What is Atrovent?
Atrovent is a bronchodilator containing the active ingredient ipratropium bromide, a short-acting anticholinergic (SAMA). It is used to treat COPD and as an add-on therapy for asthma.
Unlike Spiriva (tiotropium), Atrovent works for only 4-6 hours and therefore has to be inhaled several times a day. It is particularly useful in combination with beta-2 agonists such as salbutamol.
Atrovent is available as a metered-dose inhaler and as a solution for nebulizers.
Active Ingredients & Mechanism of Action
Active ingredient: Ipratropiumbromid
Ipratropium blocks muscarinic receptors in the bronchi:
Mechanism of action:
- Competitively inhibits muscarinic receptors
- Blocks the effect of acetylcholine
- The bronchial muscles relax
- Reduces mucus secretion
Time course:
- Onset of action: 15-30 minutes
- Peak effect: 1-2 hours
- Duration of action: 4-6 hours
Difference from salbutamol: Ipratropium works more slowly, but complements beta-2 agonists.
Who is it suitable for?
Atrovent is suitable for:
- COPD treatment
- Asthma as an add-on therapy
- Combination with beta-2 agonists
- Patients who do not tolerate beta-2 agonists
Advantages:
- Well tolerated
- Few cardiac side effects
- Complementary effect to salbutamol
Limitations:
- Not as the sole asthma therapy
- Slower onset of action than salbutamol
- Needed several times a day
Available Dosages
Metered-dose inhaler:
- 20 µg per puff
- 2 puffs 3-4x daily
- Maximum: 12 puffs per day
Inhalation solution (nebulizer):
- 250-500 µg 3-4x daily
- Dilute for use in a nebulizer
Combination product Berodual: Ipratropium + fenoterol – commonly used fixed-dose combination
Dosage form and pack sizes
The medicines catalogue lists one pack variant: one strength in one pack size.
- Dosage form
- Dosieraerosol
- Strengths
- 20 µg
- Pack sizes
- 200 Hübe
| Strength | Pack | PZN | Duration |
|---|---|---|---|
| 20 µg | 200 Hübe | 02200996 | 25 days |
Packs listed in the German medicines catalogue. Which of them are currently available and what they cost is shown in the price overview.
The Pharmazentralnummer (PZN) is the nationwide unique identifier of a pack in Germany.
Duration is the catalogue value for the usual dosage. How long a pack actually lasts depends on the dose your doctor prescribes.
How to Take
Metered-dose inhaler: 1. Remove the protective cap, shake 2. Breathe out deeply 3. Close your lips around the mouthpiece 4. Breathe in slowly and spray at the same time 5. Hold your breath for 10 seconds 6. For a second puff, wait 30 seconds
Nebulizer:
- Put the solution into the nebulizer chamber
- Dilute with 0.9% NaCl
- Inhale for 5-15 minutes
Important:
- Do not spray into the eyes (risk of a glaucoma attack)
- When combined with salbutamol: first salbutamol, then Atrovent
Contraindications
Do not use in case of:
- Hypersensitivity to ipratropium or atropine
Use with caution in case of:
- Narrow-angle glaucoma or a predisposition to it
- Prostatic hyperplasia
- Bladder neck obstruction
- Cystic fibrosis (increased tendency to gastrointestinal motility disorders)
Pregnancy: Can be used if there is an appropriate indication.
Breastfeeding: It is not known whether it passes into breast milk. Use with caution.
Possible Side Effects
Common:
- Dry mouth
- Headache
- Cough
- Nausea
Uncommon:
- Blurred vision
- Urinary retention
- Constipation
- Heart rhythm disorders
Rare:
- Glaucoma attack (with eye contact)
- Allergic reactions
- Paradoxical bronchospasm
Caution: In case of accidental eye contact, rinse immediately with water!
Interactions
Synergistic effect with:
- Beta-2 agonists (desired)
- Theophylline
Caution with:
- Other anticholinergics
- MAO inhibitors
No relevant interaction with:
- Inhaled corticosteroids
- Most oral medications
Frequently Asked Questions
The two work differently and complement each other. Salbutamol works faster (1-5 min). The two are often combined (e.g. Berodual).
Ipratropium can dilate the pupil and increase the pressure inside the eye. If the chamber angle is narrow, this can trigger a glaucoma attack. In case of eye contact, rinse immediately with water!
Atrovent can be used for asthma in addition to other medications. In severe asthma attacks, it is often nebulized together with salbutamol.
Similar Medications
Is Atrovent right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.