Atrovent, inhalation solution 0.025%, 20ml

Composition

Active ingredient:

ipratropium bromide – 0.25 mg.

Auxiliary substances:

benzalkonium chloride,

disodium edetate dihydrate,

sodium chloride,

hydrochloric acid 1 n,

purified water.

Pharmacological action

A bronchodilator drug. Blocks m-holinoreceptors of smooth muscles of the tracheobronchial tree (mainly at the level of large and medium bronchi) and suppresses reflex bronchoconstriction. Having a structural similarity to the acetylcholine molecule, it is its competitive antagonist.

Prevents bronchospasm that occurs as a result of inhaling cigarette smoke, cold air, the action of various drugs, and also eliminates bronchospasm associated with the influence of the vagus nerve.

When inhaled, it has practically no resorptive effect, with only 10% reaching the small bronchi and alveoli, and the remaining part settles in the pharynx or oral cavity and is swallowed.

In patients with bronchospasm associated with COPD (chronic bronchitis and emphysema of the lungs), the drug improves the function of external respiration: FEV 1 and the average forced expiratory volume rate of FEF25-75% increase by 15% or more within 15 minutes after drug use. The maximum effect is achieved in 1-2 hours and lasts in most patients up to 6 hours after use of ipratropium bromide.

In 40% of patients with bronchial asthma, there is a significant improvement in the indicators of external respiration (FEV 1 increased by 15% or more).

Pharmacokinetics

Suction

Absorption of the drug is low. Practically not absorbed from the gastrointestinal tract.

Distribution

It is poorly soluble in fats and weakly penetrates biological membranes. It doesn’t accumulate.

Metabolism

The absorbed (small) part is metabolized to form 8 inactive or weakly active metabolites that have an anticholinergic effect.

Deduction

It is excreted unchanged through the intestines. Metabolites are excreted in the urine.

Indications

Bronchial asthma (moderate to mild), especially with concomitant diseases of the cardiovascular system.

Chronic obstructive pulmonary disease (chronic obstructive bronchitis, emphysema).

Contraindications

• Hypersensitivity to the components.
• Pregnancy (I trimester).
• Children under 6 years of age.

Side effects

The most common adverse effects are headache, nausea, and dry mouth.

Due to the low systemic absorption of the drug, side effects associated with systemic anticholinergic action, such as tachycardia, palpitations, accommodation disorders, decreased secretion of sweat glands, impaired gastrointestinal motility, and urinary retention, are rare and reversible. However, patients with obstructive urinary tract disease have an increased risk of developing urinary retention.

As with other inhalation therapy, including bronchodilators, cough is sometimes observed, less often-paradoxical bronchospasm.

In rare cases, allergic reactions may occur, including urticaria, angioedema, rash, oropharyngeal edema and anaphylaxis.

There are isolated reports of eye complications (pupil dilation, increased intraocular pressure, angle-closure glaucoma, eye pain) when ipratropium bromide aerosol or ipratropium bromide aerosol combined with beta-2 agonists enters the eyes.

Patients should be able to use metered-dose aerosol correctly.

Interaction

Potentiates the bronchodilatory effect of beta-adrenomimetics and xanthine derivatives. Enhances the cholinolytic effect of other drugs.

How to take, course of use and dosage

By inhalation.

Solution for inhalation: adults and children over 12 years-0.5 mg (40 drops) 3-4 times a day through a nebulizer; children 6-12 years-0.25 mg (20 drops) 3-4 times a day through a nebulizer; children under 6 years-0.1-0.25 mg (8-20 drops) 3-4 times a day (under the supervision of a doctor).

The recommended dose immediately before use is diluted with saline solution to a volume of 3-4 ml.

The dose depends on the method of inhalation and the quality of the spray.

If necessary, repeated inhalations are performed at intervals of at least 2 hours.

Overdose

Symptoms: no specific symptoms of overdose were detected.

Possible minor manifestations of systemic anticholinergic action, such as dry mouth, impaired accommodation, increased heart rate.

Treatment: symptomatic.

Special instructions

It is not recommended for emergency relief of an attack of suffocation (the bronchodilator effect develops later than that of beta-adrenostimulants).

Patients with cystic fibrosis are more likely to develop slow gastrointestinal motility.

Patients should be able to correctly use Atrovent N metered-dose aerosol for inhalation.

When using the freon-free form of metered-dose aerosol for the first time, patients may notice that the taste of the new drug is slightly different from the previous dosage form of the drug containing freon. When switching from one form of the drug to another, patients should be warned about possible changes in the taste properties of the drug. It should be reported that these drugs are interchangeable, and that the taste properties are not related to the safety and effectiveness of the new drug.

0.025% solution for inhalation contains preservative benzalkonium chloride and stabilizer ethylenediaminetetraacetic acid. There are reports that these substances, when administered in high doses, can cause bronchospasm in some patients.

It is not recommended to exceed the established daily dose, both for short-term and long-term use of the drug.

The drug should be used with caution in patients with angle-closure glaucoma and urinary disorders due to benign prostatic hyperplasia.

If the drug accidentally gets into the eyes of a patient with angle-closure glaucoma, intraocular pressure may increase.

Pain in the eye or discomfort, blurred vision, the appearance of a halo and colored spots in front of the eyes in combination with conjunctival and corneal hyperemia can be symptoms of an attack of narrow-angle glaucoma. If any of these symptoms appear, you should prescribe drops that cause constriction of the pupil and immediately consult an ophthalmologist.

If the patient’s condition worsens or there is no significant improvement, a doctor’s consultation is necessary to determine a plan for further treatment. In case of sudden and rapid increase in shortness of breath (difficulty breathing), you should immediately consult a doctor.

Children should be given metered-dose aerosol Atrovent H only after a doctor’s recommendation and under adult supervision.

Form of production

Solution for inhalation

Storage conditions

In a dark place, at a temperature not exceeding 25 °C. Keep out of reach of children.

Active ingredient

Ipratropium bromide

Conditions of release from pharmacies

By prescription

Dosage form

solution for inhalation

Description

For adults as prescribed by a doctor, for children as prescribed by a doctor

Indications

Bronchial Asthma, Chronic Obstructive Pulmonary Disease, Bronchitis, Pneumonia, Bronchospasm