Atrovent

• Inhalation medicine
• Used to treat COPD and asthma
• Reduces respiratory distress quickly
• Available in various forms

Atrovent is an inhalation medicine. The active substance, ipratropium bromide, relaxes the muscles in and around the airways, allowing the airways to open. This makes it easier to breathe. Atrovent belongs to a group of medicines called bronchodilators.

Atrovent can be used to open up the air passages in people with asthma and chronic respiratory disorders such as chronic obstructive pulmonary disease (COPD) or chronic bronchitis.

Atrovent is available in various forms:

• Aerosol, a metered dose spray.
• Inhalation powder in capsules, to be used with an inhaler.
• Nebuliser solution, to be used with a nebuliser.

All variants of Atrovent are to be inhaled. The doctor will recommend the right variant for you depending on your symptoms.

Atrovent begins to act within a few minutes after use and provides up to six hours of relief. Use your medicine at about the same time each day. Using it at the same time each day will have the best effect. It will also help you remember when to use it.

Atrovent is used to treat chronic respiratory conditions. Atrovent is meant to be used as a long-term treatment.

Dosage

Dosage is determined by a doctor for each specific patient depending on the condition and symptoms. The general dosage guidelines are as follows:

Atrovent aerosol

• Adults and children aged 6 and above: Two puffs to be inhaled three to four times daily. Do not use more than 12 puffs a day.

Atrovent inhalation powder

• Adults (including the elderly) and children aged 6 and above: 40 micrograms three to four times daily.

Atrovent nebuliser solution

As maintenance treatment:

• Adults (including the elderly) and children aged 12 and above:
  250 to 500 micrograms three to four times daily.
• Children aged 6 – 12 years:
  250 micrograms at a time. The intervals between doses should be determined by a doctor.

For acute asthma attacks:

• Adults (including the elderly) and children aged 12 and above:
  500 micrograms at a time. If necessary, repeat until the asthma attack has passed. The intervals between doses should be determined by a doctor.
• Children aged 6 – 12 years:
  250 micrograms at a time. If necessary, repeat until the asthma attack has passed. The intervals between doses should be determined by a doctor.

In children under the age of six, Atrovent nebuliser solution should only be used under medical supervision.

Consult the package leaflet for instructions on how to use Atrovent. Please read the instructions carefully. It is important to inhale this medicine correctly.

Alcohol/driving

Normally this medicine does not affect your ability to drive. In the unlikely event that you feel dizzy or drowsy, do not drive or operate machinery until the symptoms have passed.

You do not need to make any adjustments to your diet or alcohol intake while taking this medicine.

If you use too much/forget to use/stop using Atrovent

If you take more Atrovent than you were told to, consult your doctor or pharmacist.

If you forget a dose, use Atrovent as soon as you remember. If it’s almost time for your next scheduled dose, then skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a forgotten one.

Do not stop using Atrovent without talking to your doctor.

Atrovent is not suitable for everyone. Do not use this medicine if you are allergic to the active ingredient ipratropium, to atropine or atropine derivatives, or to any other ingredient in this medicine (see section 'What Atrovent contains').

When should this medicine be used with caution?

Contact your doctor or pharmacist immediately if:

• After taking Atrovent you experience tightening of the muscles around your throat. This can be life-threatening. Stop using this medicine and seek medical help immediately. Your doctor may decide that you need a different medicine to help your breathing.
• You have ocular hypertension (glaucoma). You have pain in your eyes, blurred vision, see halos or rainbows around lights in combination with red eyes due to swelling. You may be developing glaucoma, which will need treatment. Contact your doctor immediately.
• When using Atrovent take care not to let any of the spray enter your eyes. Act quickly to flush out your eye with cold water if Atrovent gets in it. If any of the spray accidentally gets into your eyes, you may get blurred vision or dilated pupils. This can last several hours. Contact a doctor if you also get stinging or red eyes or eye discomfort.
• You have trouble urinating due to a bladder problem or an enlarged prostate gland.
• You have cystic fibrosis. Use of anticholinergics such as ipratropium bromide can make you more sensitive to gastrointestinal issues.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using Atrovent.

Other medicines and Atrovent

Tell your doctor if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription and herbal medicines. This is because Atrovent can affect the way some other medicines work. Also some other medicines can affect the way Atrovent works. These medicines include:

• Certain types of bronchodilator (beta-2 agonists, xanthines) to help you breathe more easily can increase the effect of Atrovent.

Always consult your doctor before using other medicines alongside Atrovent to make sure the combination is safe. For more information, see the package leaflet.

Like all medicines, Atrovent can cause side effects, although some people may not experience any. Side effects that are known to be associated with Atrovent include:

Common (may affect up to 1 in 10 people):

• Headache.
• Dizziness.
• Cough and throat irritation.
• Dry mouth, stomach upset or discomfort.

Uncommon (may affect up to 1 in 100 people):

• Hypersensitivity or severe allergic reaction (anaphylactic reaction).
• Blurred vision, new or worsening closed-angle glaucoma (increased pressure in your eyes), (see also: 'When should this medicine be used with caution?'), painful eyes, dilated pupils, seeing halos or rainbows around items, bloodshot eyes, fluid retention in the cornea.
• Palpitations (with high doses), quickening of the heart rate (atrial fibrillation) or cardiac arrhythmia.
• Diarrhoea, constipation, vomiting, inflammation of the mucous membranes in the mouth, moisture accumulation in the tissues in the mouth, changes in taste sensations.
• Itching, skin rash, sudden moisture accumulation underneath the skin and in mucous membranes (e.g., throat, tongue), breathing difficulties, and/or itching and skin rash (angioedema).
• Difficulty passing urine. Take special care with Atrovent if you have blockage of the urinary tract.

Rare (may affect up to 1 in 1,000 people):

• Difficulty focusing.
• Increased heart rate.
• Skin rash, with symptoms such as severe itching and/or bumps.
• Shortness of breath caused by tightening of the muscles that line the airways (bronchospasm), sudden spasm of the vocal cords (laryngospasm), swelling of the throat, dry throat.

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

The active substance in Atrovent Aerosol is ipratropium bromide. The other ingredients are: citric acid (E330), purified water, ethanol and propellant (HFA 134a).

The active substance in Atrovent Inhalation Powder is ipratropium bromide. One capsule contains 42 micrograms ipratropium bromide, the equivalent of 40 micrograms anhydrous ipratropium bromide. The other ingredients are: glucose, hard gelatin capsules with colouring agents titanium dioxide (E171), indigo carmine (E132) and yellow and black iron oxide (E172).

The active substance in Atrovent Nebuliser Solution is ipratropium bromide in the form of ipratropium bromide monohydrate, the equivalent of resp. 250 μg and 500 μg ipratropium bromide per bottle. The other ingredients are: sodium chloride, hydrochloric acid (E507) and purified water.

Manufacturer

The manufacturer of Atrovent Aerosol and Atrovent Inhalation Powder is Boehringer Ingelheim Pharma GmbH & Co. KG, Germany.

The manufacturer of Atrovent Nebuliser Solution is Laboratoire Unither, France.

Read the package leaflet before use. The official package leaflets of Atrovent Aerosol, Atrovent Inhalation Powder and Atrovent Nebuliser Solution are available for download here.