Ipratropium bromide

What it is

Ipratropium bromide is an inhaled anticholinergic. It blocks muscarinic receptors in the airways, reducing reflex bronchoconstriction and mucus secretion, which opens the airways over a somewhat slower time course than a beta-2 agonist. It is used mainly in COPD, and in asthma alongside other inhaled treatment.

Used for

• COPD
• Asthma

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

The effect builds over some minutes rather than instantly, so it suits regular use more than rescue from sudden breathlessness. Dry mouth and a bitter taste are the usual complaints; sips of water, good dental hygiene and rinsing after inhaling help. The spray must be kept away from the eyes, since the anticholinergic effect there can blur vision, dilate the pupil and, in people prone to narrow-angle glaucoma, raise eye pressure, which is the reason a well-fitted mouthpiece is preferred over a loose mask.

When to see a doctor

Eye pain, a red eye, blurred vision or halos around lights after exposure to the mist means see a doctor promptly. Difficulty passing urine, or breathing that worsens instead of easing after inhaling, should also be assessed.

Worth knowing

• Avoid contact with the eyes
• Dry mouth is common