Ipratropium bromide for asthma

Name of medicine

Ipratropium bromide

Brand names: Atrovent, Inhalvent

Why is it important for my child to take Iptratropium bromide?

Ipratropium bromide belongs to a group of medicines called bronchodilators. It relaxes the muscles in the lungs and makes the airways wider, making it easier to breathe. It is usually taken regularly to help prevent asthma attacks. Sometimes it is recommended as an alternative to salbutamol as a reliever (for use during an asthma attack).

What is Iptratropium bromide available as?

CFC-free inhaler:20 microgram per dose (puff)

When should I give Iptratropium bromide

Iptratropium bromide is usually given three or four times a day.

• Three times a day: This should be in the morning, early afternoon and at bedtime. Ideally, these times are at least 6 hours apart, for example 8am, 2pm and 8pm.
• Four times a day: This is usually first thing in the morning, at about midday, late in the afternoon and at bedtime. Ideally, these times should be at least 4 hours apart, for example 8am, midday, 4pm and 8pm.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of medicine (the dose) that is right for your child. The dose will be shown on the medicine label and in your asthma plan.

How should I give Iptratropium bromide?

Inhaler

Ipratropium bromide is given by inhaler. Your doctor or asthma nurse will show you and your child how to use the inhaler and spacer device. Details on how to use inhalers can be found on our website. Video on how to use inhalers can be found on the Asthma + Lung website (details at end of leaflet).

When should the medicine start working?

Ipratropium bromide needs to be given regularly to help prevent asthma and wheeze. It does not work straight away but your child should start to wheeze less and to need less reliever medicine (blue inhaler) within a week after starting treatment.

Continue to give the medicine as told to by your doctor or nurse, even if your child does not have any wheeze or symptoms of asthma, as it helps prevent symptoms.

If your child’s asthma does not seem to be getting any better and they still need to use their reliever medicine often, contact your doctor or nurse.

If your child has been given ipratropium to use as a reliever during an asthma attack it can take longer to work than salbutamol.

What if my child is sick (vomits)?

You do not need to worry if your child is sick, as the medicine will still work.

What if I forget to give it?

If you usually give it three or four times a day: You do not need to give the missed dose. Give the next dose as normal.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Iptratropium bromide by mistake. If you are concerned that you may have given too much, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).

Because ipratropium is inhaled, very little gets into the rest of the body, so side-effects are unlikely.

Side effects you must do something about

Other side-effects you need to know about

Your child may get the following side-effects when taking Iptratropium bromide.

• • Your child may get a dry mouth. Eating citrus fruits (e.g. oranges) and taking sips of water may help.

• Your child may get stomach ache and feel sick (nausea) or constipated (difficulty doing a poo). Encourage them to drink plenty of fluid and to eat foods that contain fibre (e.g. wholemeal foods, fruit and vegetables). If this is still a problem after 2 weeks, contact your doctor.

• They may have a cough, headache or feel dizzy.

Children sometimes get other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard.

More information on side-effects can be found in a leaflet on our website.

Can other medicines be given at the same time as Iptratropium bromide?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Iptratropium bromide should not be taken with some medicines that you get on prescription. It is important to tell your doctor and pharmacist about any other medicines your child is taking before starting Iptratropium bromide.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

It is important to keep track of how many puffs of inhaler your child has used, because the medicine will run out before the gas (propellant) that drives the medicine into the airways. This means that they may not be getting any medicine. Information on how to keep track can be found on our website here). Some inhalers have counters which show when they are no longer usable.

 Take old inhalers to your local pharmacy – do not put them in the household waste or recycling because they may contain gases that are harmful to the environment.

General advice about medicines

• Try to give medicines at about the same times each day, to help you remember.

• If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• If you think someone else may have taken the medicine by accident, contact your doctor or NHS local services (details at end of leaflet) for advice.

• Make sure that the medicines you have at home have not reached the ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by January 2028.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.