Atrovent 20micrograms / dose inhaler CFC free (Boehringer Ingelheim Ltd) 200 dose

Type Pressurised aerosol inhaler (MDI)
Medicine Ipratropium bromide 20micrograms/dose
Activation mechanism Non breath actuated
Dose counter No dose counter
Price £0.83 / 30 days
(based on 1 puffs / day)
Licences
  • Adult Asthma Licence
  • Adolescent Asthma Licence age range not available
  • Paediatric Asthma Licence age range not available
  • COPD Licence

Spacers

There are 49 compatible spacers

Training material

Pathways

The use of each medicine included in Right Breathe has been considered in relation to international, national, and regional prescribing pathways. The pathway points at which this medicine is considered a viable prescribing option are included below. If you wish to view the entire pathway, click on its heading, from where you can also access all the prescribing options for each pathway and each pathway point.

Prescribing

Detailed prescribing information is provided below. This content has not been generated by the RightBreathe team, but has been integrated from a 3rd party solution: Multilex (provided by FirstDataBank). Use of this prescribing content is subject to the FirstDataBank disclaimer, which is set out in the "About" section of RightBreathe.

As RightBreathe is a bespoke decision support tool, it covers each and every individual known inhaler option on the UK market to a high level of specificity. Multilex, as a more general resource, does not offer the same level of specificity. There are therefore a small number of medicines for which there are discrepancies between RightBreathe and Multilex content, most notably in relation to licensed particulars and associated licensed doses.

Given the high level of specificity the RightBreathe team work to, details of the individual inhaler licence are most likely to be summarised accurately in the content provided at the top of this page, rather than in the Multilex content below. Where there is ambiguity, users may also wish to refer to individual summaries of product characteristics prior to prescribing.

Dosing

Chronic obstructive airways disease (with reversible element)

Type Age Range Dose Licensed
Maintenance From 12 years to 18 years 1 actuation - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 actuation - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 1 month to 6 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 6 years to 12 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 1 actuation - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 actuation - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 6 years to 12 years 1 to 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 1 to 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 to 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 2 actuations - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 2 actuations - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 6 years to 12 years 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device

Chronic asthma

Type Age Range Dose Licensed
Maintenance From 12 years to 18 years 1 actuation - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 actuation - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 1 month to 6 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 6 years to 12 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 actuation - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 1 actuation - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 actuation - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 6 years to 12 years 1 to 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 1 to 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 1 to 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 2 actuations - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 2 actuations - FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 6 years to 12 years 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 2 actuations - THREE times a DAY - inhalation - using a metered dose device
Maintenance From 12 years to 18 years 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device
Maintenance From 18 years 2 actuations - THREE to FOUR times a DAY - inhalation - using a metered dose device

Safety Advice Warnings

Advice concerning formulation

  • Not all available brands are licensed for all age groups

Advice on Administration

  • Avoid contact with eyes

Discontinue due to test or exam

  • Discontinue if paradoxical bronchospasm occurs

Patient Counselling

  • Advise ability to drive/operate machinery may be affected by side effects
  • Advise patient dizziness may affect ability to drive or operate machinery
  • Advise patient that CFC-free inhalers may have different taste or sensation
  • Advise patient to contact their doctor if dyspnoea rapidly worsens
  • Advise patient to report any blurred vision or any other eye symptoms
  • Ensure patient has a fast acting bronchodilator available
  • Patient should seek medical advice if usual relief is diminished

Recommended monitoring

  • Check patient is using correct inhaler technique

Drug Interactions

With Risk Severity
METHACHOLINE Methacholine effect reduced; review dosing, see product literature Significant Risk: Usually avoid combination. Use combination only under special circumstances, taking any necessary action to reduce risk.
AMANTADINE Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
ANTIHISTAMINES - SEDATIVE Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CODEINE Antimuscarinic side effects may be increased/risk of paralytic ileus Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
CYCLIZINE (IN COMBINATION WITH STRONG OPIOIDS) Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
DISOPYRAMIDE Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
MAOIS Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
NEFOPAM Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
TRICYCLIC ANTIDEPRESSANTS Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
TRICYCLIC ANTIDEPRESSANTS AND PHENOTHIAZINES (COMBINED PRODUCT) Antimuscarinic side effects may be increased Moderate Risk: Minimise risk. Take action necessary to reduce risk. Counsel patient.
(OXYPERTINE) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
(REMOXIPRIDE) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
(TRIFLUPERIDOL) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
(ZOTEPINE) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
AMISULPRIDE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ARIPIPRAZOLE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
BENPERIDOL Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
CLOZAPINE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
DROPERIDOL Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
FLUSPIRILENE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
HALOPERIDOL Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LOXAPINE (INHALED) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
LOXAPINE (ORAL) Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
MEMANTINE effect may be increased by Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
OLANZAPINE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PALIPERIDONE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PHENOTHIAZINES Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
PIMOZIDE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
QUETIAPINE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
SERTINDOLE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
SULPIRIDE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.
ZIPRASIDONE Antimuscarinic side effects may be increased Low Risk: No action needed. Risk of adverse outcomes appears small and depends upon the condition of the patient. Counsel patient.

Precautions

  • Benign prostatic hyperplasia
  • Bladder outflow obstruction
  • Breastfeeding
  • Cystic fibrosis
  • Narrow angle glaucoma
  • Predisposition to narrow angle glaucoma
  • Pregnancy

Contraindications

  • None known

Side Effects

  • Anaphylactic reaction
  • Angioedema of tongue, lips and face
  • Atrial fibrillation
  • Blurred vision
  • Bronchospasm
  • Bronchospasm (paradoxical)
  • Conjunctival hyperaemia
  • Constipation
  • Corneal oedema
  • Cough
  • Diarrhoea
  • Disturbances in accommodation
  • Dizziness
  • Dry mouth
  • Dry throat
  • Gastro-intestinal motility disturbances
  • Headache
  • Hypersensitivity reactions
  • Increased intra-ocular pressure
  • Laryngospasm
  • Local irritation of throat and nose
  • Mydriasis
  • Narrow angle glaucoma
  • Nausea
  • Ocular pain
  • Oropharyngeal oedema
  • Palpitations
  • Pruritus
  • Rash
  • Stomatitis
  • Supraventricular tachycardia
  • Tachycardia
  • Taste disturbances
  • Urinary retention
  • Urticaria
  • Visual haloes
  • Vomiting