Indication:

1. As a bronchodilator for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease, including chronic bronchitis and emphysema.

2. Can be used in chronic treatment of patients with reversible airway obstruction who fail to respond to nebulized beta-sympathomimetic agents.

Dosage & Administration:

Adults (including elderly): The usual dosage of Ipratropium bromide inhalation solution is 100-500 mcg administered three to four times a day by oral nebulization, with doses six to eight hours apart. It can be given up to 4-hrly by nebulization either alone or as an adjuvant in acute reversible airway obstruction. It can be mixed in the nebulizer with Salbutamol if used within an hour.

Children: The dose recommended in asthmatic children is 100-500 mcg up to three times a day via nebulizer for the treatment of acute severe asthma. 1 month-3 year: 62.5 – 250 mcg up to three times daily. 3-14 years: 100 – 250 mcg three times daily.

Safety and effectiveness in the population below the age of 12 years have not been established.

Dilution of solution is adjusted according to equipment and length of administration. If dilution is necessary, only sterile 0.9% sodium chloride should be used. As paradoxical bronchospasm has occurred, first dose should be inhaled under strict medical supervision.

Preparation:

Phial containing 20 ml. solution of 0.025% w/v of Ipratropium bromide (250 mcg/ml.).