Ipratropium (Atrovent HFA) for COPD

Ipratropium (brand name, Atrovent HFABoehringer-Ingelheim) is a short-acting bronchodilator. It is used to prevent wheezing, shortness of breath, coughing, and chest tightness in people with COPD. It works to prevent bronchospasms by relaxing and opening the airways to the lungs, making it easier to breathe.

How does ipratropium for COPD work?

Ipratropium is an anticholinergic bronchodilator which, according to animal studies, inhibits reflexes mediated by the vagal nerve because it blocks the action of acetylcholine, which is a substance released at neuromuscular junctions present in the lungs. These types of bronchodilators prevent calcium ions from entering the muscle cells of the lungs, thereby relaxing the airways.

Studies of ipratropium

The effectiveness of Atrovent (ipratropium) was assessed in two randomized, double-blind, controlled studies in people with COPD. Among their findings, the study in about 500 COPD patients reported that one dose (two inhalations of 21 mcg each) of Atrovent HFA produced a significantly greater improvement in pulmonary function than placebo.

In the six hours immediately after the first treatment on the first day, the average improvement in FEV1 (forced expiratory volume in one second; a measure of lung function) was 0.148 liters for ipratropium and 0.013 liters for the placebo. On the last day of treatment (85th day), the average improvement in FEV1 was 0.141 liters for ipratropium and 0.014 for the placebo.

Two formulations of ipratropium for COPD were also compared in a one-year, open-label safety and effectiveness study (NCT02194205), with comparable results. Atrovent HFA, an inhalation aerosol, was approved by the U.S. Food and Drug Administration as a COPD maintenance treatment (bronchodilator) in 2004.

Indications and side effects

Ipratropium comes as an aerosol solution in a metered-dose inhaler, and can be used up to four times a day (two inhalations per dose). Some common side effects are dizziness, nausea, constipation, dry mouth, and stuffy nose or sinus pain.


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