In the U.S.—

In Canada—

• Anticholinergic, nasal

Ipratropium (i-pra-TROE-pee-um) nasal spray is used to relieve runny nose (rhinorrhea).

The 0.03% nasal solution is used to relieve a runny nose associated with allergic and nonallergic perennial rhinitis. However, it does not relieve the nasal congestion, sneezing, or postnasal drip associated with allergic or nonallergic perennial rhinitis.

The 0.06% nasal solution is used for 4 days to relieve a runny nose associated with the common cold. However, it does not relieve the nasal congestion or sneezing associated with the common cold.

When this medicine is sprayed into your nose, it works by preventing the glands in your nose from producing large amounts of fluid.

Ipratropium is available only with your doctor's prescription, in the following dosage form:

Nasal
• Nasal solution (nasal spray) (U.S. and Canada)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ipratropium nasal spray, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to ipratropium, atropine, belladonna, hyoscyamine, or scopolamine, or to other nasal medicines.

Pregnancy—Ipratropium has not been studied in pregnant women. However, it has not been shown to cause birth defects in animal studies.

Breast-feeding—It is not known whether ipratropium nasal spray passes into the breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Although there is no specific information comparing the use of ipratropium nasal spray in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing the use of ipratropium nasal spray in the elderly with use in other age groups, this medicine is not expected to cause different side effects in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Bladder neck obstruction or
• Enlarged prostate—Ipratropium nasal may make the condition worse

• Glaucoma, angle-closure—If ipratropium nasal is sprayed into the eyes, it may make the condition worse

It is very important that you use ipratropium nasal spray only as directed . Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of side effects.

Keep the nasal spray away from your eyes. If the nasal spray gets in your eyes, immediately flush your eyes with cool tap water for several minutes. If you get the nasal spray in your eyes, you may experience an increased sensitivity to light (which may last a few hours), blurring of vision, or eye pain. If eye pain or blurred vision occurs, check with your doctor as soon as possible.

Ipratropium nasal spray usually comes with patient directions. Read them carefully before using this medicine.

If you do not understand the directions or if you are not sure how to use the ipratropium nasal spray, ask your health care professional to show you how to use it.

When you use the nasal spray for the first time or if you have not used it for a while, the spray device may not deliver the right amount of medicine with the first spray. Therefore, before using the nasal spray, prime the device to make sure it works properly.

To prime the nasal spray device:

• The nasal spray pump must be primed before the nasal spray is used for the first time.
• To prime the pump, hold the bottle with your thumb at the base and your index and middle fingers on the white shoulder area. Make sure the bottle points upright and away from your eyes.
• Press your thumb firmly and quickly against the bottle seven times. The pump is now primed and can be used.
• Your pump should not have to be reprimed unless you have not used the medication for more than 24 hours. Repriming the pump will only require two sprays. However, if you have not used your nasal spray for more than seven days, repriming the pump will require seven sprays.

To use the nasal spray:

• Before using the nasal spray, blow your nose gently to clear your nostrils.
• Remove the clear plastic dust cap and the green safety clip from the nasal spray pump. The safety clip prevents the accidental discharge of the spray when you are not using it.
• Close one nostril by gently placing your finger against the side of your nose, tilt your head slightly forward and, keeping the bottle 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 white shoulder portion of the pump between your index and middle fingers. Do not breathe in while spraying.
• After spraying the nostril and removing the unit, sniff deeply and breathe out through the nose. Tilt your head backwards for a few seconds to let the spray spread over the back of the nose.
• Repeat these steps for the second spray in the first nostril and for the two sprays in the other nostril.
• Replace the clear plastic dust cap and the green safety clip.
• You should not take extra doses of the nasal spray without checking with your doctor.

To clean the nasal spray device:

• If the nasal tip becomes clogged, remove the clear plastic dust cap and the green safety clip.
• Hold the nasal tip under running warm tap water for about a minute.
• Dry the nasal tip, reprime the nasal spray pump (see above, To prime the nasal spray device), and replace the clear plastic dust cap and green safety clip.

Dosing—

The dose of ipratropium nasal spray will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ipratropium nasal spray. If your dose is different, do not change it unless your doctor tells you to do so:

• For the 0.03% nasal spray:
  • For runny nose associated with allergic and nonallergic perennial rhinitis:
    • Adults and children 6 years of age and older—2 sprays of the 0.03% nasal solution into each nostril two or three times a day.
    • Children up to 6 years of age—Use and dose must be determined by your doctor.
• For the 0.06% nasal spray:
  • For runny nose associated with the common cold:
    • Adults and children 5 years of age and older—2 sprays of the 0.06% nasal solution into each nostril three or four times a day. Do not use the medicine for more than 4 days.
    • Children up to 5 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you are using ipratropium nasal spray regularly and you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct sunlight.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Some improvement in your runny nose is usually seen during the first full day of treatment. However:

• If you are using the 0.03% nasal spray for runny nose associated with allergic and nonallergic perennial rhinitis, and your symptoms do not improve within one or two weeks or if your condition becomes worse, check with your doctor.
• If you are using the 0.06% nasal spray for runny nose associated with the common cold, and your condition becomes worse, check with your doctor.

Ipratropium nasal spray may cause dryness of the mouth or throat. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may require medical attention.

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

• For the 0.03% nasal spray
  • Less common
    • Nasal dryness;  nosebleeds;  sore throat 
    
    
  • Rare
    • Blurred vision;  dizziness;  eye redness, irritation, or pain;  pain or cramping in abdomen;  painful or difficult urination  
    
    
  • For the 0.06% nasal spray used for 4 days
    • Less common
      • Nasal dryness;  nosebleeds 
      
      
    • Rare
      • Blurred vision;  dizziness;  eye redness or pain;  fast, slow, or irregular heartbeat;  pain or cramping in abdomen ;  painful or difficult urination;  ringing or buzzing in ears;  sore throat 
      
      

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• For the 0.03% nasal spray
  • Less common or rare
    • Dry mouth or throat;  increased nasal congestion or runny nose;  nasal itching, burning, or irritation;  nausea 
    
    

• For the 0.06% nasal spray
  • Less common or rare
    • Dry mouth or throat;  increased nasal congestion 
    
    

Other side effects not listed above may occur in some patients. If you notice any other effects, check with your doctor.