Ipratropium belongs to the family of medications called anticholinergics. Ipratropium nasal spray comes in two strengths that are used for different purposes. The 0.03% strength is used to relieve a runny nose caused by seasonal or perennial (year-round) allergies. The 0.06% strength is used to treat a runny nose caused by the common cold.

The medication works by stopping mucus glands in the nose from overproducing the watery mucus that leads to a runny nose. Ipratropium nasal spray begins to work within 15 minutes.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The recommended dose of ipratropium nasal spray for runny nose due to allergies is 2 sprays (0.03% strength) in each nostril 2 or 3 times per day.

The recommended dose for runny nose due to the common cold is 2 sprays (0.06% strength) in each nostril 3 or 4 times per day as needed. This medication has only been studied for up to 4 days of use for the common cold. Efficacy and safety of treatment beyond 4 days have not been established.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Before using this medication for the first time, the pump must be primed. To do this, remove the cap and safety clip. Then, hold the bottle with your thumb at the base and your index and middle fingers on the shoulder area of the pump. Point the bottle upright and away from your eyes. Press your thumb firmly and quickly against the bottle 7 times. You will need to reprime the pump with 1 or 2 sprays if you have not used it for 24 hours.

To use this medication:

• Blow your nose gently to clear your nostrils if needed.
• Remove the cap and safety clip.
• Close one nostril by gently placing your finger against the side of your nose, tilt your head slightly forward, and keeping the bottle the upright, insert the nasal tip into the other nostril. Point the tip toward the back and outer side of the nose.
• Press firmly and quickly upwards with the thumb at the base while holding the shoulder portion of the pump between your index and middle fingers. Following each spray, sniff deeply and breathe out through your mouth.
• After spraying the nostril and removing the pump, tilt your head backwards for a few seconds to let the spray spread over the back of the nose.
• Repeat steps 3 through 5 in the other nostril.
• Replace the cap and safety clip.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double a dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from excessive heat and freezing, and keep it out of the reach of children.

0.03%
Each spray (0.07 mL) is a clear, colourless solution and contains 21 µg of ipratropium bromide. Nonmedicinal ingredients: benzalkonium chloride, edetate disodium, hydrochloric acid, purified water, sodium chloride, and sodium hydroxide.

Do not use this medication if you:

• are allergic to ipratropium or any ingredients of the medication
• are allergic to atropine or medications related to atropine

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• diarrhea
• dizziness
• dry mouth
• dry nose
• dry throat
• headache
• nasal discomfort
• nasal irritation
• nausea
• nosebleed
• sore throat
• throat irritation
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• difficult or painful urination
• eye pain
• fast or irregular heartbeat
• increased wheezing or tightness in the chest
• skin rash
• vision changes (e.g., blurred vision, halos, dilated pupils)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of an allergic reaction (e.g., hives; difficulty breathing; swelling of lips, face, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Cystic Fibrosis: People with cystic fibrosis (CF) may find that using this medication causes constipation. If you have CF, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Eyes: Avoid spraying ipratropium nasal spray in or around the eyes. If this happens, immediately flush your eyes with cool tap water for several minutes. If you get this medication in your eyes, you may experience blurred vision and increased sensitivity to light, which may last for a few hours. If these eye symptoms persist for more than a few hours or if you experience other eye symptoms (e.g., seeing halos, eye pain), contact your doctor.

Glaucoma: This medication may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking this medication.

Medical conditions: People with cystic fibrosis, glaucoma, enlarged prostate, or problems with urination should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Urinary Tract Problems: This medication may cause the symptoms of some urinary tract problems to become worse. People with a bladder blockage or men with an enlarged prostate, as well as anyone who has difficulty starting to urinate may find that this symptom becomes worse when using ipratropium. If you have any urinary tract problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if ipratropium nasal spray passes into breast milk. If you are breast-feeding and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.

There may be an interaction between ipratropium nasal spray and any of the following:

• acetylcholinesterase inhibitors (e.g., donepezil, galantamine, neostigmine, rivastigmine)
• aclidinium
• amantadine
• antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• atropine
• belladonna
• benztropine
• botulinum toxin
• buprenorphine
• cannabis
• chloral hydrate
• cyclobenzaprine
• darifenacin
• diuretics (e.g., chlorthalidone, hydrochlorothiazide, indapamide)
• disopyramide
• domperidone
• fesoterodine
• flavoxate
• glucagon
• glycopyrrolate
• ipratropium inhaled orally
• ketotifen
• metoclopramide
• mirabegron
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
• other nasal sprays, especially those containing corticosteroids (e.g., beclomethasone, budesonide, fluticasone)
• orphenadrine
• oxybutynin
• pizotifen
• potassium chloride
• propiverine
• prucalopride
• scopolamine
• tiotropium
• tolterodine
• topiramate
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• umeclidinium
• trihexyphenidyl
• trospium

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.