AdultPediatricDosage Forms & Strengths metered-dose inhaler 17mcg/actuation nebulized solution 0.02% Chronic Obstructive Pulmonary Disease Maintenance treatment of bronchospasm, including chronic bronchitis and emphysema Inhaler: 2 actuations (34 mcg) q6hr, then additional actuations PRN; not to exceed 12 actuations/day (408 mcg/day) Nebulizer: 2.5 mL (500 mcg) q6-8hr Acute Asthma Exacerbation (Off-label) Inhaler: 8 actuations (136 mcg) q20min PRN for 3 hr Nebulizer: 500 mcg q20min for 3 doses, then PRN Administration Prime before initial use by releasing 2 test sprays into air; repeat priming if unused for ≥3 days Dosing Considerations In treatment of acute asthma exacerbation with inhaler, short-acting beta agonist (SABA) must be coadministeredDosage Forms & Strengths metered-dose inhaler 17 mcg/actuation nebulized solution 0.02% Acute Asthma Exacerbation (Off-label) NIH asthma guidelines <5 years (inhaler): 2 inhalations q20min for 1 hr if necessary 5-12 years (inhaler): 4-8 actuations q20 min PRN for up to 3 hr ≥12 years (inhaler): 8 actuations q20 min PRN for up to 3 hr <5 years (nebulizer): 0.25 mg (250 mcg) q20min for 1 hr if necessary 5-12 years (nebulizer): 250-500 mcg q20 min for 3 doses, then PRN ≥12 years (nebulizer): 500 mcg q20 min for 3 doses, then PRN Interaction CheckerEnter a drug name and ipratropiumNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (6)glucagonglucagon increases toxicity of ipratropium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .glucagon intranasalglucagon intranasal increases toxicity of ipratropium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .macimorelinipratropium, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that may blunt the growth hormone (GH) response to macrimorelin may impact the accuracy of the diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.pramlintidepramlintide, ipratropium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.revefenacinrevefenacin and ipratropium both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.umeclidinium bromide/vilanterol inhaledipratropium, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Concomitant use with other anticholinergic-containing drugs may lead to additive anticholinergic adverse effects.Monitor Closely (94)abobotulinumtoxinAabobotulinumtoxinA increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .aclidiniumipratropium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.amantadineipratropium, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.amitriptylineipratropium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.amoxapineipratropium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.anticholinergic/sedative combosanticholinergic/sedative combos and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.aripiprazoleipratropium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.aripiprazole increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atracuriumatracurium and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineatropine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.atropine IV/IMatropine IV/IM and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna alkaloidsbelladonna alkaloids and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.belladonna and opiumipratropium and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.benperidolipratropium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.benperidol increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.benztropinebenztropine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. bethanecholbethanechol increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbacholcarbachol increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.cevimelinecevimeline increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpromazineipratropium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.chlorpromazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cisatracuriumcisatracurium and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.clomipramineipratropium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.clozapineipratropium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.clozapine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyclizinecyclizine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.cyclobenzaprinecyclobenzaprine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.darifenacindarifenacin and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.desipramineipratropium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.dicyclominedicyclomine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.diphenhydraminediphenhydramine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.donepezildonepezil increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.donepezil transdermaldonepezil transdermal, ipratropium. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.dosulepinipratropium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.doxepinipratropium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.droperidolipratropium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.droperidol increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.echothiophate iodideechothiophate iodide increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.fesoterodinefesoterodine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.flavoxateflavoxate and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.fluphenazineipratropium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.fluphenazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.galantaminegalantamine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.glycopyrrolateglycopyrrolate and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.glycopyrrolate inhaledglycopyrrolate inhaled and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.glycopyrronium tosylate topicalglycopyrronium tosylate topical, ipratropium. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.haloperidolipratropium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.haloperidol increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.henbanehenbane and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.homatropinehomatropine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.huperzine Ahuperzine A increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.hyoscyaminehyoscyamine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.hyoscyamine sprayhyoscyamine spray and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.iloperidoneipratropium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.iloperidone increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.imipramineipratropium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.lofepramineipratropium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.loxapineipratropium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.loxapine inhaledloxapine inhaled increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.ipratropium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.maprotilineipratropium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.meclizineipratropium and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.methscopolamineipratropium and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.neostigmineneostigmine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineipratropium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.olanzapineipratropium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.olanzapine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.onabotulinumtoxinAonabotulinumtoxinA and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.orphenadrineipratropium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutyninipratropium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.oxybutynin topicalipratropium and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.oxybutynin transdermalipratropium and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.paliperidoneipratropium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pancuroniumipratropium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazineipratropium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.physostigminephysostigmine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpinepilocarpine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideipratropium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.pimozide increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pralidoximeipratropium and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.prochlorperazineipratropium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.prochlorperazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.promethazineipratropium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.promethazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.propanthelineipratropium and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.protriptylineipratropium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.pyridostigminepyridostigmine