Ipratropium bromide aerosol

1. Ipratropium bromide can inhibit the vagus nerve-induced bronchoconstriction reflex. Ipratropium bromide inhibits the release of mediators that mediate bronchospasm by reducing cyclic guanosine monophosphate in mast cells (mast cell stabilization effect). 2. The bronchodilator effect of inhaled this product is caused by the anticholinergic effect of local drugs on bronchial smooth muscle, not a systemic effect. 3. A 90-day observation study was conducted on patients with bronchospasm related to chronic obstructive pulmonary disease (chronic bronchitis and emphysema). Significant improvement in lung function (FEV1 and FEF25-75% increased by 15% or more) occurred 15 minutes after treatment, reaching a peak after 1-2 hours, and its sustained effect can last up to 6 hours for most patients.

The main ingredient is ipratropium bromide monohydrate.

1. This product is suitable for the prevention and treatment of dyspnea associated with chronic obstructive airway disease; 2. Chronic obstructive bronchitis with or without emphysema; 3. Mild to moderate bronchial asthma.

1. Dosage (1) Unless otherwise prescribed by a doctor, the following dosage is generally recommended for adults and children over 6 years old: Prevention and long-term treatment: (2) 1-2 presses, several times a day; (3) Average daily dose 1-2 presses, 3-4 times a day. (4) The above dosage is also applicable to children under 6 years old. However, there is no sufficient experience with medication for this age group, so Atrovent metered dose inhaler can only be used under the supervision of a doctor. (5) If the patient needs to gradually increase the dose, it should be confirmed whether other combined treatments are needed. At the same time, the total daily dose should not exceed 12 presses. 2. Important Notes If drug treatment does not produce significant improvement or causes the patient's condition to worsen, you should see a doctor to change the treatment plan. If acute or rapidly worsening dyspnea occurs, you should see a doctor immediately. Additional treatment with corticosteroids, beta-sympathomimetic drugs or theophylline may be required. For acute or rapidly worsening dyspnea, seek medical attention immediately. In such cases, treatment with Atrovent 250 micrograms/2 ml inhalation solution or Atrovent 500 micrograms/2 ml inhalation solution should be considered. 3. Usage (1) The metered dose inhaler must be used correctly to achieve a good therapeutic effect. (2) Atrovent metered dose inhaler can only be used for inhalation. (3) It is best for the patient to sit or stand when inhaling. (4) Before using the metered dose inhaler for the first time, the aerosol valve should be pressed twice. (5) The following rules must be followed each time it is used: 1.1 Remove the dust cover; 1.2 Exhale deeply; 1.3 Hold the metered dose inhaler and bite the nozzle with your lips closed. The arrow on the base of the container should point upwards and the nozzle should point downwards; 1.4 Inhale as deeply as possible and press the base of the aerosol hard at the same time to release a dose. Hold your breath for a few seconds, then remove the nozzle from your mouth and exhale slowly; 1.5. Re-screw the dust cover after use. 1.6 Care should be taken to ensure that the inhaler does not spray into the eyes. Children need to use this product under adult supervision. 4. Other information 4.1 If the pressure metered-dose inhaler is not used for more than 3 days, the valve should be pressed once before using it again. 4.2 The nozzle should be kept clean to ensure its normal operation. Clean it regularly as follows: Move the nozzle down from the spray and clean it with warm water. If soap or detergent is used, the nozzle should be thoroughly rinsed with clean hot water. 4.3 Dry the nozzle thoroughly by shaking it. Do not dry it in any form of heating. 4.4 It is easy to keep the nozzle clean if you do not breathe deeply into the nozzle. 4.5 The spray should not be opened forcefully or exposed to temperatures above 50°C. 5. Important: The nozzle is specially developed and designed for the Atrovent metered-dose inhaler to ensure that the correct dose is released each time, so it cannot be used for any other metered-dose inhaler. Similarly, other nozzles except the provided nozzles cannot be used for the Atrovent metered-dose inhaler. The residual dose in the metered-dose inhaler can be tested by the following method: remove the nozzle of the spray and place the spray in a container filled with water. The position of the spray will show how much residual dose there is.

Like all medicines, Atrovent Metered-Dose Inhaler may also produce adverse reactions. Adverse reactions are listed below according to systematic classification and frequency of occurrence. Adverse reactions are evaluated by using the following incidence rates: 1. Very common: more than 1 case in 10 patients treated; 2. Common: less than 1 case in 10 patients treated, but more than 1 case in 100 patients treated; 3. Uncommon: less than 1 case in 100 patients treated, but more than 1 case in 1000 patients treated; 4. Rare: less than 1 case in 1000 patients treated, but more than 1 case in 10,000 patients treated; 5. Very rare: less than 1 case in 10,000 patients treated, or refers to individual cases. Adverse reactions 1. Immune system disorders: Uncommon: urticaria Rare: Allergic reactions such as angioedema of the tongue, lips and face 2. Nervous system disorders: Common: Headache, dizziness 3. Functional abnormalities of the eyes: Uncommon: Accommodative disorders, angle-closure glaucoma Rare: Increased intraocular pressure, eye pain, mydriasis If the drug accidentally enters the eye due to improper use, it may cause mild, reversible eye complications and lead to acute glaucoma in some susceptible individuals. For patients with diagnosed angle-closure glaucoma, if ipratropium bromide spray and beta;2-agonists are used at the same time, the risk of acute glaucoma may be increased. Eye pain or discomfort associated with conjunctival congestion and corneal edema, blurred vision, irises or colored images may be signs of acute glaucoma. If necessary, mydriasis can be used to treat pupil dilation or mild accommodation disorders. However, if serious eye complications occur, patients should consult an ophthalmologist. 4. Functional abnormalities of the heart: Uncommon: increased heart rate Rare: palpitations, supraventricular tachycardia, atrial fibrillation 5. Functional abnormalities of the respiratory system: Common: cough, local irritation, inhalation-related bronchospasm Rare: laryngospasm 6. Gastrointestinal abnormalities: Common: dry mouth, gastrointestinal motility disorders (such as constipation, diarrhea, abdominal pain, vomiting) Rare: nausea Gastrointestinal motility disorders are particularly common in patients with cystic fibrosis. Usually, motility returns to normal after treatment is interrupted. 7. Skin and skin appendages discomfort: Uncommon: rash, pruritus 8. Kidney and genitourinary tract abnormalities: Rare: urinary retention 9. Effects on the ability to drive and operate machines If the drug is used according to the instructions, there are no special restrictions.

1. Ipratropium metered-dose inhaler is contraindicated for patients who are allergic to ipratropium bromide, or any of its other components, as well as atropine or its derivatives. 2. Ipratropium. Metered-dose inhalers should be used with caution in patients with angle-closure glaucoma, and special care should be taken to ensure that the drug does not come into contact with the eyes (see [Adverse Reactions] and [Usage and Dosage]). 3. For patients with urination difficulties such as prostatic hyperplasia, the potential benefits of treatment with ipratropium bromide should be weighed, and it should only be used when the benefits far outweigh the risk of increased urinary retention. Pregnancy and breast-feeding 4. Although there is no evidence to date that the drug has any harmful effects on the fetus, Ipratropium metered-dose inhaler should not be used during pregnancy, especially in early pregnancy, or during breast-feeding, unless the expected benefits outweigh any possible harm to the fetus. 5. The risks associated with inadequate treatment should also be considered. There is no experience with its use in pregnant and breast-feeding women.

Precautions for children: See Dosage and Administration. Precautions for pregnancy and lactation: 1. The safety of medication during pregnancy has not been confirmed. 2. The benefits of medication and the harm to the fetus must be carefully weighed when using this product for women who are confirmed to be pregnant or suspected of being pregnant. Preclinical studies have shown that when the inhalation method or nasal administration dose is higher than the recommended dose for humans, no fetal toxicity or teratogenicity is shown. 3. It is not clear whether this product will enter breast milk. Although non-fat-soluble quaternary ammonium can enter breast milk when administered by inhalation, the amount of drug that enters the baby's body will not be large. However, because many drugs can enter breast milk, lactating women should also pay special attention when using this product. Precautions for the elderly: No special precautions.

1. The use of beta-adrenergic stimulants or xanthine preparations (such as theophylline) can enhance the effect of this product. 2. If other anticholinergic drugs, such as pirenzepine-containing preparations, are used at the same time, the therapeutic effect and adverse reactions of Atrovent Metered-dose Aerosol will be more significant.

Store below 30°C. The spray should not be opened forcefully, or exposed to direct sunlight, or at temperatures exceeding 50°C, or frozen.

20 micrograms/press

36 months