Atrovent dosage

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Atrovent - indications, instructions for use, reviews, analogues

Compound

Release form

Transparent colorless liquid without visible particles – 10 ml (200 doses), 15 ml (300 doses).

1 dose contains 20 mcg of ipratropium bromide.

Table of contents:

Steel cans with mouthpiece and dosing valve.

Transparent colorless liquid without visible particles – 20, 40, 100 ml.

1 mlmkg ipratropium bromide.

Dark glass dropper bottles.

Packaging – 100 capsules.

1 capsule – 200 mcg of ipratropium bromide.

Transparent colorless liquid without visible particles – 10 ml (200 doses), 15 ml (300 doses), 20 ml (400 doses), 30 ml (600 doses).

1 dose – 20 mcg of ipratropium bromide.

Bottles with nasal adapter.

pharmachologic effect

Indications for use

  • chronic obstructive disease of the lungs and bronchi (restriction of air flow in these organs), including in the elderly;
  • emphysema (pathological expansion of the air spaces of the distal bronchioles);
  • bronchospasm during colds;
  • bronchial asthma (except severe);
  • increased production of sputum in the bronchial mucosa;
  • bronchospasm during surgical operations;
  • tests for the reversibility of obstructive diseases (to determine an accurate diagnosis and assess the prognosis of the disease);
  • in order to prepare the surface of the respiratory tract before using aerosols of antibiotics, glucocorticosteroids, cromoglycic acid).

For intranasal use: chronic rhinitis with severe rhinorrhea (inflammation of the nasal mucosa with characteristic discharge).

Atrovent - instructions for use

Aerosol for inhalation

Rules for using Atrovent aerosol:

1. Remove the cap from the cylinder.

2. Exhale slowly and deeply.

3. Turn the can upside down and wrap your lips around the tip.

4. While inhaling as deeply as possible, sharply press the bottom of the balloon until the first dose is released. Hold your breath, remove the tip from the mouth, and exhale smoothly. After a minute, repeat the steps for the 2nd dose.

Solution for inhalation

  • Adults and children over 12 years of age: 2 ml (0.5 mg) 3-4 times a day. The maximum dose/day is 8 ml or 2 mg.
  • Children 6-12 years old: 1 ml (0.25 mg) 3-4 times a day. Maximum dose/day – 4 ml or 1 mg.
  • Children under 6 years of age: 0.4-1 ml (0.1-0.25 mg) 3-4 times a day. Maximum/dose – 4 ml or 1 mg.

Recommended single doses for acute bronchospasm are similar. But the time interval between inhalations can be shortened as prescribed by a doctor.

Powder in capsules for inhalation

Number of inhalations once a day.

Aerosol for intranasal use

Contraindications

1. Hypersensitivity to the components of the drug.

2. First trimester of pregnancy.

  • angle-closure glaucoma (increased intraocular pressure with a closed iris);
  • prostatic hyperplasia (proliferation of prostate tissue);
  • obstruction (blockage) of the urinary tract;
  • during the period of breastfeeding;
  • children under 6 years old.

Side effects

  • Allergic reactions: difficulty breathing, swelling of the face, mouth or throat, rash and itching on the skin, lips or mouth.
  • Digestive tract: nausea, metallic taste in the mouth, constipation (due to decreased intestinal tone), bloating.
  • Cardiovascular system: increased heart rate, heavy heartbeat.
  • Nervous system: nervousness, unusual weakness, tremor (shaking) of the limbs, headache, dry mouth.
  • Violations of the functions of the organ of vision: blurredness, burning or pain in the eyes, dilated pupils, inability to clearly see objects. In case of contact with the eyes – increased intraocular pressure, pain in the eyes.
  • From the respiratory system: cough, increased viscosity of sputum, paradoxical bronchospasm.

When using an aerosol in the nose: dryness and irritation of the mucous membrane.

  • When the urinary tract , urine retention may occur.

    • Atrovent aerosol or solution?

    • This is the only way to deliver the drug to the alveoli of the lungs.
    • The only method of aerosol treatment for children under 5 years of age and some elderly people.
    • Using a nebulizer, the solution is sprayed into microparticles, most of which have a size of less than 5 microns.
    • There is no freon in the solution for inhalation.
    • During inhalation, you can combine Atrovent solution with another drug.
    • It can be used in a centralized oxygen system, which provides simultaneous oxygen inhalation.

    Advantages of Atrovent metered dose aerosol:

    • The presence of a specific dose in one injection.
    • Compactness.
    • Convenient release form for constant carrying.
    • A quick method that does not limit the conditions for administering the drug.

    Atrovent or Berodual?

    Atrovent for children

    The aerosol is recommended for children from 6 years old, solution for inhalation - from 5 years old.

    Use during pregnancy

    Reviews

    Interaction with other drugs

    • Enhances the bronchodilator effect of beta-adrenergic stimulants (Alupent, Ventolin, Berotek, Bricanil) and theophylline.
    • When used simultaneously with anticholinergics (Cyclodol, Taren), an additive effect occurs (the total effect of the mixture is equal to the sum of the effects of the components separately).
    • The anticholinergic effect (limitation of sputum secretion) is enhanced by antiparkinsonian drugs, quinidine and tricyclic antidepressants.
    • When used simultaneously with inhaled beta-2 adrenergic agonists (fenoterol, salbutamol) in patients with closed-angle glaucoma, the risk of developing an attack of glaucoma increases.
    • Combination with Ditek can provoke a precipitation effect (formation of a cheesy sediment as a result of a chemical reaction).

    Analogs

    • Ipravent – ​​dosed aerosol for inhalation;
    • Ipratropium Steri-Neb – solution for inhalation;
    • Ipramol Steri-Neb – solution for inhalation;
    • Spiriva – capsules, solution for inhalation;
    • Troventol – aerosol for inhalation;
    • Truvent – ​​aerosol for inhalation.

    Additional Information

    You should not make decisions on your own to increase the therapeutic dose. If treatment does not bring tangible results, you should immediately consult a doctor.

    Due to the presence of the preservative benzalkonium chloride in the drug, a paradoxical narrowing of the bronchi may occur.

    Storage conditions and shelf life

    Read more:
    Reviews
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    Source: http://www.tiensmed.ru/news/atrovent-ud2.html

    "Atrovent" for inhalation: instructions for use, analogues and reviews

    Asthma is a very serious and unpleasant disease. Currently, about a million people worldwide suffer from it. Thanks to the efforts of modern medicine, a huge number of drugs have been created that can make the lives of such patients easier. These include the medicine “Atrovent” for inhalation. It belongs to the blockers of m-cholinergic receptors and is intended to inhibit spasms of bronchial smooth muscles. The drug must be taken strictly as prescribed by the doctor.

    Dosage forms

    The medicine "Atrovent" is available in the form of aerosols, capsules with powder or solution (0.025%) for inhalation. The main active component in it is iprotropium bromide. The solution for inhalation is a clear or almost clear, colorless liquid, free of particles.

    Composition of the drug

    Contains "Atrovent" (solution for inhalation) (1ml):

    • ipratropium bromide monohydride – 261 mcg;
    • excipients - disodium edetate, benzalkonium chloride, sodium chloride, hydrochloric acid.

    All components are dissolved in purified water.

    Properties of the medicine

    One of the advantages of the drug "Atrovent" for inhalation is that it has virtually no cauterizing or irritating effect on the mucous membrane. In this case, the alveoli and bronchi reach 10-30% of the dose. The rest is retained in the mouth and pharynx and then swallowed. The absorption of this drug is very low. Therefore, it does not enter the blood through the gastrointestinal tract. The bioavailability of the drug is only 2%. After swallowing, the medicine is eliminated through the intestines.

    Part of it that enters the body quickly breaks down into weakly active metabolites, which are quickly excreted by the kidneys. That is, the drug does not accumulate in the body. Thanks to all this, “Atrovent” (solution for inhalation), reviews of which from patients are quite good, can be used by both elderly people and children under the age of six full years.

    Operating principle

    The drug "Atrovent" is a quaternary ammonium compound with parasympatholytic properties. Its molecules are structurally similar to the molecules of acetylcholine, a neurotransmitter responsible for neuromuscular transmission. This explains the relaxing effect of the Atrovent inhaler. When it enters the bronchi and alveoli, it begins to compete with acelocholine, as a result of which smooth muscles stop responding to brain signals to contract. Thus, the drug "Atrovent" should be classified as a bronchodilator drug with a symptomatic effect.

    Efficacy of the drug

    The drug improves external respiration function in people with bronchospasms. Already a quarter of an hour after the procedure, the volume of forced expiration increases by 15%. Significant improvement in this regard is observed in 40% of patients.

    The drug effectively relieves constriction of the bronchi, for example, when inhaling cold air or cigarette smoke, and also inhibits reflex spasms of smooth muscles. The medicine reaches its maximum effect 1-2 hours after the procedure. The effect of its use lasts for about 6 hours.

    In what cases is it prescribed

    Doctors usually prescribe this drug in two cases:

    • If the patient has bronchospasms, manifested as a result of chronic diseases such as emphysema and obstructive bronchitis. In this case, it is prescribed as a maintenance drug.
    • For acute attacks of bronchospasm in patients suffering from asthma or chronic lung diseases. In this case, the drug is usually used in combination with beta-2 agonists.

    Methods of use for maintenance treatment

    When using the drug "Atrovent" for inhalation, the patient must be under the supervision of a doctor. The required dose of medication is selected individually. For maintenance treatment, the following regimen is usually recommended:

    • For adults and children over 12 years old – 2 ml 3-4 times (in 24 hours). 2 ml is approximately forty drops of the drug. A maximum of 8 ml of medication can be used per day.
    • For children 6-12 years old, the amount of medication should be halved. That is, you can use 20 drops (1 ml) at a time. Small patients should not take more than 4 ml per day.
    • For children under 6 years of age, 8-20 drops (0.4-1 ml) are administered no more than 3-4 times (in 24 hours). In 24 hours for this age group, the maximum dose is 4 ml.

    How to use for acute spasms

    Adults and elderly people, as well as teenagers from 12 years of age, can take the drug “Atrovent” for inhalation (the reviews of which, by the way, are very good) forty drops of the medicine. If the condition does not stabilize, repeated inhalation is possible. The intervals between injections, however, should be determined by a doctor.

    For children aged 6-12 years, 20 drops of an inhaler are injected with acute spasms. For younger children (up to 6 years old) use 8-20 drops.

    How to use

    “Atrovent” (solution for inhalation) should first be diluted with saline, bringing the amount of the mixture to 4 ml. Next, it should be poured into a nebulizer and injected into the throat. The duration of the procedure is determined by the consumption of the mixture. If this drug is prescribed, relatives are strongly recommended - especially at first - to monitor the patient. If you notice that the medicine is not helping, you should contact your doctor to develop a new treatment plan. The same, of course, must be done if the patient gets worse.

    The drug "Atrovent" for inhalation, instructions for use of which are given above, can be injected using any inhalation devices available on the market. If a centralized oxygen system is used for administration, it is recommended to set the rate to 6-8 l/min.

    Contraindications

    The drug is not prescribed if the patient has hypersensitivity to it. The drug "Atrovent" for inhalation is contraindicated for pregnant women (first trimester). It should not be prescribed to patients with sensitivity to hypotropium bromide or other additional elements of the drug. The drug "Atrovent" is also contraindicated for patients with angle-closure glaucoma.

    Possible side effects

    “Atrovent” (solution for inhalation), instructions for use of which are given above, can provoke such negative phenomena as:

    • headache,
    • constipation or diarrhea,
    • coughing,
    • paradoxical bronchospasm,
    • local irritation
    • skin rash,
    • constipation or diarrhea,
    • swelling of the lips, tongue and face,
    • dry mouth,
    • spasms of the larynx,
    • vomiting or nausea,
    • allergic reactions,
    • sticky sputum.

    Also, after taking the drug, unpleasant and dangerous side effects may appear, such as atrial fibrillation or tachycardia, increased heart rate, urinary retention and dizziness. However, such symptoms are quite rare in those taking the drug Atrovent. If this inhaler is used by patients with angle-closure glaucoma, unpleasant consequences such as pain or discomfort in the eye, impaired accommodation, blurred vision, and the appearance of a halo or colored spots before the eyes may occur.

    Use in combination with other medications

    Very often, the doctor prescribes the drug "Atrovent" simultaneously with "Lazolvan" and "Berotek". Beta-2-adrenergic compounds can enhance the muscle relaxation effect of this inhaler. The anticholinergic effect of the drug can be supplemented with quinidine, antiparkinsonian drugs, and tricyclic antidepressants. When taken simultaneously with other acetylcholine-substituting substances, an additive (total) effect is observed.

    You cannot use the drug "Atrovent" in combination with a solution of disodium chromoglycate, as this can lead to precipitation. The fact that this inhaler cannot be prescribed to patients with glaucoma has already been mentioned above. If in this case it is taken simultaneously with beta-agonists, the risk of developing an attack of glaucoma in the patient will sharply increase.

    Use during pregnancy

    In case of a possible or already definite pregnancy, this drug can still be prescribed. However, the attending physician must first determine how much the benefit from it will exceed the risk of harm to the unborn child. As for the lactation period, unfortunately, at the moment there is no data on the penetration of the drug Atrovent (is it a solution or an aerosol) into breast milk. However, the risk of such a phenomenon is quite significant. The fact is that many medications are excreted from the body with milk. Therefore, Atrovent should be prescribed to nursing women only as a last resort.

    Application for drivers

    In the event that a person’s professional activity is associated with a risk of danger to the health or life of himself or those around him, the drug should also be prescribed with caution. This applies, for example, to vehicle drivers and those whose line of work requires attentiveness and speed of reaction.

    What else you should know

    This drug should also be prescribed with caution to patients suffering from:

    In the case of cystic fibrosis, the patient may experience an aggravation of a phenomenon such as a slowdown in gastrointestinal motility. Of course, you should not exceed the prescribed daily dose of the drug. Some of its components, such as benzalkonium chloride and disodium edetate, can cause constriction of the bronchi.

    The best nebulizers when using the drug "Atrovent" are considered to be devices equipped with a mouthpiece. Injection with their use is much more convenient. In the event that inhalations are carried out using a mask, the latter must be selected strictly according to size. Avoid getting the medicine into your eyes. Inhalations with Atrovent for children are best done not using a conventional nebulizer or aerosol can, but through a mask.

    Overdose symptoms

    If the drug is taken uncontrolled, troubles such as increased heart rate, accommodation paresis and dry mouth may occur. No special and pronounced specific syndromes were identified when the dose of the drug “Atrovent” was exceeded. Since it has mainly local effects, the occurrence of anticholinergic reactions other than those intended is considered unlikely.

    How to store the drug

    Keep the bottle with the solution or spray can out of the reach of children. The air temperature in the room should not exceed +30 degrees. The shelf life of the medicine is 3 years. After its expiration, the drug cannot be used. This medicine is dispensed in pharmacies only with a doctor's prescription.

    The drug "Atrovent" (aerosol for inhalation): instructions for use

    The dosage of the medicine in the can is also determined by the doctor. It is usually prescribed 2 doses 4 times (24 hours). A new aerosol can must be prepared for use. To do this, press the valve twice until a cloud appears. If the drug has been inactive for a long time (several days), most likely, you will need to press the valve once before obtaining the desired result.

    Atrovent N aerosol for inhalation should be used as follows:

    • the cap is removed from the can;
    • take a deep breath;
    • the cylinder is turned upside down;
    • The tip should be wrapped around your lips.

    Next, while inhaling as deeply as possible, you will need to press the bottom of the balloon. Then you should wait a minute and repeat the action to receive the second dose. Of course, the tip of the can should be periodically rinsed with water. In this case, it is quite acceptable to use household detergents. However, of course, they should not be allowed to enter the oral cavity, especially for children. Therefore, after washing with powder or liquid, the tip should be thoroughly rinsed under running water.

    Analogues of the drug

    In some cases, Atrovent N - an inhalation aerosol or solution - can be replaced, for example, with a medicine such as Ipravent. Ipratropium bromide itself, also produced in the form of a solution, has a similar effect on the human body.

    The drug "Ipravent"

    Like the drugs “Atrovent N” for inhalation, instructions for use of which were given above, and “Atrovent” in solution, the drug “Ipravent” relaxes the muscles of the bronchi (mainly medium and large) well. In addition, it reduces the secretion of the mucous membrane of the bronchial glands and nasal cavity. Like the drug "Atrovent", the molecule of the drug "Ipravent" is an acetylcholine antagonist. When inhaled it does not cause tachycardia. The effect is noticeable 15 minutes after application and reaches a maximum within 1-2 hours. The duration of action of the drug is six hours.

    The side effects caused by the drug "Ipravert" are also similar to those that can be provoked by "Atrovent": nausea and vomiting, increased viscosity of sputum, constipation, dry mouth, urinary retention, sluggishness of the gastrointestinal tract, cough, paradoxical bronchitis. In case of overdose, this drug may provoke increased anticholinergic reactions.

    Inhalations for bronchial asthma with a metered aerosol are carried out three times a day at 0.4-0.6 mg to prevent suffocation. When treating with the drug, additional procedures of another 0.4-0.6 mg per day may be prescribed. Children receive inhalations every 6-8 hours. When using the solution for bronchitis and chronic lung diseases, adults are prescribed mcg of the drug at intervals of 6-8 hours, children – mcg 3-4 times a day. For asthma, the daily dose is 500 mcg 3-4 times (every 24 hours), for children – mcg 3-4 times.

    The drug "Ipravert" is contraindicated for pregnant women in the first trimester and is prescribed with caution to patients with urinary tract obstruction and to children under 6 years of age.

    Medicine "Atrovent": reviews

    Despite the fact that this drug was developed specifically for the treatment of bronchial asthma, it is still more often used for problems such as laryngitis and bronchitis. Doctors and patients - judging by the reviews - consider it a rather weak medicine. However, with regard to cough relief, for example, the drug “Atrovent” copes with this very well. Of course, the patient’s attending physician should first of all judge how useful or useless this medicine will be.

    Sometimes patients are interested in which drug is better to take, Atrovent or Berodual. Both of these medications belong to the same group of drugs (bronchodilators). The main advantage of the drug "Atrovent" is that it has undergone serious clinical trials. However, it is inferior in strength to Berodual, since the latter contains not only iratropium bromide, but also fenoterol hydrobromide. Therefore, the drug "Atrovent" is prescribed mainly for the initial stages of bronchitis. "Berodual" is taken for acute asthma attacks.

    Thus, the medicine “Atrovent”, which has very good reviews, can be used quite successfully for bronchospasms and various types of chronic lung diseases, especially in the initial stages. This drug is quite expensive, but the effect of its use is not bad.

    Source: http://www.syl.ru/article/170212/new_atrovent-dlya-ingalyatsiy-instruktsiya-po-primeneniyu-analogi-i-otzyivyi

    Atrovent - official instructions for use

    Registration number:

    Trade name of the drug:

    International nonproprietary name:

    Chemical name:

    Dosage form:

    Compound:

    active substance: ipratropium bromide monohydrate (SCH 1000 BR) 0.261 mg equivalent to ipratropium bromide 0.25 mg.

    excipients: benzalkonium chloride 0.10 mg, disodium edetate dihydrate 0.50 mg, sodium chloride 8.80 mg, hydrochloric acid 1N (to adjust pH 3.4) 0.659 mg, purified water to 1.00 ml.

    Description:

    Pharmacotherapeutic group:

    ATX code:

    Pharmacological properties

    Bronchodilator. Blocks m-cholinergic receptors of the smooth muscles of the tracheobronchial tree and suppresses reflex bronchoconstriction. Having structural similarity to the acetylcholine molecule, it is its competitive antagonist. Anticholinergics prevent an increase in the intracellular concentration of calcium ions, which occurs due to the interaction of acetylcholine with muscarinic receptors located in the smooth muscles of the bronchi.

    The release of calcium ions occurs with the help of secondary messengers (mediators), which include ITP (inositol triphosphate) and DAG (diacylglycerol). Effectively prevents the narrowing of the bronchi that occurs as a result of inhalation of cigarette smoke, cold air, the action of various bronchospasms, and also eliminates bronchospasm associated with the influence of the vagus nerve. When used inhalation, it has virtually no resorptive effect. Bronchodilation occurring after inhalation of Atrovent ® (ipratropium bromide) is mainly a consequence of the local and specific effect of the drug on the lungs, and not the result of its systemic effect. In controlled daily studies conducted in patients with bronchospasm due to chronic obstructive pulmonary disease, chronic bronchitis and emphysema, significant improvements in lung function were observed within 15 minutes, peaked at 1-2 hours and persisted for up to 4-6 hours.

    The therapeutic effect of Atrovent ® is a consequence of its local action in the respiratory tract. The development of bronchodilation does not parallel pharmacokinetic parameters.

    After inhalation, % of the administered dose of the drug usually enters the lungs (depending on the dosage form and method of inhalation). Most of the dose is swallowed and enters the gastrointestinal tract. Part of the drug dose that enters the lungs quickly reaches the systemic bloodstream (within a few minutes).

    Cumulative renal excretion (over 24 hours) of the parent compound is approximately 46% of the intravenous dose, less than 1% of the oral dose, and approximately 3-13% of the inhalation dose. Based on these data, the total systemic bioavailability of ipratropium bromide administered orally and inhaled is calculated to be 2% and 7-28%, respectively.

    Kinetic parameters describing the distribution of ipratropium bromide were calculated based on its plasma concentrations after intravenous administration. A rapid two-phase decrease in plasma concentration is observed. The apparent volume of distribution during steady state (Css) is approximately 176 L (≈2.4 L/kg). The drug binds to plasma proteins to a minimal extent (less than 20%). Ipratropium bromide, which is a quaternary amine, does not penetrate the blood-brain barrier.

    The half-life during the terminal phase is approximately 1.6 hours.

    The total clearance of ipratropium bromide is 2.3 l/min, and the renal clearance is 0.9 l/min. After intravenous administration, approximately 60% of the dose is metabolized by oxidation, mainly in the liver. Cumulative renal excretion (over 6 days) of the isotopically labeled dose (including parent compound and all metabolites) was 72.1% after intravenous administration, 9.3% after oral administration, and 3.2% after inhalation administration. The total isotope-labeled dose excreted through the intestine was 6.3% after intravenous administration, 88.5% after oral administration, and 69.4% after inhalation administration. Thus, excretion of the isotope-labeled dose after intravenous administration occurs primarily through the kidneys. The half-life of the parent compound and metabolites is 3.6 hours. The main metabolites excreted in the urine bind weakly to muscarinic receptors and are considered inactive.

    Indications for use

    Contraindications

    angle-closure glaucoma, urinary tract obstruction, prostatic hyperplasia; breastfeeding, children's age (up to 6 years).

    Use during pregnancy and breastfeeding

    In preclinical studies, no embryotoxic or teratogenic effects of the drug were detected after inhalation use in doses significantly higher than doses recommended in humans.

    It is unknown whether ipratropium bromide is excreted in breast milk. However, it is unlikely that ipratropium bromide, especially when it is administered by inhalation, can enter the baby's body in significant quantities through milk. But while using the drug Atrovent ®, breastfeeding mothers should be careful.

    There are no clinical data on the effect of ipratropium bromide on fertility. No adverse effects on fertility were found during the use of ipratropium bromide in preclinical studies.

    Directions for use and doses

    If treatment does not lead to significant improvement or if the patient's condition worsens, a consultation with a doctor is necessary to develop a new treatment plan. If shortness of breath (difficulty breathing) suddenly or rapidly worsens, consult your doctor immediately. Unless otherwise prescribed by your doctor, the following dosage regimen is recommended:

    Adults (including elderly) and children over 12 years of age:

    2.0 ml (40 drops = 0.5 mg) 3-4 times a day.

    The maximum daily dose is 8.0 ml (2 mg).

    Children from 6 to 12 years old:

    Treatment should be carried out under medical supervision;

    1.0 ml (20 drops = 0.25 mg) 3-4 times a day.

    The maximum daily dose is 4 ml (1 mg).

    Treatment should be carried out under medical supervision;

    0.4 -1.0 ml (8-20 drops = 0.1-0.25 mg) 3-4 times a day.

    The maximum daily dose is 4 ml (1 mg).

    Adults (including elderly) and children over 12 years of age:

    2.0 ml (40 drops = 0.5 mg); Repeated appointments are possible until the patient’s condition stabilizes. The interval between inhalations is determined by the doctor.

    Atrovent ® can be used in conjunction with inhaled ß 2 -adrenergic agonists.

    Children from 6 to 12 years old:

    Treatment should be carried out under medical supervision.

    1.0 ml (20 drops = 0.25 mg); Repeated appointments are possible until the patient’s condition stabilizes. The interval between inhalations is determined by the doctor.

    Atrovent ® can be used in conjunction with inhaled ß 2 adrenergic agonists.

    Treatment should be carried out under medical supervision.

    0.4-1.0 ml (8-20 drops = 0.1-0.25 mg); Repeated appointments are possible until the patient’s condition stabilizes. The interval between inhalations is determined by the doctor. Atrovent ® can be used in conjunction with inhaled ß 2 -adrenergic agonists.

    To ensure proper use of the drug, please read these instructions for use carefully.

    The recommended dose of the drug should be diluted with 0.9% sodium chloride solution until the volume of the drug reaches 3-4 ml, pour into a nebulizer and inhale. The drug should be diluted with 0.9% sodium chloride solution each time immediately before use, the remaining solution after inhalation is poured out.

    Dosage may depend on the method of inhalation and the type of nebulizer. The duration of inhalation can be controlled by the consumption of the diluted volume.

    Atrovent ® solution for inhalation can be used using various nebulizers available on the market. When using a centralized oxygen system, the solution is best used at a flow rate of 6-8 liters per minute.

    Side effect

    Adverse reactions to the drug were determined based on data obtained in clinical trials and during pharmacological surveillance of the use of the drug after its registration.

    The most common side effects reported in clinical studies were headache, pharyngeal irritation, cough, dry mouth, gastrointestinal motility disorders (including constipation, diarrhea and vomiting), nausea and dizziness.

    Immune system disorders

    • hypersensitivity
    • anaphylactic reaction

    Nervous system disorders

    • headache
    • dizziness

    Visual disorders

    • blurred vision
    • mydriasis
    • increased intraocular pressure
    • glaucoma
    • Pain in the eyes
    • the appearance of a halo around objects
    • conjunctival hyperemia
    • corneal edema
    • disturbances of accommodation

    Heart disorders

    • feeling of heartbeat
    • supraventricular tachycardia
    • atrial fibrillation
    • increased heart rate

    Respiratory, thoracic and mediastinal disorders

    • throat irritation
    • cough
    • bronchospasm
    • paradoxical bronchospasm
    • laryngospasm
    • swelling of the pharynx
    • dry throat

    Gastrointestinal disorders

    • dry mouth
    • nausea
    • gastrointestinal motility disorders
    • diarrhea
    • constipation
    • vomit
    • stomatitis
    • swelling of the mouth

    Changes in the skin and subcutaneous tissues

    • rash
    • itching
    • angioedema
    • hives

    Renal and urinary tract disorders

    • urinary retention

    Overdose

    Interaction with other drugs

    Beta-adrenergic agents and xanthine derivatives can enhance the bronchodilator effect of Atrovent ®.

    In the case of simultaneous use of ipratropium bromide and beta-agonists via nebulizer in patients with a history of acute-angle glaucoma, the risk of developing acute glaucoma may increase (see section Special instructions).

    Atrovent ® solution for inhalation should not be prescribed simultaneously with cromoglycic acid inhalation solution, given the possibility of precipitation.

    The anticholinergic effect is enhanced by antiparkinsonian drugs, quinidine, and tricyclic antidepressants.

    special instructions

    Immediate hypersensitivity reactions may occur after use of Atrovent ®, as indicated by rare cases of rash, urticaria, angioedema, oropharyngeal edema, bronchospasm and anaphylaxis.

    Atrovent ®, like other inhaled drugs, can cause paradoxical bronchospasm, which can be life-threatening. If paradoxical bronchospasm occurs, the use of Atrovent ® should be stopped immediately and alternative therapy should be prescribed.

    Eye complications

    Atrovent ® should be used with caution in patients predisposed to developing acute-angle glaucoma. There are isolated reports of eye complications (including the development of mydriasis, increased intraocular pressure, development of acute-angle glaucoma, eye pain) in cases where inhaled ipratropium bromide (used alone or in combination with a beta 2-adrenergic receptor agonist ) got into my eyes.

    Symptoms of acute acute-angle glaucoma may include pain or discomfort in the eyes, blurred vision, the appearance of halos on objects and colored spots in front of the eyes, combined with redness of the eyes due to injection of conjunctival vessels and corneal edema. If any combination of these symptoms develops, the use of eye drops that reduce intraocular pressure and immediate consultation with a specialist is indicated.

    Patients should be instructed on the correct use of Atrovent ®.

    Care should be taken to prevent the solution from getting into the eyes. It is recommended that the solution used with a nebulizer be applied through a mouthpiece. If the mouthpiece is missing and a nebulizer mask is used, it must be applied properly.

    Patients predisposed to the development of glaucoma should be warned about the need for eye protection.

    Effects on kidney function and urination

    Atrovent ® should be used with caution in patients with existing urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction).

    Gastrointestinal motility disorders

    Patients with cystic fibrosis may be predisposed to gastrointestinal motility disorders.

    The drug contains a preservative - benzalkonium chloride, and a stabilizer - disodium edetate dihydrate. During inhalation, these components may cause bronchospasm in sensitive patients with airway hyperresponsiveness.

    The patient should be informed that if inhalations are not effective enough or if the condition worsens, they should consult a doctor to change the treatment plan. In case of sudden onset and rapid progression of shortness of breath, the patient should also immediately consult a doctor.

    Impact on the ability to drive vehicles and machinery

    The effects of the drug on the ability to drive vehicles and use machinery have not been specifically studied. However, patients should be informed that during treatment with Atrovent ® they may experience undesirable sensations such as dizziness, accommodation disturbances, mydriasis and blurred vision. Therefore, caution should be recommended when driving vehicles or using machinery.

    Release form

    Storage conditions

    Keep out of the reach of children!

    Best before date

    Vacation conditions

    Manufacturer

    Name and address of the legal entity in whose name the registration certificate was issued

    Boehringer Ingelheim International GmbH, Germany Binger Strasse 173, 55216 Ingelheim am Rhein, Germany

    You can obtain additional information about the drug, as well as send your complaints and information about adverse events to the following address in Russia

    Boehringer Ingelheim LLC

    125171, Moscow, Leningradskoe shosse, 16A building 3

    Source: http://medi.ru/instrukciya/atrovent_6129/

    Atrovent

    Instructions for use:

    Prices in online pharmacies:

    Atrovent is a synthetic drug used to prevent bronchospasm in bronchial asthma.

    Release form and composition

    The drug is produced in the form of a colorless solution for inhalation (in glass dropper bottles of 20 ml, 1 dark glass bottle in a cardboard pack).

    1 ml of Atrovent contains:

    • Active substance: ipratropium bromide anhydrous – 250 mcg;
    • Excipients: disodium edetate dihydrate, benzalkonium chloride, hydrochloric acid, sodium chloride, purified water.

    Indications for use

    • Bronchial asthma of moderate and mild severity;
    • Chronic obstructive pulmonary disease, including emphysema and chronic obstructive bronchitis.

    Contraindications

    The inhalation agent is contraindicated for use in case of hypersensitivity to its components.

    Atrovent during pregnancy and lactation is prescribed only according to strict indications.

    The drug should be used with caution:

    • Prostatic hyperplasia;
    • Urinary tract obstruction;
    • Angle-closure glaucoma;
    • Children's age up to 6 years.

    Directions for use and dosage

    The dosage regimen for Atrovent inhalation solution is selected individually.

    Children over 12 years of age and adults are usually prescribed 3-4 inhalations per day of 2 ml, which corresponds to 40 drops, maximum 8 ml.

    The daily dose of Atrovent inhalation solution for children depends on age:

    • Up to 6 years – drops 3-4 inhalations per day;
    • From 6 to 12 years – 20 drops up to 4 times a day.

    The use of Atrovent in pediatrics is carried out only under medical supervision.

    The required dose of solution for inhalation immediately before the procedure should be diluted with physiological solution to a volume of 3-4 ml. The solution remaining after the procedure cannot be reused. The aerosol is prescribed up to 4 times a day, two doses, but no more than 12 inhalations per day.

    It is important to be careful when using Atrovent simultaneously with tricyclic antidepressants, beta2-agonists, antiparkinsonian drugs, xanthine derivatives, quinidine and other anticholinergic drugs.

    Side effects

    Atrovent most often causes dry mouth, headache and gastrointestinal motility disorders.

    In addition, the drug can cause the following manifestations:

    • Supraventricular tachycardia, increased heart rate, impaired accommodation, atrial fibrillation, palpitations, urinary retention;
    • Local irritation and cough, less often – paradoxical bronchospasm;
    • Pupil dilation and increased intraocular pressure (if the solution gets into the eyes);
    • Skin rash, laryngospasm, urticaria, itching, swelling of the tongue and face, Quincke's edema, anaphylactic reactions.

    special instructions

    It is not recommended to prescribe Atrovent for emergency relief of bronchial asthma attacks, since the bronchodilator effect develops more slowly than when using beta-agonists.

    With cystic fibrosis, the risk of developing inhibition of gastrointestinal motility increases.

    Significant excess of recommended doses is contraindicated not only in the case of treatment of acute bronchospasm, but also during maintenance therapy. If inhalations are insufficiently effective or the condition worsens, the attending physician must change the treatment plan.

    Atrovent can be used in combined inhalations simultaneously with inhalation solutions such as Ambroxol, Bromhexine and Berotec.

    The content of the antibacterial preservative benzalkonium chloride and the stabilizer disodium edetate in the drug increases the risk of developing bronchospasm due to narrowing of the bronchial lumen.

    Avoid contact of the solution with the eyes, especially in patients with a predisposition to glaucoma.

    The doctor prescribing the drug must teach the patient the rules for its use, and when using a nebulizer with a mask, help with selecting a mask of the appropriate size.

    Analogs

    Direct analogues of Atrovent for the active substance: Ipravent dosed aerosol for inhalation, Atrovent N dosed aerosol for inhalation, Ipratropium Steri-Neb solution for inhalation.

    Drugs that are similar in their mechanism of action are from the same pharmaceutical subgroup: Spiriva, Troventol, Truvent, Sibri Breezhaler.

    Terms and conditions of storage

    Store at temperatures up to 30 °C, out of reach of children.

    A prescription drug with a shelf life of 3 years.

    Atrovent solution for inhalation. 0.25 mg/ml 20ml n1

    Atrovent solution for inhalation 20ml dropper bottle

    Atrovent solution for inhalation 0.25 mg/ml 20 ml

    Atrovent N aerosol for inhalation 20 mcg/dose 10 ml 200 doses

    Atrovent n Aeroz. d/inhal. doses 20mcg/dose 200doses 10ml n1

    Atrovent N 20mcg/dose aerosol for inhalation 200 doses 10ml

    Atrovent n aerosol for inhalation 20 mcg/dose 200 doses

    Information about the drug is generalized, provided for informational purposes and does not replace official instructions. Self-medication is dangerous to health!

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    Source: http://www.neboleem.net/atrovent.php

    Atrovent ® (Atrovent ® )

    Active substance:

    Content

    Pharmacological group

    Nosological classification (ICD-10)

    3D images

    Composition and release form

    in dropper bottles of 20 ml (1 ml = 20 drops); 1 bottle in a box.

    in aerosol cans with a mouthpiece of 10 ml (200 doses); There is 1 cylinder in the box.

    pharmachologic effect

    Ipratropium bromide is a quaternary ammonium compound. Has anticholinergic properties. Inhibits the reflexes of the vagus nerve, being a competitive antagonist of the neurotransmitter acetylcholine. Blocks muscarinic receptors of the smooth muscles of the tracheobronchial tree and suppresses reflex bronchoconstriction. Bronchial dilatation during inhalation is due mainly to the local rather than systemic anticholinergic effect of the drug. Effectively prevents the narrowing of the bronchi that occurs as a result of inhalation of cigarette smoke, cold air, the action of various bronchospasms, and also inhibits bronchospasm associated with the influence of the vagus nerves. When used in inhalation, it has virtually no resorptive effect - for the development of tachycardia, about 500 doses must be inhaled, with only 10% reaching the small bronchi and alveoli, and the rest settles in the pharynx or oral cavity and is swallowed.

    Pharmacodynamics

    It has a pronounced bronchodilator effect and prevents the development of bronchospasm. Causes a decrease in the secretion of glands of the bronchial mucosa.

    Pharmacokinetics

    When administered via inhalation, absorption is extremely low. The concentration of the drug in the blood plasma is at the lower limit of definition and can only be measured when using high doses of the active substance. It is excreted primarily through the intestines, about 25% unchanged, the rest in the form of metabolites.

    Clinical pharmacology

    In patients with bronchospasm associated with chronic obstructive pulmonary disease (chronic bronchitis and emphysema), a significant improvement in lung function (increase in forced expiratory volume in 1 s - FEV 1 and average forced expiratory volumetric flow rate 25 - 75 % increased by 15% or more ) is observed after 15 minutes, the maximum effect is achieved after 1–2 hours and lasts in most patients up to 6 hours.

    In patients with bronchospasm associated with bronchial asthma, a significant improvement in lung function (an increase in FEV 1 by 15% or more) is observed in 40% of patients.

    Indications of the drug Atrovent ®

    Chronic obstructive pulmonary disease (chronic obstructive bronchitis, pulmonary emphysema); bronchial asthma (moderate and mild severity), especially with concomitant diseases of the cardiovascular system.

    Contraindications

    Hypersensitivity to atropine and its derivatives, and other components of the drug, pregnancy (first trimester), children under 6 years of age (Atrovent H).

    Use during pregnancy and breastfeeding

    Contraindicated in the first trimester of pregnancy; the drug can be prescribed in the second-third trimester of pregnancy and during breastfeeding only if the expected effect of therapy exceeds the potential risk to the fetus or child.

    Side effects

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

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

    As with other inhalation therapy, incl. bronchodilators, sometimes there is a cough, less often - paradoxical bronchospasm.

    In rare cases, allergic reactions may develop, incl. 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 2 Patients should be able to use metered dose aerosol correctly.

    Interaction

    Potentiates the bronchodilator effect of beta-agonists and xanthine derivatives. Strengthens the anticholinergic effect of other drugs.

    Directions for use and doses

    Solution for inhalation: adults and children over 12 years old - 0.5 mg (40 drops) 3-4 times a day through a nebulizer; children 6–12 years old - 0.25 mg (20 drops) 3–4 times a day via nebulizer; children under 6 years old - 0.1–0.25 mg (8–20 drops) 3–4 times a day (under medical supervision). The recommended dose is diluted with saline immediately before use 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 carried out at intervals of at least 2 hours.

    Dosed aerosol for inhalation: adults and children over 6 years old - 2 doses of aerosol 4 times a day, if necessary, the dose can be increased to 12 inhalations per day.

    Overdose

    No specific symptoms of overdose have been identified. Minor manifestations of systemic anticholinergic action are possible, such as dry mouth, impaired accommodation, increased heart rate. Treatment is symptomatic.

    Precautionary measures

    The 0.025% solution for inhalation contains the preservative benzalkonium chloride and the stabilizer ethylenediaminetetraacetic acid. There are reports that these substances, when prescribed in large 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.

    Eye pain or discomfort, blurred vision, the appearance of a halo and colored spots before the eyes in combination with conjunctival and corneal hyperemia can be symptoms of an attack of narrow-angle glaucoma. If any of these symptoms occur, you should prescribe drops that cause pupil constriction and consult an ophthalmologist without delay.

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

    Children should be prescribed Atrovent N dosed aerosol only after the recommendation of a doctor and under the supervision of adults.

    special instructions

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

    Patients with cystic fibrosis have an increased likelihood of developing slow gastrointestinal motility.

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

    When using a freon-free form of a metered-dose aerosol for the first time, patients may note that the taste of the new drug is somewhat 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 a possible change in the taste properties of the drug. It should be communicated that these drugs are interchangeable and that taste is not relevant to the safety and effectiveness of the new drug.

    Manufacturer

    Boehringer Ingelheim Pharma GmbH & Co. KG, Germany (dosed-dose inhalation aerosol).

    Boehringer Ingelheim Italia S.p.A., Italy, a division of Boehringer Ingelheim International GmbH, Germany (inhalation solution).

    Storage conditions for the drug Atrovent ®

    Keep out of the reach of children.

    Shelf life of the drug Atrovent ®

    solution for inhalation 0.25 mg/ml - 5 years.

    aerosol for inhalation dosed 20 mcg/dose - 3 years.

    Do not use after the expiration date stated on the package.

    Synonyms of nosological groups

    Prices in Moscow pharmacies

    The information is intended solely for comparing prices in stationary pharmacies operating in accordance with Article 55 of the Federal Law “On the Circulation of Medicines” dated April 12, 2010 N 61-FZ.

    solution for inhalation 0.25 mg/ml, 1 pc.

    Boehringer Ingelheim International (Germany)

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