ipratropium intranasal (Rx)

Brand and Other Names:Atrovent Nasal Spray
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray

  • 0.03%
  • 0.06%

Perennial Allergic/Nonallergic Rhinitis

Nasal spray (0.03%): 2 sprays (21 mcg/spray) per nostril q8-12hr; not to exceed 168-252 mcg/day

Seasonal allergic rhinitis: 2 sprays (0.06%) per nostril q6hr

Symptomatic relief of rhinorrhea (Common Cold)

Nasal spray (0.06%): 2 sprays (0.42 mcg/spray) per nostril q6hr; no to exceed 672 mcg/day

Seasonal Allergic Rhinitis

Nasal spray (0.06%): 2 sprays (0.42 mcg/spray) per nostril q6hr; no to exceed 672 mcg/day

Dosing Considerations

In treatment of allergic rhinitis, do not use for >3 weeks

Dosage Forms & Strengths

nasal spray

  • 0.03%
  • 0.06%

Symptomatic Relief of Rhinorrhea (Colds)

<5 years: Safety & efficacy not established

5-12 years: 2 sprays (0.06%) in each nostril q8hr

>12 years: 2 sprays (0.06%) in each nostril q6-8hr

Allergic/nonallergic rhinitis

<6 years: Safety & efficacy not established

>6 years: 2 sprays (0.03%) per nostril q8-12hr

Seasonal Allergic Rhinitis

< 5 years: Safety & efficacy not established

> 5 years: 2 sprays (0.06%) per nostril q6hr

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Adverse Effects

1-10%

Headache (9.8%)

URI (9.8%)

Epistaxis (9%)

Pharyngitis (8.1%)

Nasal dryness/irritation/congestion (5.1%)

Taste perversion (4%)

Nausea (2.2%)

Xerostomia (1-4%)

Diarrhea (2%)

Nausea (2%)

Nasal congestion (1%)

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Warnings

Contraindications

Hypersensitivity

Cautions

Use caution in patients with narrow angle glaucoma, hepatic impairment, renal impairment, and BPH or bladder neck obstruction

Contact with eye can cause burning

May cause dizziness, accomodation disorder, mydriasis and blurred vision; caution patients about performing tasks that require mental alertness, including operating a heavy machinery

Immediate hypersensitivity reactions reported; discontinue use immediately if it occurs

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Pregnancy & Lactation

Pregnancy Category: B

Lactation: Unknown whether distributed in breast milk

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Anticholinergic bronchodilator

Inhibits serous and seromucous gland secretions

Inhibits vagally mediated reflexes by antagonizing effects of acetylcholine

Pharmacokinetics

Half-life: 1.6 hr

Excretion: Urine

Absorption: < 20%

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Images

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.