Atrovent HFA is a brand-name prescription medication. It’s used to treat chronic obstructive pulmonary disease (COPD) in adults.

COPD is the name for a group of chronic (long-term) lung diseases that get progressively worse over time. These diseases include chronic bronchitis and emphysema. With COPD, the airways in your lungs become damaged, inflamed (swollen), and narrowed. This causes trouble breathing.

Atrovent HFA is a bronchodilator medication that opens your airways. This helps your lungs work better and makes breathing easier. Atrovent HFA contains the active drug ipratropium bromide. This is a type of drug called an anticholinergic.

Atrovent HFA comes in a metered-dose inhaler (a small, pressurized canister that releases one dose at a time). To use it, you press down on the canister and breathe the medication into your lungs. You’ll use the inhaler four to six times every day to help keep your airways open.

Effectiveness

In clinical studies, Atrovent HFA was shown to be effective at improving lung function (how well your lungs work).

Researchers measured the effect of Atrovent HFA by using a value called forced expiratory volume in 1 second (FEV1). This measures how much air you can force from your lungs in 1 second. FEV1 is measured in liters (L), and an increase in FEV1 shows better airflow in your lungs.

In one study, researchers compared treatment with an Atrovent HFA inhaler to treatment with a placebo inhaler (containing no active drug). FEV1 was measured before treatment, after 1 day of treatment, and again after 12 weeks of treatment. The people who used Atrovent HFA increased their FEV1 by an average of 0.295 L. Those who used a placebo increased their FEV1 by an average of 0.14 L.

For more information on Atrovent HFA’s effectiveness, see the “Atrovent HFA uses” section.

Atrovent HFA is available only as a brand-name medication. This inhaler is not currently available in generic form.

Atrovent HFA contains one active drug ingredient: ipratropium bromide. This drug is available in generic form as an inhalation solution that’s used in a machine called a nebulizer. A nebulizer changes liquid medication into a fine mist that you inhale through a mouthpiece or face mask.

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Atrovent HFA comes as a metered-dose inhaler, which is a small, pressurized canister. It releases one measured dose of medication each time you press down on the canister. You breathe in through the inhaler mouthpiece at the same time as you press down on the canister.

Atrovent HFA is only available in one strength. The inhaler delivers a dose of 17 micrograms (mcg) from the mouthpiece each time you press down on the canister. This is called one puff. Each inhaler contains enough medication for 200 puffs.

Dosage for chronic obstructive pulmonary disease (COPD)

The usual starting dose for COPD is two puffs of Atrovent HFA taken four times a day. If you still have trouble breathing with this dosage, your doctor may have you take two puffs up to six times a day.

Do not take more than 12 puffs in 24 hours.

Note: Don’t take Atrovent HFA to relieve sudden breathing problems. Use your rescue inhaler, such as albuterol, if you are breathless and need to quickly improve your breathing.

What if I miss a dose?

If you forget to take a dose, take it as soon as you remember. However, if it’s almost time for your next dose, just skip the missed dose and take your next dose at the normal time. Never take extra puffs to make up for a missed dose.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Atrovent HFA is meant to be used as a long-term treatment. If you and your doctor determine that Atrovent HFA is safe and effective for you, you’ll likely take it long term.

Atrovent HFA can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Atrovent HFA. These lists do not include all possible side effects.

For more information on the possible side effects of Atrovent HFA, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Association (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Atrovent HFA, you can do so through MedWatch.

More common side effects

The more common side effects of Atrovent HFA can include:

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Atrovent HFA aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Paradoxical bronchospasm (sudden, unexpected breathing problems immediately after inhaling the drug). Symptoms can include:
    • problems getting enough air
    • wheezing
    • coughing
    • chest tightness or pain
  • New or worsening closed-angle glaucoma (increased pressure in your eyes). Symptoms can include:
    • pain in your eyes
    • seeing “halos” around lights
    • red eyes
    • blurred vision
  • New or worsening urinary retention (trouble emptying your bladder). Symptoms can include:
    • trouble passing urine
    • pain passing urine
    • urinating more often than usual
    • urinating with a weak flow or in drips
  • Serious allergic reactions. See “Side effect details” below for more information.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s more detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Atrovent HFA. It’s not known how often this occurs. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Atrovent HFA. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Cough

Since Atrovent HFA has been on the market, some people have reported having a cough while using it. It’s not known how often this occurs. In clinical studies, cough was reported in at least 3% of people using Atrovent HFA. However, this wasn’t more common than in people using a placebo inhaler (containing no active drug).

A cough is a common symptom of chronic obstructive pulmonary disease (COPD). A new or worsening cough may be a sign that your COPD is getting worse or that you have a chest infection. Talk to your doctor if you get a new or worsening cough while you’re using Atrovent HFA.

Worsening of COPD

Atrovent HFA may make some symptoms of COPD worse. These include flare-ups, bronchitis, and shortness of breath.

A 12-week clinical trial compared Atrovent HFA with a placebo.

Of the people taking Atrovent HFA in the clinical trial:

  • 8% had COPD flare-ups
  • 10% had bronchitis
  • 8% experienced shortness of breath

Of those taking a placebo in the clinical trial:

  • 13% had COPD flare-ups
  • 6% had bronchitis
  • 4% experienced shortness of breath

It’s important to note that some people with COPD may experience worsening of their condition regardless of the medication they take to treat it. Therefore, it’s possible that the side effects described above were caused by the COPD itself rather than Atrovent HFA.

Talk with your doctor if you’re concerned about your COPD getting worse while taking Atrovent HFA.

Other drugs are available that can treat chronic obstructive pulmonary disease (COPD). Some may be a better fit for you than others. If you’re interested in finding an alternative to Atrovent HFA, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for COPD

Examples of other drugs that may be used to treat COPD include:

  • Long-acting anticholinergic inhalers, such as:
    • aclidinium (Tudorza)
    • tiotropium (Spiriva)
    • umeclidinium (Incruse Ellipta)
  • Long-acting beta-agonist (LABA) inhalers, such as:
    • indacaterol (Arcapta)
    • olodaterol (Striverdi)
    • salmeterol (Serevent)
  • Combination bronchodilator combination inhalers, such as:
    • glycopyrrolate/indacaterol (Utibron)
  • Inhaled corticosteroid and LABA combination inhalers, such as:
    • fluticasone/salmeterol (Advair, Seretide)
    • fluticasone/vilanterol (Breo)
    • budesonide/formoterol (Symbicort)
  • Triple-combination inhalers, such as:
    • fluticasone/umeclidinium/vilanterol (Trelegy)

You may wonder how Atrovent HFA compares to other medications that are prescribed for similar uses. Here we look at how Atrovent HFA and albuterol are alike and different.

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About

Atrovent HFA and albuterol are both bronchodilator medications that open your airways. However, these drugs work in different ways.

Atrovent HFA is a brand-name medication containing ipratropium bromide. It’s a type of drug called an anticholinergic. It takes about 15 minutes to start working, so you take it every day to help keep your airways open all the time. It’s not a rescue medication.

Albuterol is a generic drug that also comes as various brand-name medications. These include ProAir, Proventil, and Ventolin. Albuterol is a type of drug called a short-acting beta-agonist. When you breathe it into your lungs, it opens your airways almost right away (within a few minutes).

Albuterol inhalers are most commonly prescribed as rescue medications. You use them if you need to quickly relieve breathlessness. However, albuterol may also be prescribed to take daily to help keep your airways open all the time. In addition, it can be used to open your airways before you exercise.

Uses

Atrovent HFA is FDA-approved to treat chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis.

Albuterol is FDA-approved to treat shortness of breath related to reversible obstructive airway disease, including COPD and asthma.

Drug forms and administration

Atrovent HFA comes as a metered-dose inhaler (a small, pressurized cannister). It releases one measured dose of medication each time you press down on the canister.

Albuterol comes in several different forms:

  • metered-dose inhalers (ProAir HFA, Proventil HFA, Ventolin HFA)
  • dry powder inhalers (ProAir Digihaler, ProAir RespiClick)
  • nebulizer solutions (AccuNeb)
  • syrup (available as a generic only)
  • tablets (available as a generic only)
  • extended-release tablets (Vospire ER)

Inhalers containing both ipratropium bromide and albuterol are also available. These come in generic form and as the brand-name medication Combivent Respimat.

Side effects and risks

Atrovent HFA and albuterol have some similar side effects and others that differ. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Atrovent HFA, with albuterol, or with both drugs (when taken individually).

  • Can occur with Atrovent HFA:
    • bitter taste
    • indigestion
    • back pain
    • flu-like symptoms
  • Can occur with albuterol:
  • Can occur with both Atrovent HFA and albuterol:
    • headache
    • dizziness
    • nausea

Serious side effects

These lists contain examples of serious side effects that can occur with Atrovent HFA, with albuterol, or with both drugs (when taken individually).

  • Can occur with Atrovent HFA:
    • new or worsening closed-angle glaucoma (increased pressure in your eyes)
    • new or worsening urinary retention (trouble emptying your bladder)
  • Can occur with albuterol:
    • heart problems such as chest pain or irregular heartbeat
    • high blood pressure
    • low levels of potassium in the blood
  • Can occur with both Atrovent HFA and albuterol:
    • paradoxical bronchospasm (sudden, unexpected breathing problems immediately after taking the drug)
    • serious allergic reactions

Effectiveness

Atrovent HFA and albuterol have some different FDA-approved uses, but the two drugs are both used to treat COPD.

The use of ipratropium bromide (the active drug in Atrovent HFA) and albuterol for COPD has been directly compared in a review of clinical studies. No major differences in effectiveness were seen between the two drugs when they were used as a maintenance treatment. They both improve how well your lungs work and reduce COPD symptoms.

Atrovent HFA and albuterol are both included as treatment options in current guidelines for maintenance treatment of COPD. Your doctor might suggest trying either one of these, or other bronchodilators, to see which works best for you.

Costs

Atrovent HFA is a brand-name drug. There are currently no generic forms available. Brand-name medications usually cost more than generics.

Albuterol is a generic drug. Some of its forms are available as brand-name drugs. (See “Drug forms and administration” above for the brand names.)

According to estimates on GoodRx.com, Atrovent HFA may be significantly more expensive than albuterol. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like albuterol (above), the drug Spiriva has uses similar to those of Atrovent HFA. Here’s a comparison of how Atrovent HFA and Spiriva are alike and different.

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Uses

Atrovent HFA is a medication used to treat chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. It’s approved as a maintenance (long-term) treatment.

Spiriva HandiHaler and Spiriva Respimat are also used to treat COPD, including emphysema and chronic bronchitis. Both types of Spiriva inhalers are approved as maintenance treatments. They’re also both approved to reduce COPD flare-ups (periods when your symptoms get worse).

Spiriva Respimat is also approved as a maintenance treatment for asthma in adults and in children ages 6 years and older.

Drug forms and administration

Atrovent HFA contains the active drug ipratropium bromide. Spiriva contains the active drug tiotropium. These both belong to a class of drugs called anticholinergics. A class of drugs is a group of medications that work in a similar way.

Atrovent HFA is short-acting and needs to be taken several times a day. Spiriva is long-acting and is only taken once a day.

Atrovent HFA comes as a metered-dose inhaler (a small, pressurized cannister). This type of inhaler releases one measured dose of medication as a spray each time you press down on the canister. It comes in one dosage strength: 17 micrograms (mcg).

Spiriva HandiHaler is a dry powder inhaler that you use to inhale the powder from Spiriva capsules. With this type of inhaler, you take quick, deep breaths to deliver the medication to your lungs. Spiriva capsules come in one strength: 18 mcg.

Spiriva Respimat is a metered-dose inhaler that comes in two dosage strengths: 1.25 mcg and 2.5 mcg.

Side effects and risks

Atrovent HFA and Spiriva have some similar side effects and others that differ. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Atrovent HFA, with Spiriva, or with both drugs (when taken individually).

Serious side effects

This list contains examples of serious side effects that can occur with both Atrovent HFA and with Spiriva (when taken individually).

  • new or worsening closed-angle glaucoma (increased pressure in your eyes)
  • new or worsening urinary retention (trouble emptying your bladder)
  • paradoxical bronchospasm (sudden, unexpected breathing problems immediately after inhaling the drug)
  • serious allergic reactions

Effectiveness

Atrovent HFA and Spiriva have different FDA-approved uses, but they’re both used to treat COPD.

The use of ipratropium bromide (the active drug in Atrovent HFA) and Spiriva in treating COPD has been directly compared in a review of clinical studies. The review found Spiriva to be more effective than ipratropium bromide at improving lung function (how well your lungs work).

Researchers compared the effect of the drugs by using a value called forced expiratory volume in 1 second (FEV1). This measures how much air you can force from your lungs in 1 second. FEV1 is measured in liters (L), and an increase in FEV1 shows better airflow in your lungs.

After 3 months, people using either ipratropium bromide or Spiriva had an improvement in their FEV1 compared with before they started treatment. However, the improvement in FEV1 was 0.109 L better in people who used Spiriva than in people who used ipratropium bromide.

People using Spiriva were also found to have fewer flare-ups of their COPD, fewer hospital visits, and improved quality of life (when your condition has less of an effect on your daily life).

Costs

Atrovent HFA and Spiriva are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Atrovent HFA and Spiriva generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

The Food and Drug Administration (FDA) approves prescription drugs such as Atrovent HFA to treat certain conditions. Atrovent HFA may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Effectiveness

Atrovent HFA for chronic obstructive pulmonary disease (COPD)

Atrovent HFA has been approved by the FDA for the maintenance treatment (long-term, everyday treatment) of COPD.

COPD is the name for a group of lung diseases that includes emphysema and chronic bronchitis. Most people with COPD have both of these conditions to some degree.

Emphysema damages the tiny air sacs that are deep in your lungs, making it difficult to breathe out. Bronchitis makes your airways inflamed (swollen) and narrowed, making it harder for air to flow in and out of your lungs. It also makes your lungs produce more mucus. All of these issues cause trouble breathing and make it difficult to get enough oxygen.

COPD is a chronic (long-term) illness that gets progressively worse over time. Medication can’t cure COPD. However, treatment guidelines for COPD recommend maintenance treatment to:

  • reduce symptoms of COPD, such as wheezing, breathlessness, and coughing
  • reduce how often you have flare-ups (periods when your symptoms get worse), and how severe these are
  • improve your overall health, including your ability to be physically active

Atrovent HFA is a bronchodilator medication you take every day to help keep your airways open and make breathing easier.

In two clinical studies, Atrovent HFA was shown to improve lung function (how well your lungs work).

Researchers measured the effect of Atrovent HFA by using a value called forced expiratory volume in 1 second (FEV1). This measures how much air you can force from your lungs in 1 second. FEV1 is measured in liters (L), and an increase in FEV1 shows better airflow in your lungs.

In the first study, Atrovent HFA treatment was compared to treatment with a placebo inhaler (containing no active drug). The researchers measured FEV1 before treatment, after one day of treatment, and again after 12 weeks of treatment. Atrovent HFA treatment increased FEV1 by an average of 0.295 L. Those who used a placebo increased their FEV1 by an average of 0.14 L.

In this study, treatment with Atrovent HFA was also compared to treatment with Atrovent CFC. Atrovent HFA replaced the Atrovent CFC inhaler, which was phased out due to laws banning the use of chlorofluorocarbon (CFC) propellants in inhalers. (A propellant is a gas that forces the medication out of the inhaler as a spray when you press down on the canister.)

Atrovent HFA contains the same active drug as Atrovent CFC but has a different propellant, called hydrofluoroalkane (HFA). The researchers found Atrovent HFA to be just as effective at improving FEV1 as Atrovent CFC. A second 12-week study compared Atrovent HFA with Atrovent CFC and confirmed these results.

Off-label use for Atrovent HFA

In addition to the use listed above, Atrovent HFA may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved.

Atrovent HFA for asthma

Atrovent HFA is not FDA-approved for treating asthma. Current guidelines don’t recommend using Atrovent HFA for maintenance (long-term, everyday) treatment of asthma.

Also, in the latest guidelines, ipratropium bromide (the active drug in Atrovent HFA) is recommended for managing moderate to severe flare-ups of asthma that require treatment in the emergency room. Ipratropium bromide is used with albuterol to help open your airways and relieve severe breathing difficulties.

In this situation, ipratropium bromide may be taken with a nebulizer (a machine that changes liquid medication into a fine mist that you inhale). It may also be taken with an inhaler such as Atrovent HFA (which is an off-label use for this drug).

Your doctor may prescribe Atrovent HFA along with other medications to treat your chronic obstructive pulmonary disease (COPD).

In most cases, one of the other drugs prescribed is a rescue inhaler. Rescue inhalers work quickly (within a few minutes) to open your airways and help make breathing easier. They contain drugs called short-acting beta-agonists. Keep your rescue inhaler with you at all times, and use it if you need to quickly relieve sudden breathlessness.

Rescue inhalers that can be used with Atrovent HFA include:

  • albuterol (ProAir HFA, Proventil HFA, Ventolin HFA)
  • levalbuterol (Xopenex, Xopenex HFA)

You shouldn’t need to use your rescue inhaler all the time. If you’re using your rescue inhaler more often than usual, contact your doctor as soon as possible. They may need to change your daily medication to one that better controls your COPD. This should mean you don’t need to use your rescue inhaler as much.

There are no known interactions between Atrovent HFA and alcohol.

However, some research suggests that regular drinking over a long period of time can make it harder for your lungs to remove bacteria. It can also damage certain immune cells in your lungs, making it harder to fight off infections. This means if you have COPD, it’s possible that drinking alcohol could increase your risk of lung infections (including pneumonia) and make your COPD symptoms worse.

If you have COPD and drink alcohol, talk with your doctor about how much is safe for you to drink.

Atrovent HFA can interact with certain medications. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Atrovent HFA and other medications

Below is a list of medications that can interact with Atrovent HFA. This list does not contain all drugs that may interact with Atrovent HFA.

Before taking Atrovent HFA, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Atrovent HFA and other anticholinergic drugs

Atrovent HFA is a type of drug called an anticholinergic. If you take it with other anticholinergic drugs, you may be more likely to get certain side effects. These can include eye problems, such as glaucoma, or urinary problems, such as trouble urinating.

Examples of anticholinergic drugs that may increase the risk of side effects if taken with Atrovent HFA include:

  • other anticholinergic drugs for COPD or asthma, such as:
    • aclidinium (Tudorza)
    • glycopyrronium (Seebri)
    • tiotropium (Spiriva)
  • certain drugs for an overactive bladder or urinary incontinence, such as:
    • oxybutynin (Ditropan XL)
    • tolterodine (Detrol)
    • darifenacin (Enablex)
    • solifenacin (VESIcare)
    • fesoterodine (Toviaz)
  • certain drugs for Parkinson’s disease, such as:
    • benztropine (Cogentin)
    • procyclidine (Kemadrin)
    • trihexyphenidyl
    • orphenadrine

If you need to take one of these medications with Atrovent HFA, your doctor will monitor you closely. Tell them if you notice any side effects, such as changes to your vision or trouble urinating.

Atrovent HFA and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Atrovent HFA. However, you should still check with your doctor or pharmacist before using any of these products while taking Atrovent HFA.

As with all medications, the cost of Atrovent HFA can vary. To find current prices for Atrovent HFA in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before they approve coverage for Atrovent HFA. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug.

The insurance company will review the request and let you and your doctor know if your plan will cover Atrovent HFA.

If you’re not sure if you’ll need to get prior authorization for Atrovent HFA, contact your insurance plan.

Financial assistance

If you need financial support to pay for Atrovent HFA, help is available. Boehringer Ingelheim Pharmaceuticals Inc., the manufacturer of Atrovent HFA, allows you to register as a Puffagin Pen Pal for savings offers. For more information and to find out if you’re eligible for support, call 800-243-0127 or visit the program website.

Atrovent HFA comes as a metered-dose inhaler, which is a small, pressurized canister. It releases one measured dose of medication each time you press down on the canister.

To take a puff from your Atrovent HFA inhaler, press down on the canister while steadily breathing in through the mouthpiece. Your healthcare provider or pharmacist will show you how to use your Atrovent HFA inhaler correctly. There are also detailed instructions on the manufacturer’s website.

Talk to your doctor or pharmacist if you find Atrovent HFA hard to use. They may suggest using a spacer device with your inhaler.

A spacer is a large plastic container with a mouthpiece at one end. It has a hole at the other end for inserting the mouthpiece of your inhaler. You spray the dose from your inhaler into the spacer, then you inhale it through the spacer mouthpiece. This means you don’t need to coordinate breathing in with pressing down on the inhaler canister.

When to take

You’ll take Atrovent HFA every day for as long as your doctor prescribes it.

You’ll usually start treatment by taking two puffs, four times a day. Space your doses out evenly over the day. If you still have trouble breathing on this dosage, your doctor may have you take two puffs up to six times a day. Again, space your doses out evenly over the day. Do not take more than 12 puffs in 24 hours.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Some important points about using Atrovent HFA

  • Be careful not to spray Atrovent HFA in your eyes.
  • If you have trouble breathing right after using your inhaler, use your rescue inhaler (a short-acting beta-agonist, such as albuterol) right away. Don’t use the Atrovent HFA inhaler again. Call your doctor as soon as possible so they can find you a different treatment.
  • Don’t use Atrovent HFA to relieve sudden breathing problems. Use your rescue inhaler to quickly improve your breathing if you’re suddenly short of breath. Keep your rescue inhaler with you at all times.
  • If you need to use your rescue inhaler more often than usual, contact your doctor as soon as possible.
  • If your rescue inhaler doesn’t improve your breathing and you think you’re having a medical emergency, call 911 or go to the nearest emergency room.

Atrovent HFA is a bronchodilator medication that works by opening your airways to help make breathing easier.

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What happens with COPD

Chronic obstructive pulmonary disease (COPD) is a long-term condition that causes trouble breathing. People with COPD usually have a mixture of two conditions, called emphysema and chronic bronchitis.

Emphysema damages the small air sacs (called alveoli) that are deep in your lungs. This makes it hard to breathe out (exhale).

Chronic bronchitis involves long-term inflammation (swelling) in your airways. This makes your airways produce more mucus than usual. The mucus is difficult to cough up because your airways are narrowed by the swelling. All of these factors cause wheezing, coughing, and feeling short of breath.

What Atrovent HFA does

Atrovent HFA contains the active drug ipratropium bromide. This belongs to a class of drugs called anticholinergics. A class of drugs is a group of medications that work in a similar way.

Ipratropium bromide stops a natural body chemical called acetylcholine (which normally makes your airways tighten) from acting on muscle cells in the walls of your airways. By blocking acetylcholine, ipratropium bromide helps open your airways and keep them open. This makes it easier to breathe and easier to clear the mucus from your lungs. It helps you get enough oxygen so that you don’t feel short of breath.

How long does it take to work?

Each puff of Atrovent HFA starts to work in about 15 minutes. It keeps your airways open for 2 to 4 hours.

It’s not known if Atrovent HFA is safe to use during pregnancy because it hasn’t been studied in pregnant women. When the drug was studied in pregnant animals, no birth defects were reported. However, studies in animals don’t always predict what will happen in humans.

If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of using Atrovent HFA.

It’s not known if Atrovent HFA is safe to take during pregnancy. If you are sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Atrovent HFA.

It’s not known if ipratropium bromide (the active drug in Atrovent HFA) passes into breast milk or if it can affect a breastfeeding child. If you’re breastfeeding, talk with your doctor about the possible risks and benefits of using Atrovent HFA.

Here are answers to some frequently asked questions about Atrovent HFA.

Does Atrovent HFA come in other forms?

The Atrovent HFA inhaler is not available in generic form. However, ipratropium bromide (the active drug in Atrovent HFA) is available as a solution for nebulization. It comes in vials that contain 0.5 mg of ipratropium bromide per vial.

Ipratropium bromide vials are used in a machine called a nebulizer. A nebulizer changes liquid medication into a fine mist that you inhale through a mouthpiece or face mask. Nebulizers are used to deliver higher doses of medications than inhalers.

Is Atrovent HFA a corticosteroid?

No, Atrovent HFA is not a corticosteroid (a medication that reduces swelling in your lungs). Atrovent HFA belongs to a group of drugs called anticholinergics. Atrovent HFA opens your airways. It doesn’t reduce inflammation in your lungs.

Do I need to rinse my mouth after taking Atrovent HFA?

No. It’s only recommended that you rinse your mouth after using a corticosteroid inhaler. That’s because this type of inhaler can sometimes cause a fungal infection in your mouth, called oral thrush. Rinsing your mouth reduces the risk of developing this infection. Atrovent HFA doesn’t contain a corticosteroid, so you’re not at risk of getting oral thrush from using it.

Some people find that Atrovent HFA gives them dry mouth. If you experience this side effect, rinsing your mouth may help. However, it’s not something you have to do.

Can I use Atrovent HFA as a rescue treatment?

No, you should not use Atrovent HFA as a rescue treatment because it doesn’t work fast enough for this purpose. It takes about 15 minutes to start working after you take a dose.

Rescue treatments open up your airways very quickly. They relieve breathing difficulties within a few minutes. Rescue treatments contain medications called short-acting beta-agonists, such as albuterol (Ventolin, Proventil, ProAir) and levalbuterol (Xopenex).

Atrovent HFA is meant to be used as a maintenance medication to help keep your airways open all the time. If you need to quickly relieve wheezing or trouble breathing, you should use your rescue inhaler, not Atrovent HFA.

What does “HFA” stand for in “Atrovent HFA”?

“HFA” stands for hydrofluoroalkane. This is the propellant that’s used in the Atrovent HFA inhaler. (A propellant is a pressurized gas that forces the medication out of the inhaler as a spray when you press down on the canister.)

Atrovent HFA has replaced a product called Atrovent CFC. The Atrovent CFC inhaler contained chlorofluorocarbon (CFC) gas as a propellant. Inhalers containing CFCs have been phased out and replaced with more environmentally friendly propellants such as HFAs.

This drug comes with several precautions. Before taking Atrovent HFA, talk with your doctor about your health history. Atrovent HFA may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergy to ipratropium bromide (the active drug in Atrovent HFA) or atropine. Atropine is a similar drug to ipratropium bromide. You shouldn’t use Atrovent HFA if you’ve ever had an allergic reaction to one of these drugs or to similar drugs such as hyoscyamine.
  • Closed-angle glaucoma. Atrovent HFA can cause or worsen closed-angle glaucoma (a condition where the pressure inside your eye gets too high). If you have a history of increased pressure in your eyes, talk to your doctor about whether Atrovent HFA is right for you.
  • Problems urinating. Atrovent HFA can cause or worsen urinary problems, such as those due to a bladder problem or an enlarged prostate gland. If you have trouble passing urine, talk with your doctor about whether Atrovent HFA is right for you.
  • Pregnancy. It’s not known if Atrovent HFA is safe to use during pregnancy. For more information, see the “Atrovent HFA and pregnancy” section above.
  • Breastfeeding. It’s not known if the active drug in Atrovent HFA passes into breast milk. For more information, see the “Atrovent HFA and breastfeeding” section above.

Note: For more information about the potential negative effects of Atrovent HFA, see the “Atrovent HFA side effects” section above.

It’s unlikely that inhaling more than the recommended dosage of Atrovent HFA will lead to serious side effects. This is because only a small amount of the drug is absorbed into your bloodstream from your lungs or digestive tract.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if you have symptoms that are severe, call 911 or go to the nearest emergency room right away.

An expiration date will be printed on the box your Atrovent HFA inhaler comes in. It will also be printed on the inhaler itself. Don’t use the inhaler if it’s past the expiration date.

The expiration date helps guarantee the medication will be effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Atrovent HFA should be kept at room temperature between 68°F and 77°F (20°C to 25°C). If you’re traveling, the temperature range can be 59°F to 86°F (15°C to 30°C). However, in this situation, it’s recommended that you let your inhaler get back to room temperature before using it.

Disposal

It’s important to carefully dispose of used inhalers. This is because the propellants (pressurized gases) they contain are greenhouse gases. These can contribute to climate change if the inhalers are burned or sent to landfills.

Some pharmacies provide take-back programs for recycling inhalers. Ask your pharmacist if you can return your empty Atrovent HFA inhaler to them for recycling. You can also contact your local trash and recycling company to ask about the best way to dispose of your used inhalers.

The following information is provided for clinicians and other healthcare professionals.

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Indications

Atrovent HFA is a bronchodilator that’s approved for the maintenance treatment of chronic obstructive pulmonary disease (COPD). This includes emphysema and chronic bronchitis.

Atrovent HFA should not be used to treat acute bronchospasm.

Mechanism of action

Atrovent HFA contains the active drug ipratropium bromide (an anticholinergic bronchodilator). It blocks muscarinic receptors on bronchial smooth muscle, thereby opposing the broncho-constricting effect of acetylcholine.

Pharmacokinetics and metabolism

After using the Atrovent HFA inhaler, most of the inhaled dose is swallowed and deposited in the gastrointestinal tract. A smaller proportion of the inhaled dose is deposited in the lungs, where it produces a local effect.

Atrovent HFA improves FEV1 in COPD patients within 15 minutes of inhalation. Peak effect on FEV1 occurs within 1 to 2 hours and lasts for 2 to 4 hours in most people.

Ipratropium bromide is poorly absorbed systemically from both the gastrointestinal tract and the lungs. After inhalation, the majority of the drug is excreted in the feces. Most of the systemically absorbed drug is partially metabolized.

The pharmacokinetics of Atrovent HFA haven’t been studied in people with renal or hepatic impairment.

Contraindications

Atrovent HFA is contraindicated in people allergic to ipratropium bromide, atropine, atropine derivatives such as hyoscyamine, or any of the excipients of Atrovent HFA.

Storage

Atrovent HFA should be stored at room temperature (68°F to 77°F/20°C to 25°C), with allowed excursions between 59°F and 86°F (15°C and 30°C). For best results, the canister should be at room temperature before use.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.