(i pra TROE pee um)
Symptomatic relief of rhinorrhea associated with the common cold and allergic and nonallergic rhinitis
Hypersensitivity to ipratropium, atropine (and its derivatives), or any component of the formulation
Colds (symptomatic relief of rhinorrhea): Safety and efficacy of use beyond 4 days not established: Intranasal: Nasal spray (0.06%): 2 sprays in each nostril 3-4 times/day
Allergic/nonallergic rhinitis:Intranasal: Nasal spray (0.03%): 2 sprays in each nostril 2-3 times/day
Seasonal allergic rhinitis (safety and efficacy of use beyond 3 weeks in patients with seasonal allergic rhinitis has not been established): Intranasal: Nasal spray (0.06%): 2 sprays in each nostril 4 times/day
Refer to adult dosing.
Colds (symptomatic relief of rhinorrhea): Intranasal: Safety and efficacy of use beyond 4 days in patients with the common cold have not been established:
Children 5-11 years: 0.06%: 2 sprays in each nostril 3 times/day
Children ≥12 years and Adults: 0.06%: 2 sprays in each nostril 3-4 times/day
Allergic/nonallergic rhinitis: Intranasal: Children ≥6 years: Refer to adult dosing.
Seasonal allergic rhinitis: Intranasal: Children ≥5 years: Refer to adult dosing.
No dosage adjustment provided in manufacturer 's labeling (has not been studied); use with caution.
No dosage adjustment provided in manufacturer 's labeling (has not been studied); use with caution.
Avoid spraying into the eyes. Prior to initial use, prime inhaler by releasing 7 test sprays into the air. If the inhaler has not been used for >24 hours, reprime by releasing 2 test sprays into the air.
Store at controlled room temperature of 25 ‚ °C (77 ‚ °F). Do not store near heat or open flame.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Nasal, as bromide:
Atrovent: 0.03% (30 mL [DSC]); 0.06% (15 mL [DSC])
Generic: 0.03% (30 mL); 0.06% (15 mL)
AbobotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of AbobotulinumtoxinA. Monitor therapy
Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Monitor therapy
Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Analgesics (Opioid): Anticholinergic Agents may enhance the adverse/toxic effect of Analgesics (Opioid). Specifically, the risk for constipation and urinary retention may be increased with this combination. Monitor therapy
Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Exceptions: Cannabidiol. Monitor therapy
Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Avoid combination
Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Monitor therapy
Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Avoid combination
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination
Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Monitor therapy
Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Avoid combination
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Monitor therapy
OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. Monitor therapy
Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Consider therapy modification
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy
RimabotulinumtoxinB: Anticholinergic Agents may enhance the anticholinergic effect of RimabotulinumtoxinB. Monitor therapy
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor closely for a diminished response to secretin. Consider therapy modification
Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Monitor therapy
Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination
Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Monitor therapy
Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
1% to 10%:
Central nervous system: Headache (4% to 10%)
Gastrointestinal: Dysgeusia ( ≤4%), xerostomia (1% to 4%), diarrhea (2%), nausea (2%)
Respiratory: Upper respiratory tract infection (5% to 10%), epistaxis (6% to 9%), pharyngitis ( ≤8%), dry nose ( ≤5%), nasal mucosa irritation (2%), nasal congestion (1%)
<2% (Limited to important or life-threatening): Anaphylaxis, angioedema, blurred vision, burning sensation of the nose, conjunctivitis, cough, dizziness, eye irritation, hoarseness, increased thirst, laryngospasm, palpitations, skin rash, tachycardia, tinnitus, urticaria
Concerns related to adverse effects:
- Hypersensitivity reactions: Immediate hypersensitivity reactions (urticaria, angioedema, rash, bronchospasm) have been reported.
Disease-related concerns:
- Glaucoma: Use with caution in patients with narrow-angle glaucoma.
- Myasthenia gravis: Use with caution in patients with myasthenia gravis.
- Prostatic hyperplasia/bladder neck obstruction: Use with caution in patients with prostatic hyperplasia or bladder neck obstruction.
B
Adverse events have not been observed in animal reproduction studies.
Local application to nasal mucosa inhibits serous and seromucous gland secretions.
<20%
To inactive metabolites via ester hydrolysis
Urine (50%, as metabolites and unchanged drug)
1.6 hours
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Have patient report immediately to prescriber severe nasal irritation, severe nosebleeds, or vision changes (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.