.
Category B: No evidence shown of risk to the fetus found in animal reproduction studies, and there are not enough studies on pregnant women
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a result in humans must take care of potential risks in pregnant women
Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits
Category X: Drugs listed in this category outweigh risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Ipratropium is an anticholinergic (parasympatholytic) agent that works by blocking the action of acetylcholine on muscarinic receptors in the bronchial smooth muscle. By doing so, it interferes with vagally mediated reflexes that would normally lead to bronchoconstriction. This blockade prevents acetylcholine-induced increases in intracellular calcium levels, resulting in relaxation of the airway smooth muscle.
Pharmacokinetics
Absorption
Ipratropium is minimally absorbed through the respiratory mucosa due to its charged structure. After inhalation or oral administration, only about 1–2% of the dose reaches systemic circulation, with peak plasma levels occurring within 1–2 hours and an overall bioavailability of about 2%.
Distribution
The drug distributes extensively in body tissues, with an estimated volume of distribution of 4.6 L/kg, and shows very low plasma protein binding (0–9%).
Metabolism
Ipratropium undergoes limited metabolism, primarily in the gastrointestinal tract via cytochrome P450 enzymes and ester hydrolysis, forming inactive metabolites.
Elimination/Excretion
The absorbed portion is mainly excreted unchanged in the urine (up to 100%), while unabsorbed drug is eliminated in the feces. The terminal half-life is around 1.6 hours. Total clearance is about 2.3 L/min, with renal clearance contributing approximately 0.9 L/min.
Pharmacodynamics
Ipratropium is a short-acting bronchodilator that works by blocking parasympathetic activity in the airways, leading to airway smooth muscle relaxation and bronchodilation. Its effects begin within 1–2 hours and typically last about 4–6 hours. By widening the airways, it helps relieve symptoms such as wheezing, chest tightness, cough, and impaired gas exchange.
Clinical studies have shown that ipratropium can improve lung function when used early in severe asthma attacks (status asthmaticus) in both adults and children. However, ongoing use after an acute episode or routine preventive use has not demonstrated significant additional benefit.
Ipratropium is typically administered by inhalation using a metered-dose inhaler (MDI) or nebulizer. It is used on a regular schedule for maintenance treatment of bronchospasm and should not be used for immediate relief of acute symptoms. Patients should follow the prescribed dosing and technique to ensure proper delivery to the airways.
Patient Information Leaflet
Generic Name: ipratropium (Rx)
Pronunciation: IP-ra-TROE-pee-um
Why do we use ipratropium?
Ipratropium is an Anticholinergic Agent used to treat COPD, acute asthma exacerbation, and emphysema.
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