Atrovent Inhalation Solution

What Atrovent Inhalation Solution is used for

Atrovent Inhalation Solution is used to open up the air passages in people with asthma and chronic obstructive bronchitis. It may also be used in other conditions where breathing is difficult such as may occur after surgery or during assisted ventilation.

Atrovent belongs to a group of medicines called anticholinergic bronchodilators. These medicines work by relaxing and opening up the airways, allowing more air to the lungs. It begins to act quickly It begins to act quickly after use but may take up to 2 hours to give maximum benefit.

It is for relief of symptoms and should be part of a management program that is prescribed by your doctor.

Your doctor may have prescribed Atrovent Inhalation Solution for another reason. Ask your doctor if you have any questions about why Atrovent Inhalation Solution has been prescribed for you.

Atrovent Inhalation Solution is available only with a doctor's prescription.

There is no evidence that Atrovent Inhalation Solution is addictive.

Before you use Atrovent Inhalation Solution

When you must not use it

Do not use Atrovent Inhalation Solution if you are allergic to:

  • ipratropium bromide
  • similar medicines which contain atropine or medicines like atropine
  • any of the ingredients listed at the end of this leaflet

Some of the symptoms of an allergic reaction may include:

  • rash, itching or hives on the skin
  • swelling of the face, lips, tongue or other parts of the body
  • shortness of breath, wheezing or troubled breathing.

Never give it to someone else even if their symptoms seem to be the same as yours.

Do not use Atrovent Inhalation Solution after the EXPIRY DATE on the bottle or carton.

If you take this medicine after the expiry date has passed, it may not work as well.

Do not use Atrovent Inhalation Solution if the packaging is torn or shows signs of tampering.

If you are not sure whether you should start using Atrovent Inhalation Solution, contact your doctor or pharmacist.

Before you use it

Tell your doctor or pharmacist if you have allergies to:

  • any other medicines
  • any other substances, such as foods, preservatives or dyes

Tell your doctor or pharmacist if you are pregnant or intend to become pregnant.

Care is recommended during pregnancy, particularly in the first three months.Your doctor or pharmacist will discuss the possible risks and benefits of using Atrovent Inhalation Solution during pregnancy.

Tell your doctor or pharmacist if you are breast-feeding or plan to breast-feed.

Your doctor or pharmacist will discuss the possible risks and benefits of using Atrovent Inhalation Solution during breastfeeding.

Tell your doctor or pharmacist if you have or have had any of the following medical conditions:

  • glaucoma (high pressure in the eye)
  • difficulty or pain when passing urine
  • constipation
  • cystic fibrosis.

If you have not told your doctor or pharmacist about any of the above, tell them before you start using Atrovent Inhalation Solution

Tell your doctor if you have or have had a hyperreactive airway.

This is because 2 ingredients of Atrovent Inhalation Solution, benzalkonium chloride and disodium edetate, have caused breathing difficulties in some patients with hyperreactive airways.

Your doctor needs to know this in order to assess the suitability of Atrovent Inhalation Solution for you.

Using other medicines

Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Atrovent Inhalation Solution may interfere with each other. Your doctor and pharmacist may have more information on medicines to be careful with or avoid while using Atrovent Inhalation Solution.

Atrovent Inhalation Solution may be used with other medicines that relax the air passages for additional symptom relief, when prescribed by a doctor.

Check with your doctor or pharmacist before mixing other nebuliser solutions with Atrovent Inhalation Solution.

This is because some nebuliser solutions may not mix well with Atrovent Inhalation Solution and may need to be nebulised separately.

How to use Atrovent Inhalation Solution

You will find instructions on how to use Atrovent Inhalation Solution at the end of this leaflet

Children should only use Atrovent Inhalation Solution on medical advice and with the help of an adult.

You must make sure that a nebuliser mask is properly fitted to your nose and mouth or your child's nose and mouth before nebulising and inhaling Atrovent Inhalation Solution.

Fit the nebuliser mask properly to your nose and mouth or your child's nose and mouth to prevent the mist from contacting the eyes.

If you are not sure how to use a nebuliser mask, ask your doctor or pharmacist

If you find it difficult to breathe in and use your nebulising mask at the same time, talk to your doctor or pharmacist. They may be able to recommend another method.

Never let the Atrovent inhalation solution or mist enter in or around your eyes. Should this occur, immediately flush your eyes with cold tap water for several minutes.

How much to use

The usual doses for adults and children are stated below.

For Adults:

  • 1 to 2 mLs, diluted to 2-3 mLs with normal saline and nebulised until the entire volume of solution is inhaled 4 times daily.

For children:

1 mL, diluted to 2-3 mLs with normal saline and nebulised until the entire volume of solution is inhaled 4 times daily.

Your doctor will decide the right dose for you. Depending on your condition and specific needs, your doctor may advise you to take a different dose.

When to use it

If your doctor has advised you to use Atrovent Inhalation Solution regularly, then use it at about the same time each day.

Using it at the same time each day will help you remember when to use it.

If you forget to use it

If you forget to use your Atrovent Inhalation Solution, use it as soon as you remember, and then go back to using your medicine as you would normally.

If it is almost time for your next dose, skip the dose you missed and use your next dose when you are meant to.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to use your medicine, ask your pharmacist for some hints.

How long to use it

Atrovent Inhalation Solution helps control your condition, but does not cure it. Therefore you must continue using the medicine for as long as your doctor or pharmacist tells you.

Do not stop using it unless your doctor or pharmacist tells you to even if you feel better.

If you take too much (overdose)

Telephone your doctor or pharmacist or the Poisons Information Centre (telephone 13 11 26) if you think that you or anyone else may have used too much Atrovent Inhalation Solution. Do this even if there are no signs of discomfort or poisoning.

You may need urgent medical attention.

If you use too much Atrovent Inhalation Solution, you may have a fast or irregular heart beat, dry mouth or blurred vision.

While you are using Atrovent Inhalation Solution

Things you must do

Tell your doctor or pharmacist immediately if:

your breathing suddenly becomes more difficult after using Atrovent Inhalation Solution.
This may be a sign of an allergic reaction.
you develop eye pain or discomfort, or any disturbances with your sight (blurred vision, visual halos or coloured images).
This may mean that you have developed a serious eye condition called narrow-angle glaucoma. This can happen if the mist gets in your eyes.

If you find that the usual dose of Atrovent Inhalation Solution is not giving as much relief as before, or you need to use it more often, contact your doctor so that your condition can be checked.

This is important to ensure your breathing problem is controlled properly.

If you have Asthma Action Plan that you have agreed with your doctor, follow it closely at all times.

Continue using Atrovent Inhalation Solution for as long as your doctor or pharmacist tells you.

Visit your doctor regularly to check on your asthma condition.

Tell any other doctors, dentists, and pharmacists who are treating you that you are using Atrovent Inhalation Solution.

If you are about to start any new medicine, tell your doctor or pharmacist that you are using Atrovent Inhalation Solution.

If you plan to have surgery (which requires a general anaesthetic), tell your doctor or dentist that you are using Atrovent Inhalation Solution.

If you become pregnant while using Atrovent Inhalation Solution tell your doctor or pharmacist.

Things you must not do

Do not take any other medicines for your breathing problems without checking with your doctor.

Do not give Atrovent Inhalation Solution to anyone else, even if they have the same condition as you.

Do not use Atrovent Inhalation Solution to treat any other complaints unless your doctor or pharmacist tells you to.

Do not stop using Atrovent Inhalation Solution or lower the dosage, without checking with your doctor or pharmacist.

Things to be careful of

Be careful driving or operating machinery until you know how Atrovent Inhalation Solution affects you.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using Atrovent Inhalation Solution.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor or pharmacist to answer any questions you may have.

If you get any side effects, do not stop using the Atrovent without first talking to your doctor or pharmacist.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • headache
  • dizziness
  • dry mouth
  • vomiting
  • a change in bowel movements (eg constipation, diarrhoea)
  • throat irritation, cough.

These are the more common side effects of Atrovent Inhalation Solution. Mostly these are mild and short lived.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at the nearest hospital:

  • difficulty breathing or worsening of your breathing problems
  • fast or irregular heart beat
  • pounding heart beat
  • symptoms of allergic reactions such as rash, itching or hives on the skin; swelling of the face, lips, tongue or other parts of the body; shortness of breath, wheezing or troubled breathing.
  • if it is accidentally sprayed into the eye, you may get eye problems such as increased pressure in the eye, painful, stinging and dilated pupils, blurred vision, see colours of lights.You may be developing glaucoma, which will need treatment straight away.

These are serious side effects. You may need urgent medical attention or hospitalisation.

Other side effects not listed above may occur in some patients. Tell your doctor or pharmacist if you notice anything else that is making you feel unwell. .

Do not be alarmed by this list of possible side effects.

You may not experience any of them.

After using Atrovent Inhalation Solution

Storage

Keep your Atrovent Inhalation Solution in a cool, dry place where the temperature stays below 30°C.

Do not store Atrovent Inhalation Solution or any other medicine in the bathroom or near a sink.

Do not leave it in the car on hot days or on window sills.

Heat and dampness can destroy some medicines.

Keep it where children cannot reach it.

A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop using Atrovent Inhalation Solution or it has passed its expiry date, ask your pharmacist what to do with any that is left over.

Product Description

What it looks like

Atrovent Inhalation Solution is a clear, colourless solution, supplied in bottles which contain 20 mL of solution.

Ingredients

Each mL of Atrovent Inhalation Solution contains 261 micrograms of ipratropium bromide [equivalent to 250 micrograms of ipratropium bromide (anhydrous)] as the active ingredient.

Other ingredients:

  • sodium chloride,
  • benzalkonium chloride,
  • disodium edetate,
  • hydrochloric acid,
  • purified water.

Atrovent Inhalation Solution does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.

Manufacturer

Atrovent Inhalation Solution is made in Italy and supplied in Australia by:

Boehringer Ingelheim Pty Limited

(ABN 52 000 452 308)

78 Waterloo Road

NORTH RYDE NSW 2113

Australian Registration Number:

AUST R 39953

This leaflet was revised in September 2010

® = registered trademark

© Boehringer Ingelheim Pty Limited 2010

Atrovent® Inhalation Solution

Ipratropium bromide

Directions For Use

Atrovent Inhalation Solution is intended for inhalation with suitable nebulising equipment and must not be swallowed.

Diluted solutions should be freshly prepared before use.

At the end of inhalation, leftover solution from the nebuliser bowl should be discarded.

Take the following steps in using Atrovent Inhalation Solution and if you have any problems, ask your doctor or pharmacist for assistance.

1. Get your nebuliser ready by following the manufacturer's instructions and the advice of your doctor.

2. If the Atrovent Inhalation Solution bottle is new, write the FIRST date of use on the bottle label. There is a space on the label next to "Date opened:" for you to fill in a date. Writing this date on the bottle label is important because Atrovent Inhalation Solution should not be used if the bottle has been opened for more than 28 days.

After this period, a new Atrovent Inhalation Solution bottle should be used.

3. If the Atrovent Inhalation Solution bottle has been used before, check the date on the bottle label to make sure that the bottle has not been opened for more than 28 days.

After this period, a new Atrovent Inhalation Solution bottle should be used.

4. Place the prescribed number of drops into the nebuliser bowl.

The dropper insert on top of the bottle delivers 1mL of Atrovent Inhalation Solution per 20 drops. Each 1 mL of Atrovent Inhalation Solution contains 261 micrograms of ipratropium bromide [equivalent to 250 micrograms of ipratropium bromide (anhydrous)].
To make the dropper function, tap lightly on the bottom of the bottle.

5. If dilution is necessary this should be carried out using normal saline and as instructed by your doctor.

6. Assemble the nebuliser and use it as directed by your doctor.

7. After nebulisation follow the manufacturer's instructions about cleaning your nebuliser.