SAMA (short-acting muscarinic antagonist)
Ipratropium bromide
Brand names: Atrovent, Rinatec
Adult dose
Dose: Inhaled MDI: 20–40 micrograms TDS-QDS. Nebulised: 250–500 micrograms QDS. Nasal (Rinatec): 21 micrograms each nostril BD-TDS
Route: Inhaled/Nebulised/Nasal
Frequency: QDS
Clinical pearls
- Acute COPD/asthma exacerbations alongside SABA
- Combination with salbutamol nebulised in severe asthma
- Eye protection during nebulisation in glaucoma
Contraindications
- Hypersensitivity
Side effects
- Dry mouth
- Tachycardia
- Headache
- Glaucoma (esp. nebulised splashing eyes — use mask correctly)
- Urinary retention
Interactions
- Other antimuscarinics
Reference: BNF; BTS/SIGN; NICE NG115; https://bnf.nice.org.uk/drugs/ipratropium-bromide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Cervical Cerclage Criteria (Short Cervix / Preterm Risk) · Preterm Labour
- Brief Pain Inventory — Short Form (BPI-SF) · Pain
- Montreal Cognitive — Short Screening for Substance Misuse · Substance Misuse Screening
- Short Michigan Alcoholism Screening Test (SMAST) · Alcohol Use
- Short Michigan Alcoholism Screening Test — Geriatric Version (SMAST-G) · Alcohol Use
- ICIQ-UI Short Form (Urinary Incontinence) · Incontinence
Pathways
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024