Table 16

Ipratropium nasal

Ipratropium nasal
What is it?Antimuscarinic
Mechanism of actionAntisecretory with bronchodilator properties
Starting dose41 μg (two sprays) 6–8 hourly prn
Time to onset of effect15–30 min17
FormulationNasal spray
Bronchial secretions
Respiratory secretions
Common adverse effectsDizziness; dry mouth; headache; urinary disorders; vision disorders; vomiting; tachycardia; GI dysmotility; oropharyngeal irritation; bronchoconstriction16
ContraindicationsTachycardia >100
Cardiac conduction disorders16
CautionNarrow angle glaucoma
Bladder outflow obstruction
Cystic fibrosis
Licence‘off label’ use of licensed product
BenefitsEasy to use
RisksIt is unknown whether sufficient systemic absorption is achieved via the intranasal route to improve bronchial and respiratory secretions
Cost£6.54 for 180×21 μg/dose nasal spray