Ipratropium or ipratropium bromide is a drug to relieve and prevent symptoms due to narrowing of the airways (bronchospasm ) , such as wheezing or shortness of breath, due to chronic obstructive pulmonary disease (COPD ). 

Ipratropium belongs to the class of drugs known as bronchodilators. This drug works by relaxing the muscles in the respiratory tract, so that air can flow more smoothly and sufferers can breathe more easily.

This drug can also be used to relieve the symptoms of a severe asthma attack when combined with a fast- acting beta 2 agonist drug   , such as salbutamol.

Trademarks of ipratropium:  Atrovent, Combivent , Ipratropium Bromide, Midatro

What is Ipratropium


Prescription drug


Anticholinergic bronchodilators


Relieve complaints and prevent the appearance of symptoms of narrowing of the respiratory tract due to COPD

Consumed by

Adults and children

Ipratropium for pregnant and lactating women

Category B:  Animal studies have not demonstrated a risk to the fetus, but there are no controlled studies in pregnant women.

Ipratropium is not known whether it can be absorbed into breast milk or not. If you are breastfeeding, do not use this medicine without consulting your doctor first.

Drug form

Solutions for inhalation (inhalation) and aerosols ( inhalers )

Precautions Before Using Ipratropium

Ipratropium should not be used carelessly. The following are things you need to pay attention to before using ipratropium:

  • Do not use ipratropium if you are allergic to this drug. Tell your doctor if you have ever had an allergy after using a similar drug, such as tiotropium.
  • Tell your doctor if you have had or currently have glaucoma , bladder obstruction, enlarged prostate , myasthenia gravis , or cystic fibrosis .
  • Tell your doctor if you are pregnant, planning a pregnancy, or are breastfeeding.
  • Do not drive a vehicle or do activities that require alertness while being treated with ipratropium, because this drug can cause dizziness and blurred vision.
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • Tell your doctor that you are using ipratropium if you are having surgery, including dental surgery.
  • See your doctor immediately if you have an allergic drug reaction , serious side effects, or overdose after using ipratropium.

Dosage and Rules for Use Ipratropium

Ipratropium will be given by the doctor. The dosage will be adjusted according to the dosage form of the drug and the patient's age. In general, the following is the dose of ipratropium to relieve symptoms of narrowing of the airways or bronchospasm:

Aerosol form ( inhaler )

  • Adults and children >12 years: 20–40 mcg 3–4 times daily
  • Children 6–12 years: 20–40 mcg 3 times daily
  • Children < 6 years: 20 mcg 3 times daily

Form a solution for inhalation with a nebulizer

  • Adults and children > 12 years: 250–500 mcg 3–4 times daily
  • Children 6–12 years: 250 mcg, repeat dose up to a maximum of 1,000 mcg or 1 mg per day
  • Children < 6 years: 125–250 mcg, 4 times daily, up to a maximum of 1,000 mcg or 1 mg per day

In patients with chronic obstructive pulmonary disease (COPD) with symptoms of severe bronchospasm, the doctor will give ipratropium in the form of an inhalation solution using a nebulizer, which is a tool to change the drug solution into vapor form and will be inhaled using a special mask.

How to Use Ipratropium Properly

Follow  the doctor 's recommendations and read the information printed on the drug packaging before using ipratropium. Do not increase or decrease your dose without consulting your doctor first.

To use ipratropium aerosol (inhaler), open the safety lock of the inhaler package. Exhale first before inhaling from the inhaler. Place the inhaler muzzle in your mouth. Close your lips tightly, then take a deep breath. Do not bite the inhaler spout.

After inhaling from the inhaler, hold your breath for 10 seconds and repeat the previous steps if advised by your doctor. Don't forget to close the inhaler again with the safety lock, then rinse your mouth with clean water.

If you are using ipratropium inhalation solution with a nebulizer, follow the instructions given by your doctor and make sure you understand how to use the nebulizer device and how to clean it properly to prevent infection.

Take ipratropium at around the same times each day. If you forget to use it, use ipratropium immediately if the next scheduled use interval is not too close. If it's close, ignore it and don't double the dose.

During the use of ipratropium, patients are advised to stop smoking. This is because smoking can inhibit the performance of drugs by triggering irritation to the lungs and exacerbating respiratory problems.

Store ipratropium at room temperature and in a closed container, so that it is not exposed to direct sunlight. Keep this drug out of reach of children.

Interactions of Ipratropium with Other Drugs

Inter-drug interactions that can occur when using ipratropium together with other drugs are:

  • Increased effectiveness and bronchodilator effects of ipratropium when used with beta-agonist drugs, such as salbutamol, or xanthine-derived drugs, such as aminophylline
  • Increased toxic effects of ipratropium when used with  glucagon
  • Increased risk of impaired bowel movement when used with pramlintide
  • Increased risk of side effects, such as drowsiness, blurred vision, or dry mouth when used with revefenacin

Ipratropium Side Effects and Dangers

The following are side effects that may appear after using ipratropium:

  • Flu symptoms, such as a  stuffy nose , sneezing, or sore throat
  • Dizziness or headache
  • Nauseous
  • Stomach ache
  • Dry mouth
  • Constipation or constipation

Check with your doctor if the side effects above don't go away. Immediately see a doctor if a drug allergic reaction appears which can be characterized by certain symptoms, such as an itchy and swollen rash, swollen eyes and lips, or difficulty breathing.

In addition, you should also see a doctor immediately if you experience more serious side effects, such as:

  • Changes in voice, for example becoming hoarse
  • Blurred vision
  • Heartbeat feels fast
  • Pain when urinating
  • Pain, swelling, or redness of the eye
  • Chest pain


Back to blog