Composition and release form
| Solution for inhalation | 1 ml |
| ipratropium bromide | 0.25 mg |
in dropper bottles of 20 ml (1 ml = 20 drops); 1 bottle in a box.
| Aerosol for inhalation dosed | 1 dose |
| ipratropium bromide | 0.021 mg |
| (corresponding to 0.02 mg ipratropium bromide anhydrous) | |
| propellant: 1,1,1,2-tetrafluoroethane (HFA 134a) | |
| excipients: anhydrous citric acid; distilled water; ethanol |
in aerosol cans with a mouthpiece of 10 ml (200 doses); There is 1 cylinder in the box.
pharmachologic effect
Pharmacological action: bronchodilator.
Ipratropium bromide is a quaternary ammonium compound. Has anticholinergic properties. Inhibits the reflexes of the vagus nerve, being a competitive antagonist of the neurotransmitter acetylcholine. Blocks muscarinic receptors of the smooth muscles of the tracheobronchial tree and suppresses reflex bronchoconstriction. Bronchial dilatation during inhalation is due mainly to the local rather than systemic anticholinergic effect of the drug. Effectively prevents the narrowing of the bronchi that occurs as a result of inhalation of cigarette smoke, cold air, the action of various bronchospasms, and also inhibits bronchospasm associated with the influence of the vagus nerves. When used in inhalation, it has virtually no resorptive effect - for the development of tachycardia, about 500 doses must be inhaled, with only 10% reaching the small bronchi and alveoli, and the rest settles in the pharynx or oral cavity and is swallowed.
Clinical pharmacology
In patients with bronchospasm associated with chronic obstructive pulmonary disease (chronic bronchitis and emphysema), significant improvement in lung function (increase in forced expiratory volume in 1 s - FEV1 and average forced expiratory volume flow rate 25-75% increased by 15% or more) observed after 15 minutes, the maximum effect is achieved after 1–2 hours and lasts in most patients up to 6 hours.
In patients with bronchospasm associated with bronchial asthma, a significant improvement in lung function (an increase in FEV1 by 15% or more) is observed in 40% of patients.
ATROVENT N
Directions for use and doses
Dosing should be done individually.
During treatment, patients must be under medical supervision. The recommended daily dose should not be exceeded during either acute or maintenance therapy. If treatment does not lead to significant improvement or the patient’s condition worsens, a doctor’s consultation is necessary to develop a new treatment plan. If shortness of breath (difficulty breathing) suddenly or rapidly worsens, consult your doctor immediately. The following dosages are recommended (unless a different dosage regimen is prescribed): Adults and children over 6 years of age:
2 inhalation doses (injection) 4 times a day. Since the need for increasing doses indicates the possible need for additional treatment methods, as a rule, more than 12 inhalation doses should not be used per day.
For the treatment of sudden exacerbations of chronic obstructive pulmonary disease, ATROVENT® inhalation solution may be indicated.
In children, ATROVENTA® N metered dose aerosol should only be used
after consulting a doctor and under adult supervision (due to insufficient information).
Using a metered aerosol
Correct application is essential for successful therapy.
Before first use
Before using the inhaler for the first time, press the bottom of the canister 2 times.
Before each use
The following rules must be observed:
1. Remove the protective cap.
2. Take a deep breath.
3. Hold the inhaler as shown in Fig. 1 and wrap your lips tightly around the mouthpiece. The arrow and the bottom of the cylinder should be directed upward.
4. Take as deep a breath as possible and at the same time sharply press the bottom of the cylinder. This will release one inhalation dose. Hold your breath for a few seconds, then remove the mouthpiece from your mouth and exhale. Repeat the same steps to receive the second inhalation dose.
5. After using the inhaler, put on the protective cap.
6. If the metered dose aerosol inhaler is not used for three days, press the valve once before using it.
The container is not transparent, so it is impossible to determine by eye when it becomes empty. The inhaler contains 200 inhalation doses. After all doses have been used, the container may still seem to contain a small amount of liquid. However, in such cases the inhaler must be replaced, as it may contain an insufficient amount of the drug.
The amount of drug in your inhaler can be checked in the following way:
- Shake the container, this will show whether there is any liquid left in it.
- Another way. Remove the plastic mouthpiece from the balloon and place the balloon in a container of water. The contents of the cylinder can be estimated depending on its position in the water (Fig. 2).
Clean your inhaler at least once a week. It is important to keep the mouthpiece of the inhaler clean to prevent any drug from getting into it, which could block the release of the aerosol.
When cleaning, first remove the protective cap and remove the canister from the inhaler. Run a stream of warm water through the inhaler, ensuring that the drug and/or visible dirt is removed (Fig. 3).
After cleaning, shake the inhaler and allow it to air dry without using heat. Once the mouthpiece is dry, insert the balloon into the inhaler and put on the protective cap (Fig. 4).
WARNINGS:
The plastic mouthpiece was designed specifically for the use of metered-dose aerosol ATROVENTA® N, and serves for precise dosing of this drug. This mouthpiece should not be used with other metered dose aerosols. ATROVENT® N metered dose aerosol should also not be used with other mouthpieces. The aerosol in the container is under pressure. The cylinder must not be opened or stored at temperatures above 50°C.
Side effects
The most common undesirable effects are headache, nausea, and dry mouth.
Due to the low systemic absorption of the drug, side effects associated with systemic anticholinergic effects, such as tachycardia, palpitations, accommodation disturbances, decreased secretion of sweat glands, impaired gastrointestinal motility, urinary retention, are rare and reversible. However, patients with obstructive urinary tract diseases have an increased risk of developing urinary retention.
As with other inhalation therapy, incl. bronchodilators, sometimes there is a cough, less often - paradoxical bronchospasm.
In rare cases, allergic reactions may develop, incl. urticaria, angioedema, rash, oropharyngeal edema and anaphylaxis.
There are isolated reports of eye complications (pupil dilation, increased intraocular pressure, angle-closure glaucoma, eye pain) when ipratropium bromide aerosol or ipratropium bromide aerosol combined with beta2-agonists gets into the eyes. Patients should be able to use metered dose aerosol correctly.
Atrovent N 20 mcg/dose 200 doses aerosol for inhalation dosed
Release form
Aerosol.
Package
20 ml - 200 doses.
pharmachologic effect
Ipratropium bromide is a quaternary ammonium compound. Has anticholinergic properties. Inhibits the reflexes of the vagus nerve, being a competitive antagonist of the neurotransmitter acetylcholine. Blocks muscarinic receptors of the smooth muscles of the tracheobronchial tree and suppresses reflex bronchoconstriction. Bronchial dilatation during inhalation is due mainly to the local rather than systemic anticholinergic effect of the drug. Effectively prevents the narrowing of the bronchi that occurs as a result of inhalation of cigarette smoke, cold air, the action of various bronchospasms, and also inhibits bronchospasm associated with the influence of the vagus nerves. When used in inhalation, it has virtually no resorptive effect - for the development of tachycardia, about 500 doses must be inhaled, with only 10% reaching the small bronchi and alveoli, and the rest settles in the pharynx or oral cavity and is swallowed.
In patients with bronchospasm associated with chronic obstructive pulmonary disease (chronic bronchitis and emphysema), significant improvement in lung function (increase in forced expiratory volume in 1 s - FEV1 and average forced expiratory volume flow rate 25-75% increased by 15% or more) observed after 15 minutes, the maximum effect is achieved after 1–2 hours and lasts in most patients up to 6 hours.
In patients with bronchospasm associated with bronchial asthma, a significant improvement in lung function (an increase in FEV1 by 15% or more) is observed in 40% of patients.
Indications
Chronic obstructive pulmonary disease (chronic obstructive bronchitis, pulmonary emphysema).
Bronchial asthma (moderate and mild severity), especially with concomitant diseases of the cardiovascular system.
Contraindications
Hypersensitivity to atropine and its derivatives, and other components of the drug.
Pregnancy (1st trimester).
Children's age up to 6 years.
Use during pregnancy and breastfeeding
Contraindicated in the first trimester of pregnancy; the drug can be prescribed in the second-third trimester of pregnancy and during breastfeeding only if the expected effect of therapy exceeds the potential risk to the fetus or child.
special instructions
It is not recommended for emergency relief of an attack of suffocation (the bronchodilator effect develops later than that of beta-agonists).
Patients with cystic fibrosis have an increased likelihood of developing slow gastrointestinal motility.
Patients should be able to correctly use Atrovent N metered aerosol for inhalation.
When using a freon-free form of a metered-dose aerosol for the first time, patients may note that the taste of the new drug is somewhat different from the previous dosage form of the drug containing freon. When switching from one form of the drug to another, patients should be warned about a possible change in the taste properties of the drug. It should be communicated that these drugs are interchangeable and that taste is not relevant to the safety and effectiveness of the new drug.
The 0.025% solution for inhalation contains the preservative benzalkonium chloride and the stabilizer ethylenediaminetetraacetic acid. There are reports that these substances, when prescribed in large doses, can cause bronchospasm in some patients.
It is not recommended to exceed the established daily dose, both for short-term and long-term use of the drug.
Carefully
The drug should be used in patients with angle-closure glaucoma and urinary disorders due to benign prostatic hyperplasia.
If the drug accidentally gets into the eyes of a patient with angle-closure glaucoma, intraocular pressure may increase.
Eye pain or discomfort, blurred vision, the appearance of a halo and colored spots before the eyes in combination with conjunctival and corneal hyperemia can be symptoms of an attack of narrow-angle glaucoma. If any of these symptoms occur, you should prescribe drops that cause pupil constriction and consult an ophthalmologist without delay.
If the patient's condition worsens or there is no significant improvement, a doctor's consultation is necessary to determine a further treatment plan. In case of sudden and rapid increase in shortness of breath (difficulty breathing), you should immediately consult a doctor.
Children should be prescribed Atrovent N dosed aerosol only after the recommendation of a doctor and under the supervision of adults.
Compound
1 dose contains:
Active substance: ipratropium bromide - 0.021 mg (corresponding to 0.02 mg ipratropium bromide anhydrous).
Propellant: 1,1,1,2-tetrafluoroethane (HFA 134a).
Excipients: anhydrous citric acid; distilled water; ethanol
Directions for use and doses
Inhalation.
Dosed aerosol for inhalation: adults and children over 6 years old - 2 doses of aerosol 4 times a day, if necessary, the dose can be increased to 12 inhalations per day.
Side effects
The most common undesirable effects are headache, nausea, and dry mouth.
Due to the low systemic absorption of the drug, side effects associated with systemic anticholinergic effects, such as tachycardia, palpitations, accommodation disturbances, decreased secretion of sweat glands, impaired gastrointestinal motility, urinary retention, are rare and reversible. However, patients with obstructive urinary tract diseases have an increased risk of developing urinary retention.
As with other inhalation therapy, incl. bronchodilators, sometimes there is a cough, less often - paradoxical bronchospasm.
In rare cases, allergic reactions may develop, incl. urticaria, angioedema, rash, oropharyngeal edema and anaphylaxis.
There are isolated reports of eye complications (pupil dilation, increased intraocular pressure, angle-closure glaucoma, eye pain) when ipratropium bromide aerosol or ipratropium bromide aerosol combined with beta2-agonists gets into the eyes. Patients should be able to use metered dose aerosol correctly.
Drug interactions
Potentiates the bronchodilator effect of beta-agonists and xanthine derivatives. Strengthens the anticholinergic effect of other drugs.
Overdose
Symptoms:
no specific symptoms of overdose have been identified. Minor manifestations of systemic anticholinergic action are possible, such as dry mouth, impaired accommodation, and increased heart rate.
Treatment:
symptomatic.
Storage conditions
In a place protected from light, at a temperature not exceeding 25 °C.
Keep out of the reach of children.
Directions for use and doses
Inhalation.
Solution for inhalation: adults and children over 12 years old - 0.5 mg (40 drops) 3-4 times a day through a nebulizer; children 6–12 years old - 0.25 mg (20 drops) 3–4 times a day via nebulizer; children under 6 years old - 0.1–0.25 mg (8–20 drops) 3–4 times a day (under medical supervision). The recommended dose is diluted with saline immediately before use to a volume of 3–4 ml. The dose depends on the method of inhalation and the quality of the spray. If necessary, repeated inhalations are carried out at intervals of at least 2 hours.
Dosed aerosol for inhalation: adults and children over 6 years old - 2 doses of aerosol 4 times a day, if necessary, the dose can be increased to 12 inhalations per day.
Buy Atrovent N aerosol for inhalation 20mcg/dose 200 doses 10ml in pharmacies
Atrovent N Buy Atrovent N in pharmacies DOSAGE FORMS aerosol for inhalation 20mcg/dose 200dz aerosol for inhalation dosed 20mcg/dose 200dz
MANUFACTURERS Boehringer Ingelheim (Germany) Boehringer Ingelheim Pharma GmbH and Co.KG (Germany)
GROUP Bronchodilators - m-anticholinergics
COMPOSITION Active substance: Iptratropium bromide.
INTERNATIONAL NON-PROPENTED NAME Ipratropium bromide
SYNONYMS Atrovent, Ipravent, Ipratropium Steri-Neb, Itrop
PHARMACOLOGICAL ACTION Bronchodilating, antispasmodic. Blocks m-cholinergic receptors of the smooth muscles of the tracheobronchial tree. Having structural similarity to the acetylcholine molecule, it is its competitive antagonist. As a derivative of quaternary nitrogen, it is slightly soluble in fats and diffuses poorly through biological membranes. Has low bioavailability. It is practically not absorbed in the gastrointestinal tract and is excreted in feces. The bronchodilator effect develops 5-10 minutes after inhalation and lasts for 5-6 hours. It dilates mainly large and medium-sized bronchi, reduces the secretion of bronchial mucus.
INDICATIONS FOR USE Chronic obstructive bronchitis, bronchial asthma, hyperproduction of sputum, broncho-obstruction due to colds.
CONTRAINDICATIONS Hypersensitivity.
SIDE EFFECTS From the respiratory system: cough, very rarely - paradoxical bronchospasm. Allergic reactions: rash, urticaria. Other: dry mouth, headache, nausea, impaired accommodation (if it gets into the eyes). From the respiratory system: dry mouth.
INTERACTION Enhances the bronchodilator effect of beta-agonists and xanthine derivatives. Strengthens the anticholinergic effect of other drugs.
METHOD OF APPLICATION AND DOSAGE Inhalation. Adults and school-age children - 2 doses of aerosol 4 times a day; if necessary, the dose can be increased to 12 inhalations per day (no more). Solution for inhalation: adults and children over 14 years of age 0.1 - 0.5 mg (8 - 40 drops) 3-4 times a day through a nebulizer; children 6-14 years old 0.1 - 0.25 mg (8 - 20 drops) 3-4 times a day via nebulizer; children under 6 years old - 0.1-0.25 mg (8-20 drops) 3-4 times a day (under medical supervision). The recommended dose is diluted with saline immediately before use to a volume of 3-4 ml. The dose depends on the method of inhalation and the quality of the spray. If necessary, repeated inhalations are carried out at intervals of at least 2 hours.
OVERDOSE No specific symptoms of overdose have been identified. Minor manifestations of systemic anticholinergic action are possible, such as dry mouth, impaired accommodation, and increased heart rate. Treatment is symptomatic.
SPECIAL INSTRUCTIONS Restrictions on use: angle-closure glaucoma, urinary disorders due to prostate hypertrophy, breastfeeding, pregnancy.
STORAGE CONDITIONS List B. In a place protected from light, at a temperature not exceeding 25 degrees. WITH.
Precautionary measures
The 0.025% solution for inhalation contains the preservative benzalkonium chloride and the stabilizer ethylenediaminetetraacetic acid. There are reports that these substances, when prescribed in large doses, can cause bronchospasm in some patients.
It is not recommended to exceed the established daily dose, both for short-term and long-term use of the drug.
The drug should be used with caution in patients with angle-closure glaucoma and urinary disorders due to benign prostatic hyperplasia.
If the drug accidentally gets into the eyes of a patient with angle-closure glaucoma, intraocular pressure may increase.
Eye pain or discomfort, blurred vision, the appearance of a halo and colored spots before the eyes in combination with conjunctival and corneal hyperemia can be symptoms of an attack of narrow-angle glaucoma. If any of these symptoms occur, you should prescribe drops that cause pupil constriction and consult an ophthalmologist without delay.
If the patient's condition worsens or there is no significant improvement, a doctor's consultation is necessary to determine a further treatment plan. In case of sudden and rapid increase in shortness of breath (difficulty breathing), you should immediately consult a doctor.
Children should be prescribed Atrovent N dosed aerosol only after the recommendation of a doctor and under the supervision of adults.
Atrovent® N
Dosing should be done individually. During treatment, patients must be under medical supervision. The recommended daily dose should not be exceeded during either acute or maintenance therapy. If treatment does not lead to significant improvement or the patient’s condition worsens, a doctor’s consultation is necessary to develop a new treatment plan. If shortness of breath (difficulty breathing) suddenly or rapidly worsens, consult your doctor immediately. The following dosages are recommended (unless another dosage regimen is prescribed):
Adults and children over 6 years of age:
2 inhalation doses (injection) 4 times a day. Since the need for increasing doses indicates the possible need for additional treatment methods, as a rule, more than 12 inhalation doses should not be used per day.
For the treatment of sudden exacerbations of chronic obstructive pulmonary disease, ATROVENT inhalation solution may be indicated.
In children, ATROVENT N metered dose aerosol should only be used
after consulting a doctor and under adult supervision (due to insufficient information).
Using a metered aerosol
Correct application is essential for successful therapy.
Before first use
Before using the inhaler for the first time, press the bottom of the canister 2 times.
Before each use, the following rules must be observed:
1. Remove the protective cap.
2. Take a deep breath.
3. Hold the inhaler as shown in Fig. 1 and wrap your lips tightly around the mouthpiece. The arrow and the bottom of the cylinder should be directed upward.
4. Take as deep a breath as possible and at the same time sharply press the bottom of the cylinder. This will release one inhalation dose. Hold your breath for a few seconds, then remove the mouthpiece from your mouth and exhale. Repeat the same steps to receive the second inhalation dose.
5. After using the inhaler, put on the protective cap.
6. If the metered dose aerosol inhaler is not used for three days, press the valve once before using it.
The container is not transparent, so it is impossible to determine by eye when it becomes empty. The inhaler contains 200 inhalation doses. After all doses have been used, the container may still seem to contain a small amount of liquid. However, in such cases the inhaler must be replaced, as it may contain an insufficient amount of the drug.
The amount of drug in your inhaler can be checked in the following way:
- Shake the container, this will show whether there is any liquid left in it.
- Another way. Remove the plastic mouthpiece from the balloon and place the balloon in a container of water. The contents of the cylinder can be estimated depending on its position in the water (Fig. 2).
Clean your inhaler at least once a week. It is important to keep the mouthpiece of the inhaler clean to prevent any drug from getting into it, which could block the release of the aerosol.
When cleaning, first remove the protective cap and remove the canister from the inhaler. Run a stream of warm water through the inhaler, ensuring that the drug and/or visible dirt is removed (Fig. 3).
After cleaning, shake the inhaler and allow it to air dry without using heat. Once the mouthpiece is dry, insert the balloon into the inhaler and put on the protective cap (Fig. 4).
WARNINGS:
The plastic mouthpiece was designed specifically for the use of metered-dose aerosol ATROVENT N, and serves for precise dosing of this drug. This mouthpiece should not be used with other metered dose aerosols. You should also not use ATROVENT N metered dose aerosol with other mouthpieces. The aerosol in the container is under pressure. The can cannot be opened or stored at temperatures above 50°C.
special instructions
It is not recommended for emergency relief of an attack of suffocation (the bronchodilator effect develops later than that of beta-agonists).
Patients with cystic fibrosis have an increased likelihood of developing slow gastrointestinal motility.
Patients should be able to correctly use Atrovent N metered aerosol for inhalation.
When using a freon-free form of a metered-dose aerosol for the first time, patients may note that the taste of the new drug is somewhat different from the previous dosage form of the drug containing freon. When switching from one form of the drug to another, patients should be warned about a possible change in the taste properties of the drug. It should be communicated that these drugs are interchangeable and that taste is not relevant to the safety and effectiveness of the new drug.
