Atrovent Inhaler

Atrovent is a pressurised metered dose inhaler (pMDI) used by those with asthma. It is also used to treat chronic obstructive pulmonary disease (COPD).

It contains the active ingredient ipratropium bromide, which is known as an antimuscarinic bronchodilator. These medicines reduce inflammation and relax the muscles in the airways to prevent asthma attacks. Ipratropium bromide can also be used in a nebuliser in higher doses to treat sudden and severe asthma symptoms.

Atrovent is available as a CFC-free inhaler also known as a HFA inhaler. It is a type of inhaler that is better for the environment. This inhaler has been found to be safe and effective for the treatment of asthma and COPD.

Ipratropium bromide is a short-acting muscarinic antagonist (SAMA). These work by opening up the breathing tubes to your lungs, allowing air to travel through them more freely.

Ipratropium bromide reverses the action of certain chemicals that cause inflammation and mucus production, thereby unblocking the airways. This will relieve symptoms of asthma like wheezing, shortness of breath and a tight chest.

Atrovent should not be used for sudden breathing problems. Your doctor may give you another medicine to use for this.

Components

Atrovent is a pressurised metered dose inhaler (pMDI). When you press down on the inhaler, the medicine is released from the pressurised canister and a mist is released through the mouthpiece.

Testing your inhaler

You will first need to check if your inhaler is working. To do this, test-fire it into the air twice before using it for the first time. Also do this if you have not used your inhaler for three days or more.

Instructions for use

Follow these instructions on how to use your Atrovent inhaler.

How to use an Atrovent inhaler

Remove the cap from the mouthpiece

Hold the inhaler with the arrow pointing upwards and breathe out gently

Put the mouthpiece in your mouth and hold it in your lips

Press the top of the inhaler firmly while breathing in through your mouth

Hold your breath for 10 seconds, then breathe out slowly

If you are having more than one puff, wait at least 1 minute before taking your next one. Then repeat steps 2 to 5.

If you find it difficult to press your inhaler and breathe in at the same time, you can ask your doctor about using a spacer. The medicine will be sprayed into the spacer and held there until you breathe it in.

When should I take it?

Atrovent should be used as your doctor instructs, so directions may differ from person to person. The usual dose of 2 puffs 4 times a day should be taken as follows unless directed otherwise:

1. In the morning when you first wake up
2. At midday
3. In the early evening
4. At night before you go to bed

You should be using your inhaler in a way that feels comfortable and natural. Talk with your doctor to come up with a dosing schedule that works for you.

How long does it take for an Atrovent inhaler to work?

You should feel the effects of ipratropium bromide 15 to 30 minutes after using your inhaler. Consult your doctor if your breathing does not improve within this time. Daily use of your inhaler will cause your symptoms to decrease even more over time.

How long should I take it for?

Use Atrovent for as long as your doctor tells you. Atrovent is safe for long-term use and is considered a maintenance treatment. This medicine does not cure asthma, but rather relieves symptoms, making breathing easier.

What if I miss a dose?

If you miss a dose of Atrovent, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and continue treatment as normal.

Cleaning your inhaler

You must clean your mouthpiece at least once a week to maximise safety and effectiveness. Do this by following these instructions:

• Wash your inhaler’s mouthpiece with warm water for 30 seconds
• Shake off any excess water
• Leave it to air dry
• Once the mouthpiece is dry, replace both the canister and the green protective dust cap

Atrovent inhalers come with 200 measured doses. Each dose contains 20 mcg (micrograms) of ipratropium bromide.

The usual starting dose is 2 puffs, 4 times a day. However, your doctor may instruct you differently depending on the severity of your condition or any other individual circumstances.

What should I do in the case of an overdose?

If you use more Atrovent than your doctor has instructed, call your doctor immediately or go to accident and emergency at your nearest hospital. Do this even if you feel no symptoms.

Symptoms of an overdose may include:

• Fast or irregular heartbeat
• Dry mouth
• Blurred vision

If you experience any of these symptoms, seek emergency medical treatment.

Clearing your airways has benefits other than treating your asthma or COPD. Other benefits include the following:

• Makes exercise easier
• Can improve mood and mental wellbeing
• Makes daily tasks more achievable

Are inhalers the most effective form of treatment?

HFA inhalers have been found to be just as safe and effective as CFC inhalers for the treatment of COPD. Inhalers are the primary method of administering ipratropium bromide.

Ipratropium nasal spray is an effective treatment for rhinorrhoea (runny nose) but is not used for asthma or COPD.

Inhaling ipratropium bromide also reduces the chance of experiencing side effects. This is because the amount that is absorbed into the bloodstream through the lungs is much lower than with oral treatments.

Clinical trials have found Atrovent to be a highly effective treatment for COPD. One trial tested the FEV1 (forced expiratory volume) of men and women over 40 after taking ipratropium bromide and compared this to a placebo.

The average hourly improvement in adjusted mean FEV1 was 0.141 litres for the Atrovent group compared to just 0.014 litres for the placebo group.

This means that those using Atrovent have greatly improved pulmonary function on average compared to a placebo. This is especially true within the first hour after using your inhaler, with effects dropping off as time goes on.

How to maximise effectiveness

Here are a few tips from one of our doctors on how to maximise the effectiveness of your Atrovent inhaler:

• Prime your inhaler before you use it for the first time by test-firing it twice into the air. Also do this after you haven’t used your inhaler for three days or more
• Atrovent inhalers do not need to be shaken
• Breathe out fully before using your inhaler so your inhalation is deeper
• When you use your inhaler, keep your chin up and form a tight seal around the mouthpiece with your lips
• Breathe in strongly as you press down on your inhaler
• Hold your breath for 10 seconds after using your inhaler, then breathe out slowly

To get the most out of your Atrovent inhaler, make sure to prime it by spraying twice into the air before your first use and whenever you haven’t used it for three days or more. Before using your inhaler, breathe out completely to ensure a deeper inhalation. Keep your chin up, seal your lips around the mouthpiece, and take a strong breath in as you press the inhaler. Hold your breath for 10 seconds, then exhale slowly. These steps help ensure the medication works effectively.

You don’t necessarily need to make any changes to your lifestyle for the treatment. However, some things can be done to prevent worsening your condition.

Anti-inflammatory foods like fruits, vegetables and wholegrains can help to reduce the severity of your symptoms.

Silvia Fonda Nutritionist

Maintaining a healthy diet

What you eat also has an impact on the severity of the symptoms of inflammatory diseases like asthma. Research has specifically identified anti-inflammatory foods like fruits, vegetables, and wholegrains as foods that help asthma sufferers. On the other hand, foods high in saturated fat should be avoided.

Here is a helpful table describing which nutrients to include in your diet and what foods contain them:

Maintaining a healthy weight

Obesity has been linked to both increased incidence of asthma and increased severity of symptoms. Therefore, weight loss may help to alleviate some of your symptoms naturally.

Exercise

While intense exercise can be an asthma trigger for some people, regular physical activity is good for your health. Keep up with an exercise routine and you may find your condition easier to manage. Just make sure not to overdo it.

This study shows that yoga may help treat bronchial asthma symptoms. If you are unable to perform more high energy exercises like running or weight lifting, this could be a suitable alternative. However, more research into the effect of yoga in asthma sufferers is needed before definitive claims can be made.

You should start to notice your airways opening up 15-30 minutes after using your inhaler. Your airways should stay opened for 2-4 hours after each use, at which point it may be time to use it again. It is important to only use Atrovent as prescribed. If you feel a sudden and unexpected problem with your breathing, use your rescue inhaler.

During this time, you can also expect your mucus to clear up. However, Atrovent does not affect baseline mucus production in the long term. This means that when you stop using it, you will likely find your airways becoming congested again.

Atrovent is a maintenance treatment, meaning it is to be taken long-term to alleviate symptoms. Do not expect it to cure your asthma.

Who can use it?

euroClinix prescribes the treatment to those over the age of 18 with asthma or COPD who fill out a short online consultation form. Each person's individual case will be taken into account when choosing the right treatment.

Who should NOT use Atrovent

Those with an allergy to similar medicines

Those with an allergy to ipratropium

Those who are pregnant or breastfeeding

Do not use Atrovent if any of the following apply to you:

• You are allergic to ipratropium or any other ingredient found in Atrovent
• You are allergic to similar medicines that contain atropine or its derivatives
• You are pregnant, think you are pregnant, likely to get pregnant, or are breastfeeding

It can be difficult to determine the effect of pregnancy on the severity of asthma. According to this study, approximately 30% of women showed worse symptoms, 40% showed improved symptoms, and in 30% of pregnant women symptoms of asthma stayed the same. This means that depending on your individual circumstances, your treatment may change.

Check with your doctor before using Atrovent if any of the following apply to you:

• You have glaucoma, or you have been told you may develop it
• You have problems passing urine
• You are a man with prostate problems
• You have cystic fibrosis

Make sure you disclose this information in a consultation so a doctor can review if Atrovent is safe for you to take.

As with all prescription medication, there may be side effects when using this treatment.

Inhalation of ipratropium bromide is associated with fewer systemic side effects compared to other routes of administration, such as oral or intravenous, due to its localised action in the lungs.

Dr. Caroline Fontana Lead Prescribing Doctor

When should I contact my doctor?

Contact your doctor if you experience any of the following serious side effects. You may require urgent medical treatment.

• You have difficulty breathing after using Atrovent
• You experience an allergic reaction. This may include a skin rash and itching, or in severe cases, swelling of the mouth and face
• Palpitations, or quickening of the heart rate

Some drugs interact with Atrovent. If you are taking any other medication alongside it, you must tell your doctor. Here are some of the most notable ones:

• Clozapine: this medication can cause constipation. Using it alongside Atrovent increases the risk of developing intestinal obstructions.
• Levodopa: Atrovent may decrease the absorption of Levodopa.
• Other asthma and COPD medications: certain medications can increase the risk of glaucoma when taken with Atrovent, including:
  • Formoterol
  • Olodaterol
  • Indacaterol
  • Salbutamol
  • Salmeterol
• Other antimuscarinics: other antimuscarinic medications may increase the risk of side effects when taken with Atrovent. These include:
  • Baclofen
  • Aclidinium
  • Cyclizine
  • Doxepin
  • Loxapine

For a full list of all drugs that interact with Atrovent, use the drug interactions checker on drugs.com. You can also type in any medication you are taking and it will tell you if they interact.

Here is some safety advice for Atrovent use. Consult your doctor if there is anything else you are worried about when taking this medication.

For correct storage of this medicine, there are some things you should keep in mind.

Storage instructions

Do not store above 25°C. To ensure this, keep Atrovent away from direct sunlight and heat. You must also protect it from frost.

Since the canister contains a pressurised liquid, you must also take care not to expose it to temperatures above 50°C. Direct heat of this temperature will cause increased pressure inside the canister and may cause it to rupture or explode.

Keep your ipratropium inhaler away from the reach of children, and do not use it after the expiry date. You can find this on the carton and the canister label. The expiry date refers to the last day of the month.

Instructions for disposal

Any unused canisters must be taken to a pharmacy so they can be disposed of safely. The same goes for the inhalers, as they are unsuitable for household waste.

No, Atrovent can only be obtained with a prescription from a licensed healthcare provider. Proper use is crucial to your health and well-being.

Why is a prescription necessary?

• Ensures appropriate use for your specific condition.
• Prevents potential misuse and associated health risks.
• Allows monitoring for side effects and interactions with other medications.

Ordering Atrovent through euroClinix is simple and secure. Follow these steps:

1. Start your confidential online questionnaire from the top of this page. It takes about 5-10 minutes to complete.
2. A UK-registered doctor will review your consultation.
3. If approved, the doctor will write a prescription.
4. Your medication will be dispensed in discreet packaging from a licensed UK pharmacy, with next-day delivery and tracking information provided.

euroClinix offers ongoing support for any questions. Privacy and security are guaranteed through compliance with relevant regulatory standards and encrypted transactions.

Why should I choose euroClinix?

euroClinix is a trusted online clinic that offers services in several European countries. All consultations and prescriptions are handled by our UK-registered doctors.

The process is convenient with online consultations and discreet home delivery. Our friendly customer service team is always happy to assist with any questions related to our services.

The euroClinix platform is user-friendly for managing prescriptions and reorders securely.

Choosing euroClinix ensures a trusted, professional, and supportive service to treat asthma and COPD.

Some alternatives to Atrovent may be more suitable for you. Here is a helpful table listing the different inhalers that are used for the same purpose as Atrovent.

These examples are all used for the same reason as Atrovent, and so should not be used for fast-acting relief. For this, a rescue inhaler like Ventolin may be a more suitable option.

An alternative method of administration for severe asthma or COPD is a nebuliser. A nebuliser is a machine that can deliver high doses of asthma medication at one time. This is used for patients who have severe symptoms or are at risk of an asthma attack.

There are many alternatives to Atrovent and many reasons why they might be more suitable. For more in-depth information and to find out which inhaler is suitable for you, see our asthma treatment guide.

Does my choice of inhaler impact the environment?

HFA inhalers like Atrovent are better for the environment than inhalers using CFC, however, they still emit harmful greenhouse gases.

Even if they are CFC-free, pMDIs like Atrovent are still responsible for most greenhouse gas emissions from inhalers. Soft-mist inhalers (Spiriva respimat) and dry-powder inhalers (Bricanyl turbohaler) may be more suitable options if you want an inhaler better for the environment.