A muscarinic antagonist structurally related to atropine but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic.

Structure

Similar Structures

Synonyms

(endo,syn)-(±)-3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-8-azoniabicyclo[3.2.1]octane bromide
3α-hydroxy-8-isopropyl-1αH,5αH-tropanium bromide (±)-tropate
8-Isopropylnoratropine methobromide
Bromure d'ipratropium
Bromuro de ipratropio
Ipratropii bromidum
Ipratropium bromide (anhydrous)
Ipratropium bromide anhydrous
Ipratropiumbromid
N-Isopropylnoratropinium bromomethylate

External IDs

Not Available

Product Ingredients

Ingredient	UNII	CAS	InChI Key
Ipratropium bromide hydrate	J697UZ2A9J	66985-17-9	KEWHKYJURDBRMN-ZEODDXGYSA-M

Approved Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Atrovent	Spray, metered	21 ug/1	Nasal	Boehringer Ingelheim	1996-01-01	Not applicable
Atrovent	Spray, metered	42 ug/1	Nasal	Boehringer Ingelheim	1996-01-01	Not applicable
Atrovent	Spray, metered	21 ug/1	Nasal	Physicians Total Care, Inc.	2006-03-31	Not applicable
Atrovent	Spray, metered	42 ug/1	Nasal	Remedy Repack	2014-05-28	Not applicable
Atrovent	Solution	250 mcg	Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1988-12-31	2007-10-11
Atrovent HFA	Aerosol, metered	17 ug/1	Respiratory (inhalation)	A S Medication Solutions	2005-05-01	2017-06-20
Atrovent HFA	Aerosol, metered	20 mcg	Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	2004-03-24	Not applicable
Atrovent HFA	Aerosol, metered	17 ug/1	Respiratory (inhalation)	Boehringer Ingelheim	2005-05-01	Not applicable
Atrovent Nasal Aerosol 20mcg/aem	Aerosol	20 mcg	Nasal; Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1989-12-31	1999-08-09
Atrovent Nasal Spray	Aerosol, metered	42 mcg	Nasal	Sanofi Aventis	1996-02-02	Not applicable
Atrovent Nasal Spray	Aerosol, metered	21 mcg	Nasal	Sanofi Aventis	1995-12-31	Not applicable
Atrovent UDV 125mcg/ml	Solution	125 mcg	Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1993-12-31	2008-09-18
Atrovent Udv Sol Inh 250mcg/ml	Solution	250 mcg	Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1992-12-31	2008-04-16
AtroventHFA	Aerosol, metered	17 ug/1	Respiratory (inhalation)	Physicians Total Care, Inc.	2006-01-20	Not applicable
Dom-ipratropium	Liquid	0.3 mg	Nasal; Respiratory (inhalation)	Dominion Pharmacal	1999-09-15	Not applicable
Dom-ipratropium 125 Mcg/ml	Liquid	125 mcg	Respiratory (inhalation)	Dominion Pharmacal	Not applicable	Not applicable
Dom-ipratropium 250 Mcg/ml (1 Ml)	Liquid	250 mcg	Respiratory (inhalation)	Dominion Pharmacal	Not applicable	Not applicable
Dom-ipratropium 250 Mcg/ml (2 Ml)	Liquid	250 mcg	Respiratory (inhalation)	Dominion Pharmacal	Not applicable	Not applicable
Dom-ipratropium 250 Mcg/ml (20 Ml)	Liquid	250 mcg	Respiratory (inhalation)	Dominion Pharmacal	Not applicable	Not applicable
Ipratropium	Liquid	0.30 mg	Respiratory (inhalation)	Pharmel Inc	Not applicable	Not applicable
Ipravent	Solution	0.03 %	Nasal	Aa Pharma Inc	2002-12-03	Not applicable
Ipravent	Solution	0.06 %	Nasal	Aa Pharma Inc	2002-12-03	Not applicable
Mylan-ipratropium Solution	Solution	0.25 mg	Respiratory (inhalation)	Mylan Pharmaceuticals	1998-12-04	Not applicable
Novo-ipramide - Liq 0.25mg/ml	Solution	.25 mg	Respiratory (inhalation)	Novopharm Limited	1996-12-31	2015-10-26
Nu-ipratropium Plastic Ampules 250 Mcg/ml	Solution	250 mcg	Respiratory (inhalation)	Nu Pharm Inc	1997-12-03	2012-09-04
Penta-ipratropium Bromide	Liquid	0.25 mg	Respiratory (inhalation)	Pentapharm Ltd.	Not applicable	Not applicable
PHL-ipratropium	Solution	125 mcg	Respiratory (inhalation)	Pharmel Inc	1998-02-17	2016-10-25
PHL-ipratropium - 20ml	Solution	250 mcg	Respiratory (inhalation)	Pharmel Inc	1998-02-17	2009-10-26
PHL-ipratropium - 1ml Polyneb	Solution	250 mcg	Respiratory (inhalation)	Pharmel Inc	1998-02-17	2016-10-25
PHL-ipratropium - 2ml Polyneb	Solution	250 mcg	Respiratory (inhalation)	Pharmel Inc	1998-02-17	2016-10-25
PMS-ipratropium	Solution	250 mcg	Respiratory (inhalation)	Pharmascience Inc	1997-10-29	Not applicable
PMS-ipratropium	Solution	125 mcg	Respiratory (inhalation)	Pharmascience Inc	1997-10-29	Not applicable
PMS-ipratropium	Liquid	0.30 mg	Respiratory (inhalation)	Pharmascience Inc	1999-04-15	Not applicable
PMS-ipratropium	Solution	250 mcg	Respiratory (inhalation)	Pharmascience Inc	1997-10-29	Not applicable
PMS-ipratropium	Solution	250 mcg	Respiratory (inhalation)	Pharmascience Inc	1997-07-15	Not applicable
Ratio-ipratropium	Spray, metered	21 mcg	Nasal	Ratiopharm Inc Division Of Teva Canada Limited	1999-09-28	2008-08-01
Ratio-ipratropium Inhalation Solution	Solution	250 mcg	Nasal; Respiratory (inhalation)	Ratiopharm Inc Division Of Teva Canada Limited	1994-12-31	2009-07-17
Ratio-ipratropium Udv	Solution	125 mcg	Respiratory (inhalation)	Teva	1997-12-04	Not applicable
Ratio-ipratropium Udv	Solution	250 mcg	Respiratory (inhalation)	Teva	1995-12-31	Not applicable
Teva-ipratropium Sterinebs	Solution	0.025 %	Respiratory (inhalation)	Teva	1998-03-04	Not applicable

Approved Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Apo-ipravent Solution - Inh 250mcg/ml	Solution	250 mcg	Respiratory (inhalation)	Apotex Corporation	1994-12-31	Not applicable
Apo-ipravent Sterules	Solution	0.025 %	Respiratory (inhalation)	Apotex Corporation	1998-07-09	Not applicable
Apo-ipravent Sterules	Solution	125 mcg	Respiratory (inhalation)	Apotex Corporation	2001-08-28	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Preferreed Pharmaceuticals Inc.	2013-02-22	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Remedy Repack	2017-01-17	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Physicians Total Care, Inc.	1998-12-03	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Mylan Pharmaceuticals	2010-11-09	Not applicable
Ipratropium Bromide	Spray	21 ug/1	Nasal	West Ward Pharmaceutical	2003-11-05	Not applicable
Ipratropium Bromide	Spray, metered	42 ug/1	Nasal	Remedy Repack	2013-06-12	2017-02-17
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Sandoz	2011-09-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	A S Medication Solutions	2011-02-01	2017-06-20
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Unit Dose Services	2011-03-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Aidarex Pharmaceuticals LLC	2011-02-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Remedy Repack	2015-04-29	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Cardinal Health	2001-09-27	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Proficient Rx LP	2011-03-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Rebel Distributors	2011-03-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	A S Medication Solutions	2011-02-01	2017-06-20
Ipratropium Bromide	Spray	42 ug/1	Nasal	West Ward Pharmaceutical	2003-11-05	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Remedy Repack	2013-06-04	2017-01-20
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Preferreed Pharmaceuticals Inc.	2017-02-14	Not applicable
Ipratropium Bromide	Spray, metered	42 ug/1	Nasal	Physicians Total Care, Inc.	2004-04-12	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Nephron Pharmaceuticals Corporation	2001-09-27	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Cardinal Health	1997-01-10	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Rebel Distributors	2005-05-09	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Unit Dose Services	2011-03-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Preferreed Pharmaceuticals Inc.	2012-07-25	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	The Ritedose Corporation	2011-02-01	Not applicable
Ipratropium Bromide	Spray, metered	42 ug/1	Nasal	Rebel Distributors	2003-03-31	Not applicable
Ipratropium bromide	Spray, metered	21 ug/1	Nasal	Bauch & Lomb Incorporated	2003-03-31	Not applicable
Ipratropium Bromide	Spray	42 ug/1	Nasal	Remedy Repack	2013-07-16	2017-02-14
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	A S Medication Solutions	2011-03-01	2017-06-20
Ipratropium Bromide	Spray, metered	21 ug/1	Nasal	Physicians Total Care, Inc.	2007-01-24	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Watson Pharmaceuticals	2011-03-01	Not applicable
Ipratropium Bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	St. Marys Medical Park Pharmacy	2014-01-30	Not applicable
Ipratropium Bromide	Spray, metered	42 ug/1	Nasal	Bauch & Lomb Incorporated	2003-03-31	Not applicable
Ipratropium bromide	Solution	.5 mg/2.5mL	Respiratory (inhalation)	Aurobindo Pharma	2016-10-27	Not applicable

Approved Over the Counter Products

Not Available

Unapproved/Other Products

Not Available

International/Other Brands

Aerovent (Teva) / Apovent (Apotex Inc.) / Atronase (Boehringer Ingelheim) / Ipraxa (Ivax) / Ipvent (Cipla Medpro) / Rhinovent (Boehringer Ingelheim) / Rinatec (Boehringer Ingelheim) / Rinovagos (Valeas)

Brand mixtures

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End
Apo-salvent-ipravent Sterules	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Apotex Corporation	2006-08-25	Not applicable
Combivent Inhalation Aerosol	Ipratropium bromide Salbutamol	Aerosol, metered	Oral; Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1995-12-31	2007-10-02
Combivent Respimat	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	2014-09-16	Not applicable
Combivent Udv	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1997-07-25	Not applicable
DuoNeb	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Mylan Specialty	2011-02-15	2016-10-13
Duovent Udv	Fenoterol Ipratropium bromide	Solution	Oral; Respiratory (inhalation)	Boehringer Ingelheim (Canada) Ltd Ltee	1995-12-31	2017-01-31
Ipramol	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Ivax Pharmaceuticals Incorporated	Not applicable	Not applicable
Ipratropium Bromide and Albuterol Sulfate	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Teva	2008-01-02	Not applicable
Ratio-ipra Sal Udv	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Teva	2002-05-14	Not applicable
Teva-combo Sterinebs	Ipratropium bromide Salbutamol	Solution	Respiratory (inhalation)	Teva	2005-11-18	Not applicable

Categories

UNII

VJV4X1P2Z1

CAS number

22254-24-6

Weight

Average: 412.361
Monoisotopic: 411.140906478

Chemical Formula

C₂₀H₃₀BrNO₃

InChI Key

LHLMOSXCXGLMMN-VVQPYUEFSA-M

InChI

InChI=1S/C20H30NO3.BrH/c1-14(2)21(3)16-9-10-17(21)12-18(11-16)24-20(23)19(13-22)15-7-5-4-6-8-15;/h4-8,14,16-19,22H,9-13H2,1-3H3;1H/q+1;/p-1/t16-,17+,18+,19?,21+;

IUPAC Name

(1R,3R,5S,8R)-3-[(3-hydroxy-2-phenylpropanoyl)oxy]-8-methyl-8-(propan-2-yl)-8-azabicyclo[3.2.1]octan-8-ium bromide

SMILES

[Br-].[H][C@]12CC[C@]([H])(C[C@@H](C1)OC(=O)C(CO)C1=CC=CC=C1)[N@+]2(C)C(C)C

Pharmacology

Indication

For maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease, including chronic bronchitis and emphysema.

Structured Indications

Pharmacodynamics

Ipratropium bromide, a synthetic ammonium compound structurally similar to atropine, is used as a bronchodilator in the management of cholinergic-mediated bronchospasm associated with chronic obstructive pulmonary disease and in the treatment of rhinorrhea associated with the common cold or with allergic or nonallergic seasonal rhinitis.

Mechanism of action

Ipratropium bromide is an anticholinergic agent. It blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in a decrease in the formation of cyclic guanosine monophosphate (cGMP). Most likely due to actions of cGMP on intracellular calcium, this results in decreased contractility of smooth muscle.

Target	Actions	Organism
AMuscarinic acetylcholine receptor M1	antagonist	Human
AMuscarinic acetylcholine receptor M2	antagonist	Human
AMuscarinic acetylcholine receptor M3	antagonist	Human

Absorption

Inhalation (local)-minimal; Nasal-rapid and minimal

Volume of distribution

4.6 L/kg

Protein binding

Minimally (0 to 9% in vitro) bound to plasma albumin and α1-acid glycoproteins

Metabolism

Partially metabolized to at least 8 metabolites formed primarily via hydrolysis and conjugation. The main metabolites are N-isopropylnortropium methobromide, which is formed by enzymatic hydrolysis of the ester; α-phenylacrylic acid-N-isopropylnortropine-ester methobromide, which is formed by enzymatic loss of a water; and phenylacetic acid-N-isopropylnortropine-ester methobromide, which is formed by enzymatic loss of a CH₃OH-group. These metabolites appear to be inactive.

Reactions:

Route of elimination

Primarily eliminated renally via active secretion.

Half life

2-4 hours after administration orally, IV or by oral inhalation (radiolabeled ipratropium bromide assay measures parent drug and its metabolites). Using a radioreceptor assay that measures only unchanged ipratropium bromide, the initial distribution-phase half-life (t_{1/2 α}) and terminal elimination-phase half-life (t_{1/2 β}) were 0.07 and 1.6 hours, respectively, following a single 2 mg IV dose of the drug in healthy adults.

Clearance

2.3 L/min (total clearance of active ingredient)

Toxicity

LD₅₀=1001mg/kg (orally in mice)

Affected organisms

Humans and other mammals

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

Drug	Interaction	Drug group
1,10-Phenanthroline	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with 1,10-Phenanthroline.	Experimental
Abiraterone	The serum concentration of Ipratropium bromide can be increased when it is combined with Abiraterone.	Approved
Aclidinium	Aclidinium may increase the anticholinergic activities of Ipratropium bromide.	Approved
Alfentanil	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Alfentanil.	Approved, Illicit
Alphacetylmethadol	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Alphacetylmethadol.	Experimental, Illicit
Ambenonium	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Ambenonium.	Approved
Amiodarone	The metabolism of Ipratropium bromide can be decreased when combined with Amiodarone.	Approved, Investigational
Anisotropine Methylbromide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Anisotropine Methylbromide.	Approved
Aprepitant	The serum concentration of Ipratropium bromide can be increased when it is combined with Aprepitant.	Approved, Investigational
Artemether	The metabolism of Ipratropium bromide can be decreased when combined with Artemether.	Approved
Atazanavir	The metabolism of Ipratropium bromide can be decreased when combined with Atazanavir.	Approved, Investigational
Atomoxetine	The metabolism of Ipratropium bromide can be decreased when combined with Atomoxetine.	Approved
Atracurium besylate	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Atracurium besylate.	Approved
Atropine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Atropine.	Approved, Vet Approved
Benactyzine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Benactyzine.	Withdrawn
Bendroflumethiazide	The serum concentration of Bendroflumethiazide can be increased when it is combined with Ipratropium bromide.	Approved
Benzatropine	The risk or severity of adverse effects can be increased when Benzatropine is combined with Ipratropium bromide.	Approved
Betaxolol	The metabolism of Ipratropium bromide can be decreased when combined with Betaxolol.	Approved
Bexarotene	The serum concentration of Ipratropium bromide can be decreased when it is combined with Bexarotene.	Approved, Investigational
Bezitramide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Bezitramide.	Experimental, Illicit, Withdrawn
Biperiden	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Biperiden.	Approved
Boceprevir	The metabolism of Ipratropium bromide can be decreased when combined with Boceprevir.	Withdrawn
Bortezomib	The metabolism of Ipratropium bromide can be decreased when combined with Bortezomib.	Approved, Investigational
Bosentan	The serum concentration of Ipratropium bromide can be decreased when it is combined with Bosentan.	Approved, Investigational
Botulinum Toxin Type A	Ipratropium bromide may increase the anticholinergic activities of Botulinum Toxin Type A.	Approved, Investigational
Botulinum Toxin Type B	Ipratropium bromide may increase the anticholinergic activities of Botulinum Toxin Type B.	Approved
Buprenorphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Buprenorphine.	Approved, Illicit, Investigational, Vet Approved
Bupropion	The metabolism of Ipratropium bromide can be decreased when combined with Bupropion.	Approved
Butorphanol	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Butorphanol.	Approved, Illicit, Vet Approved
Carbamazepine	The metabolism of Ipratropium bromide can be increased when combined with Carbamazepine.	Approved, Investigational
Carfentanil	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Carfentanil.	Illicit, Vet Approved
Celecoxib	The metabolism of Ipratropium bromide can be decreased when combined with Celecoxib.	Approved, Investigational
Ceritinib	The serum concentration of Ipratropium bromide can be increased when it is combined with Ceritinib.	Approved
Chloroquine	The metabolism of Ipratropium bromide can be decreased when combined with Chloroquine.	Approved, Vet Approved
Chlorothiazide	The serum concentration of Chlorothiazide can be increased when it is combined with Ipratropium bromide.	Approved, Vet Approved
Chlorphenoxamine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Chlorphenoxamine.	Withdrawn
Chlorpromazine	The metabolism of Ipratropium bromide can be decreased when combined with Chlorpromazine.	Approved, Vet Approved
Chlorthalidone	The serum concentration of Chlorthalidone can be increased when it is combined with Ipratropium bromide.	Approved
Cholecalciferol	The metabolism of Ipratropium bromide can be decreased when combined with Cholecalciferol.	Approved, Nutraceutical
Cimetidine	The metabolism of Ipratropium bromide can be decreased when combined with Cimetidine.	Approved
Cimetropium	Ipratropium bromide may increase the anticholinergic activities of Cimetropium.	Experimental
Cinacalcet	The metabolism of Ipratropium bromide can be decreased when combined with Cinacalcet.	Approved
Citalopram	The metabolism of Ipratropium bromide can be decreased when combined with Citalopram.	Approved
Clarithromycin	The metabolism of Ipratropium bromide can be decreased when combined with Clarithromycin.	Approved
Clemastine	The metabolism of Ipratropium bromide can be decreased when combined with Clemastine.	Approved
Clobazam	The metabolism of Ipratropium bromide can be decreased when combined with Clobazam.	Approved, Illicit
Clomipramine	The metabolism of Ipratropium bromide can be decreased when combined with Clomipramine.	Approved, Vet Approved
Clotrimazole	The metabolism of Ipratropium bromide can be decreased when combined with Clotrimazole.	Approved, Vet Approved
Clozapine	The metabolism of Ipratropium bromide can be decreased when combined with Clozapine.	Approved
Cobicistat	The serum concentration of Ipratropium bromide can be increased when it is combined with Cobicistat.	Approved
Cocaine	The metabolism of Ipratropium bromide can be decreased when combined with Cocaine.	Approved, Illicit
Codeine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Codeine.	Approved, Illicit
Conivaptan	The serum concentration of Ipratropium bromide can be increased when it is combined with Conivaptan.	Approved, Investigational
Coumaphos	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Coumaphos.	Vet Approved
Crizotinib	The metabolism of Ipratropium bromide can be decreased when combined with Crizotinib.	Approved
Cyclopentolate	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Cyclopentolate.	Approved
Cyclosporine	The metabolism of Ipratropium bromide can be decreased when combined with Cyclosporine.	Approved, Investigational, Vet Approved
Dabrafenib	The serum concentration of Ipratropium bromide can be decreased when it is combined with Dabrafenib.	Approved
Darifenacin	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Darifenacin.	Approved, Investigational
Darunavir	The serum concentration of Ipratropium bromide can be increased when it is combined with Darunavir.	Approved
Dasatinib	The serum concentration of Ipratropium bromide can be increased when it is combined with Dasatinib.	Approved, Investigational
Decamethonium	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Decamethonium.	Approved
Deferasirox	The serum concentration of Ipratropium bromide can be decreased when it is combined with Deferasirox.	Approved, Investigational
Delavirdine	The metabolism of Ipratropium bromide can be decreased when combined with Delavirdine.	Approved
Demecarium	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Demecarium.	Approved
Desipramine	The metabolism of Ipratropium bromide can be decreased when combined with Desipramine.	Approved
Desloratadine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Desloratadine.	Approved, Investigational
Dexamethasone	The serum concentration of Ipratropium bromide can be decreased when it is combined with Dexamethasone.	Approved, Investigational, Vet Approved
Dexetimide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dexetimide.	Withdrawn
Dextromoramide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dextromoramide.	Experimental, Illicit
Dextropropoxyphene	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dextropropoxyphene.	Approved, Illicit, Withdrawn
Dezocine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dezocine.	Approved
Dichlorvos	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Dichlorvos.	Vet Approved
Dicyclomine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dicyclomine.	Approved
Dihydrocodeine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dihydrocodeine.	Approved, Illicit
Dihydroergotamine	The metabolism of Ipratropium bromide can be decreased when combined with Dihydroergotamine.	Approved
Dihydroetorphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dihydroetorphine.	Experimental, Illicit
Dihydromorphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Dihydromorphine.	Experimental, Illicit
Diltiazem	The metabolism of Ipratropium bromide can be decreased when combined with Diltiazem.	Approved
Diphenhydramine	The metabolism of Ipratropium bromide can be decreased when combined with Diphenhydramine.	Approved
Diphenoxylate	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Diphenoxylate.	Approved, Illicit
Donepezil	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Donepezil.	Approved
Doxycycline	The metabolism of Ipratropium bromide can be decreased when combined with Doxycycline.	Approved, Investigational, Vet Approved
DPDPE	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with DPDPE.	Investigational
Dronabinol	Ipratropium bromide may increase the tachycardic activities of Dronabinol.	Approved, Illicit
Dronedarone	The metabolism of Ipratropium bromide can be decreased when combined with Dronedarone.	Approved
Duloxetine	The metabolism of Ipratropium bromide can be decreased when combined with Duloxetine.	Approved
Echothiophate	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Echothiophate.	Approved
Edrophonium	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Edrophonium.	Approved
Efavirenz	The serum concentration of Ipratropium bromide can be decreased when it is combined with Efavirenz.	Approved, Investigational
Eliglustat	The metabolism of Ipratropium bromide can be decreased when combined with Eliglustat.	Approved
Eluxadoline	Ipratropium bromide may increase the constipating activities of Eluxadoline.	Approved
Enzalutamide	The serum concentration of Ipratropium bromide can be decreased when it is combined with Enzalutamide.	Approved
Erythromycin	The metabolism of Ipratropium bromide can be decreased when combined with Erythromycin.	Approved, Vet Approved
Eslicarbazepine acetate	The serum concentration of Ipratropium bromide can be decreased when it is combined with Eslicarbazepine acetate.	Approved
Ethopropazine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Ethopropazine.	Approved
Ethylmorphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Ethylmorphine.	Approved, Illicit
Etorphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Etorphine.	Illicit, Vet Approved
Etravirine	The serum concentration of Ipratropium bromide can be decreased when it is combined with Etravirine.	Approved
Fentanyl	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Fentanyl.	Approved, Illicit, Investigational, Vet Approved
Fenthion	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Fenthion.	Vet Approved
Fesoterodine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Fesoterodine.	Approved
Fluconazole	The metabolism of Ipratropium bromide can be decreased when combined with Fluconazole.	Approved
Fluoxetine	The metabolism of Ipratropium bromide can be decreased when combined with Fluoxetine.	Approved, Vet Approved
Fluvoxamine	The metabolism of Ipratropium bromide can be decreased when combined with Fluvoxamine.	Approved, Investigational
Fosamprenavir	The metabolism of Ipratropium bromide can be decreased when combined with Fosamprenavir.	Approved
Fosaprepitant	The serum concentration of Ipratropium bromide can be increased when it is combined with Fosaprepitant.	Approved
Fosphenytoin	The metabolism of Ipratropium bromide can be increased when combined with Fosphenytoin.	Approved
Fusidic Acid	The serum concentration of Ipratropium bromide can be increased when it is combined with Fusidic Acid.	Approved
Galantamine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Galantamine.	Approved
Gallamine Triethiodide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Gallamine Triethiodide.	Approved
Ginkgo biloba	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Ginkgo biloba.	Approved, Nutraceutical
Glucagon recombinant	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Glucagon recombinant.	Approved
Glycopyrronium	Ipratropium bromide may increase the anticholinergic activities of Glycopyrronium.	Approved, Investigational, Vet Approved
Haloperidol	The metabolism of Ipratropium bromide can be decreased when combined with Haloperidol.	Approved
Heroin	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Heroin.	Approved, Illicit
Hexamethonium	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Hexamethonium.	Experimental
Homatropine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Homatropine.	Approved
Huperzine A	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Huperzine A.	Investigational
Hydrochlorothiazide	The serum concentration of Hydrochlorothiazide can be increased when it is combined with Ipratropium bromide.	Approved, Vet Approved
Hydrocodone	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Hydrocodone.	Approved, Illicit
Hydroflumethiazide	The serum concentration of Hydroflumethiazide can be increased when it is combined with Ipratropium bromide.	Approved
Hydromorphone	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Hydromorphone.	Approved, Illicit
Hyoscyamine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Hyoscyamine.	Approved
Idelalisib	The serum concentration of Ipratropium bromide can be increased when it is combined with Idelalisib.	Approved
Imatinib	The metabolism of Ipratropium bromide can be decreased when combined with Imatinib.	Approved
Imipramine	The metabolism of Ipratropium bromide can be decreased when combined with Imipramine.	Approved
Indapamide	The serum concentration of Indapamide can be increased when it is combined with Ipratropium bromide.	Approved
Indinavir	The metabolism of Ipratropium bromide can be decreased when combined with Indinavir.	Approved
Isavuconazonium	The metabolism of Ipratropium bromide can be decreased when combined with Isavuconazonium.	Approved, Investigational
Isoflurophate	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Isoflurophate.	Approved, Withdrawn
Isoniazid	The metabolism of Ipratropium bromide can be decreased when combined with Isoniazid.	Approved
Isradipine	The metabolism of Ipratropium bromide can be decreased when combined with Isradipine.	Approved
Itopride	The therapeutic efficacy of Itopride can be decreased when used in combination with Ipratropium bromide.	Investigational
Itraconazole	The metabolism of Ipratropium bromide can be decreased when combined with Itraconazole.	Approved, Investigational
Ivacaftor	The serum concentration of Ipratropium bromide can be increased when it is combined with Ivacaftor.	Approved
Ketobemidone	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Ketobemidone.	Approved
Ketoconazole	The metabolism of Ipratropium bromide can be decreased when combined with Ketoconazole.	Approved, Investigational
Levomethadyl Acetate	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Levomethadyl Acetate.	Approved
Levorphanol	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Levorphanol.	Approved
Lofentanil	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Lofentanil.	Illicit
Lopinavir	The metabolism of Ipratropium bromide can be decreased when combined with Lopinavir.	Approved
Lorcaserin	The metabolism of Ipratropium bromide can be decreased when combined with Lorcaserin.	Approved
Lovastatin	The metabolism of Ipratropium bromide can be decreased when combined with Lovastatin.	Approved, Investigational
Loxapine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Loxapine.	Approved
Luliconazole	The serum concentration of Ipratropium bromide can be increased when it is combined with Luliconazole.	Approved
Lumacaftor	The metabolism of Ipratropium bromide can be increased when combined with Lumacaftor.	Approved
Lumefantrine	The metabolism of Ipratropium bromide can be decreased when combined with Lumefantrine.	Approved
Malathion	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Malathion.	Approved, Investigational
Mecamylamine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Mecamylamine.	Approved
Mefloquine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Mefloquine.	Approved
Memantine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Memantine.	Approved, Investigational
Methadone	The metabolism of Ipratropium bromide can be decreased when combined with Methadone.	Approved
Methadyl Acetate	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Methadyl Acetate.	Approved, Illicit
Methanesulfonyl Fluoride	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Methanesulfonyl Fluoride.	Investigational
Methantheline	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Methantheline.	Approved
Methotrimeprazine	The metabolism of Ipratropium bromide can be decreased when combined with Methotrimeprazine.	Approved
Methyclothiazide	The serum concentration of Methyclothiazide can be increased when it is combined with Ipratropium bromide.	Approved
Metixene	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Metixene.	Approved
Metolazone	The serum concentration of Metolazone can be increased when it is combined with Ipratropium bromide.	Approved
Metoprolol	The metabolism of Ipratropium bromide can be decreased when combined with Metoprolol.	Approved, Investigational
Mianserin	Mianserin may increase the anticholinergic activities of Ipratropium bromide.	Approved
Mifepristone	The serum concentration of Ipratropium bromide can be increased when it is combined with Mifepristone.	Approved, Investigational
Minaprine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Minaprine.	Approved
Mirabegron	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Mirabegron.	Approved
Mitotane	The serum concentration of Ipratropium bromide can be decreased when it is combined with Mitotane.	Approved
Modafinil	The serum concentration of Ipratropium bromide can be decreased when it is combined with Modafinil.	Approved, Investigational
Morphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Morphine.	Approved, Investigational
Nabilone	Ipratropium bromide may increase the tachycardic activities of Nabilone.	Approved, Investigational
Nafcillin	The serum concentration of Ipratropium bromide can be decreased when it is combined with Nafcillin.	Approved
Nalbuphine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Nalbuphine.	Approved
Nefazodone	The metabolism of Ipratropium bromide can be decreased when combined with Nefazodone.	Approved, Withdrawn
Nelfinavir	The metabolism of Ipratropium bromide can be decreased when combined with Nelfinavir.	Approved
Neostigmine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Neostigmine.	Approved, Vet Approved
Netupitant	The serum concentration of Ipratropium bromide can be increased when it is combined with Netupitant.	Approved
Nevirapine	The metabolism of Ipratropium bromide can be increased when combined with Nevirapine.	Approved
Nicardipine	The metabolism of Ipratropium bromide can be decreased when combined with Nicardipine.	Approved
Nilotinib	The metabolism of Ipratropium bromide can be decreased when combined with Nilotinib.	Approved, Investigational
Normethadone	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Normethadone.	Approved, Illicit
Olaparib	The metabolism of Ipratropium bromide can be decreased when combined with Olaparib.	Approved
Opium	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Opium.	Approved, Illicit
Orphenadrine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Orphenadrine.	Approved
Osimertinib	The serum concentration of Ipratropium bromide can be increased when it is combined with Osimertinib.	Approved
Oxybutynin	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Oxybutynin.	Approved, Investigational
Oxycodone	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Oxycodone.	Approved, Illicit, Investigational
Oxymorphone	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Oxymorphone.	Approved, Investigational, Vet Approved
Oxyphenonium	The risk or severity of adverse effects can be increased when Oxyphenonium is combined with Ipratropium bromide.	Approved
Palbociclib	The serum concentration of Ipratropium bromide can be increased when it is combined with Palbociclib.	Approved
Pancuronium	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Pancuronium.	Approved
Panobinostat	The serum concentration of Ipratropium bromide can be increased when it is combined with Panobinostat.	Approved, Investigational
Paroxetine	The metabolism of Ipratropium bromide can be decreased when combined with Paroxetine.	Approved, Investigational
Peginterferon alfa-2b	The serum concentration of Ipratropium bromide can be decreased when it is combined with Peginterferon alfa-2b.	Approved
Pentazocine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Pentazocine.	Approved, Vet Approved
Pentobarbital	The metabolism of Ipratropium bromide can be increased when combined with Pentobarbital.	Approved, Vet Approved
Pentolinium	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Pentolinium.	Approved
Pethidine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Pethidine.	Approved
Phenobarbital	The metabolism of Ipratropium bromide can be increased when combined with Phenobarbital.	Approved
Phenytoin	The metabolism of Ipratropium bromide can be increased when combined with Phenytoin.	Approved, Vet Approved
Physostigmine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Physostigmine.	Approved
Pipecuronium	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Pipecuronium.	Approved
Pirenzepine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Pirenzepine.	Approved
Piritramide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Piritramide.	Investigational
Polythiazide	The serum concentration of Polythiazide can be increased when it is combined with Ipratropium bromide.	Approved
Posaconazole	The metabolism of Ipratropium bromide can be decreased when combined with Posaconazole.	Approved, Investigational, Vet Approved
Potassium Chloride	Ipratropium bromide may increase the ulcerogenic activities of Potassium Chloride.	Approved, Withdrawn
Pramlintide	Pramlintide may increase the anticholinergic activities of Ipratropium bromide.	Approved, Investigational
Primidone	The metabolism of Ipratropium bromide can be increased when combined with Primidone.	Approved, Vet Approved
Procyclidine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Procyclidine.	Approved
Promazine	The metabolism of Ipratropium bromide can be decreased when combined with Promazine.	Approved, Vet Approved
Propantheline	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Propantheline.	Approved
Propiverine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Propiverine.	Investigational
Pyridostigmine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Pyridostigmine.	Approved
Quinethazone	The serum concentration of Quinethazone can be increased when it is combined with Ipratropium bromide.	Approved
Quinidine	The metabolism of Ipratropium bromide can be decreased when combined with Quinidine.	Approved
Quinine	The metabolism of Ipratropium bromide can be decreased when combined with Quinine.	Approved
Ramosetron	Ipratropium bromide may increase the constipating activities of Ramosetron.	Approved
Ranolazine	The metabolism of Ipratropium bromide can be decreased when combined with Ranolazine.	Approved, Investigational
Remifentanil	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Remifentanil.	Approved
Rifabutin	The metabolism of Ipratropium bromide can be increased when combined with Rifabutin.	Approved
Rifampicin	The metabolism of Ipratropium bromide can be increased when combined with Rifampicin.	Approved
Rifapentine	The metabolism of Ipratropium bromide can be increased when combined with Rifapentine.	Approved
Ritonavir	The metabolism of Ipratropium bromide can be decreased when combined with Ritonavir.	Approved, Investigational
Rivastigmine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Rivastigmine.	Approved, Investigational
Rolapitant	The metabolism of Ipratropium bromide can be decreased when combined with Rolapitant.	Approved
Ropinirole	The metabolism of Ipratropium bromide can be decreased when combined with Ropinirole.	Approved, Investigational
Saquinavir	The metabolism of Ipratropium bromide can be decreased when combined with Saquinavir.	Approved, Investigational
Scopolamine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Scopolamine.	Approved
Scopolamine butylbromide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Scopolamine butylbromide.	Approved, Vet Approved
Secretin	The therapeutic efficacy of Secretin can be decreased when used in combination with Ipratropium bromide.	Approved, Investigational
Sertraline	The metabolism of Ipratropium bromide can be decreased when combined with Sertraline.	Approved
Sildenafil	The metabolism of Ipratropium bromide can be decreased when combined with Sildenafil.	Approved, Investigational
Siltuximab	The serum concentration of Ipratropium bromide can be decreased when it is combined with Siltuximab.	Approved
Simeprevir	The serum concentration of Ipratropium bromide can be increased when it is combined with Simeprevir.	Approved
Solifenacin	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Solifenacin.	Approved
St. John's Wort	The serum concentration of Ipratropium bromide can be decreased when it is combined with St. John's Wort.	Nutraceutical
Stiripentol	The serum concentration of Ipratropium bromide can be increased when it is combined with Stiripentol.	Approved
Sufentanil	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Sufentanil.	Approved, Investigational
Sulfisoxazole	The metabolism of Ipratropium bromide can be decreased when combined with Sulfisoxazole.	Approved, Vet Approved
Sulpiride	The therapeutic efficacy of Sulpiride can be decreased when used in combination with Ipratropium bromide.	Approved
Tacrine	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Tacrine.	Withdrawn
Tapentadol	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Tapentadol.	Approved
Telaprevir	The metabolism of Ipratropium bromide can be decreased when combined with Telaprevir.	Withdrawn
Telithromycin	The metabolism of Ipratropium bromide can be decreased when combined with Telithromycin.	Approved
Terbinafine	The metabolism of Ipratropium bromide can be decreased when combined with Terbinafine.	Approved, Investigational, Vet Approved
Thioridazine	The metabolism of Ipratropium bromide can be decreased when combined with Thioridazine.	Withdrawn
Ticlopidine	The metabolism of Ipratropium bromide can be decreased when combined with Ticlopidine.	Approved
Tiotropium	Ipratropium bromide may increase the anticholinergic activities of Tiotropium.	Approved
Tipranavir	The metabolism of Ipratropium bromide can be decreased when combined with Tipranavir.	Approved, Investigational
Tocilizumab	The serum concentration of Ipratropium bromide can be decreased when it is combined with Tocilizumab.	Approved
Tolterodine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Tolterodine.	Approved, Investigational
Topiramate	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Topiramate.	Approved
Tramadol	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Tramadol.	Approved, Investigational
Tranylcypromine	The metabolism of Ipratropium bromide can be decreased when combined with Tranylcypromine.	Approved
Trichlorfon	The therapeutic efficacy of Ipratropium bromide can be decreased when used in combination with Trichlorfon.	Vet Approved
Trichlormethiazide	The serum concentration of Trichlormethiazide can be increased when it is combined with Ipratropium bromide.	Approved, Vet Approved
Trihexyphenidyl	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Trihexyphenidyl.	Approved
Trimethaphan	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Trimethaphan.	Approved
Tropicamide	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Tropicamide.	Approved
Trospium	The risk or severity of adverse effects can be increased when Trospium is combined with Ipratropium bromide.	Approved
Tubocurarine	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Tubocurarine.	Approved
Umeclidinium	Umeclidinium may increase the anticholinergic activities of Ipratropium bromide.	Approved
Vecuronium	The risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Vecuronium.	Approved
Venlafaxine	The metabolism of Ipratropium bromide can be decreased when combined with Venlafaxine.	Approved
Verapamil	The metabolism of Ipratropium bromide can be decreased when combined with Verapamil.	Approved
Voriconazole	The metabolism of Ipratropium bromide can be decreased when combined with Voriconazole.	Approved, Investigational
Ziprasidone	The metabolism of Ipratropium bromide can be decreased when combined with Ziprasidone.	Approved

Food Interactions

Not Available

References

Synthesis Reference

Abdine HH, Belala F, and Al-Badra AA. (2003). Ipratropium bromide: Methods of chemical and biochemical synthesis. In H.G. Brittain (Ed.). Profiles of drug substances, excipients and related methodology (pp. 85-99). Amsterdam, Netherlands: Elsevier Academic Press.

General References

Yamatake Y, Sasagawa S, Yanaura S, Okamiya Y: [Antiallergic asthma effect of ipatropium bromide (Sch 1000) in dogs (author's transl)]. Nihon Yakurigaku Zasshi. 1977 Oct;73(7):785-91. [PubMed:145994 ]

External Links

Human Metabolome Database: HMDB14476
KEGG Compound: C07052
PubChem Compound: 657308
PubChem Substance: 46506138
ChemSpider: 21865423
ChEBI: 46659
ChEMBL: CHEMBL1908368
Therapeutic Targets Database: DNC000806
PharmGKB: PA450082
IUPHAR: 325
Guide to Pharmacology: GtP Drug Page
RxList: RxList Drug Page
Drugs.com: Drugs.com Drug Page
Wikipedia: Ipratropium_bromide

ATC Codes

R03BB01 — Ipratropium bromide

R03AL01 — Fenoterol and ipratropium bromide

R01AX03 — Ipratropium bromide

R03AL02 — Salbutamol and ipratropium bromide

AHFS Codes

12:08.08

PDB Entries

Not Available

FDA label

Download (88.1 KB)

MSDS

Download (72.7 KB)

Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
1	Completed	Basic Science	Pulmonary Disease, Chronic Obstructive	1
1	Completed	Diagnostic	Pulmonary Disease, Chronic Obstructive	1
1	Recruiting	Treatment	Status Asthmaticus	1
2	Completed	Diagnostic	Lung Diseases, Obstructive	1
2	Completed	Treatment	Chronic Obstructive Pulmonary Disease (COPD)	4
2	Completed	Treatment	Parkinson's Disease (PD)	1
2	Completed	Treatment	Pulmonary Disease, Chronic Obstructive	2
2	Not Yet Recruiting	Treatment	Exercise Induced Laryngeal Obstruction (EILO)	1
3	Completed	Prevention	Chronic Lung Diseases / Chronic Obstructive Pulmonary Disease (COPD) / Lung Diseases, Obstructive	1
3	Completed	Treatment	Acute Exacerbation of Chronic Obstructive Pulmonary Disease	1
3	Completed	Treatment	Asthma Bronchial	1
3	Completed	Treatment	Chronic Obstructive Pulmonary Disease (COPD)	1
3	Completed	Treatment	Familial Dysautonomia	1
3	Completed	Treatment	Pulmonary Disease, Chronic Obstructive	8
3	Recruiting	Treatment	Acute Exacerbation of Chronic Obstructive Airways Disease / Chronic Obstructive Pulmonary Disease Exacerbation	1
4	Active Not Recruiting	Treatment	Asthma Bronchial	1
4	Completed	Diagnostic	Asthma Bronchial	1
4	Completed	Supportive Care	Chronic Obstructive Pulmonary Disease (COPD) / Sepsis / Shock	1
4	Completed	Treatment	Acute Asthma / Asthma Bronchial / Reactive Airway Exacerbation	1
4	Completed	Treatment	Asthma Bronchial	1
4	Completed	Treatment	Chronic Obstructive Pulmonary Disease (COPD)	3
4	Completed	Treatment	Cold	1
4	Completed	Treatment	Exercise-Induced Bronchoconstriction (EIB)	1
4	Completed	Treatment	Pulmonary Disease, Chronic Obstructive	5
4	Recruiting	Treatment	Asthma Bronchial	1
4	Terminated	Treatment	Asthma Bronchial	1
4	Unknown Status	Treatment	Chronic Obstructive Pulmonary Disease (COPD)	1
Not Available	Completed	Not Available	Dyspnea / Quadriplegia	1
Not Available	Completed	Not Available	Pulmonary Disease, Chronic Obstructive	6
Not Available	Completed	Not Available	Acute Rhinitis	1
Not Available	Completed	Diagnostic	Chronic Obstructive Pulmonary Disease (COPD)	2
Not Available	Completed	Treatment	Anaesthesia therapy / Extravascular Lung Water / Intensive Care, Surgical / Lung Injury, Acute / THoracotomy	1
Not Available	Completed	Treatment	Asthma Bronchial	1
Not Available	Completed	Treatment	Bronchitis	1
Not Available	Not Yet Recruiting	Not Available	Lung Diseases, Interstitial	1
Not Available	Terminated	Basic Science	Chronic Obstructive Pulmonary Disease (COPD)	1
Not Available	Unknown Status	Not Available	Electrophysiological Parameters / Influence of Nebulized Bronchodilatators on Selected	1
Not Available	Unknown Status	Treatment	Chronic Obstructive Pulmonary Disease (COPD)	1

Pharmacoeconomics

Manufacturers

Boehringer ingelheim pharmaceuticals inc
Actavis mid atlantic llc
Bausch and lomb pharmaceuticals inc
Cobalt laboratories inc
Dey lp
Holopack international corp
Landela pharmaceutical
Nephron corp
Novex pharma
Pharmascience inc
Roxane laboratories inc
Teva parenteral medicines inc
Bausch and lomb inc

Packagers

Dosage forms

Form	Route	Strength
Solution	Respiratory (inhalation)	250 mcg
Spray, metered	Nasal	21 ug/1
Spray, metered	Nasal	42 ug/1
Aerosol, metered	Respiratory (inhalation)	17 ug/1
Aerosol, metered	Respiratory (inhalation)	20 mcg
Aerosol	Nasal; Respiratory (inhalation)	20 mcg
Aerosol, metered	Nasal	21 mcg
Aerosol, metered	Nasal	42 mcg
Aerosol, metered	Oral; Respiratory (inhalation)
Spray, metered	Respiratory (inhalation)
Liquid	Nasal; Respiratory (inhalation)	0.3 mg
Liquid	Respiratory (inhalation)	125 mcg
Liquid	Respiratory (inhalation)	250 mcg
Solution	Oral; Respiratory (inhalation)
Solution	Respiratory (inhalation)	.5 mg/2.5mL
Spray	Nasal	21 ug/1
Spray	Nasal	42 ug/1
Solution	Respiratory (inhalation)
Solution	Nasal	0.03 %
Solution	Nasal	0.06 %
Solution	Respiratory (inhalation)	0.25 mg
Solution	Respiratory (inhalation)	.25 mg
Liquid	Respiratory (inhalation)	0.25 mg
Liquid	Respiratory (inhalation)	0.30 mg
Spray, metered	Nasal	21 mcg
Solution	Nasal; Respiratory (inhalation)	250 mcg
Solution	Respiratory (inhalation)	125 mcg
Solution	Respiratory (inhalation)	0.025 %

Prices

Unit description	Cost	Unit
Atrovent HFA 17 mcg/act Aerosol 12.9 gm Inhaler	143.59USD	inhaler
Ipratropium bromide powder	100.06USD	g
Atrovent 0.03% Solution 30ml Nasal Spray	96.95USD	bottle
Atrovent 0.06% Solution 15ml Nasal Spray	84.68USD	bottle
Ipratropium Bromide 0.03% Solution 30ml Bottle	53.82USD	bottle
Ipratropium Bromide 0.06% Solution 15ml Bottle	46.14USD	bottle
Ipratropium Bromide 0.02% Solution Each Box Contains Twenty-Five 2.5ml Vials	45.86USD	box
Atrovent hfa inhaler	11.89USD	g
Atrovent 0.06% spray	5.33USD	ml
Atrovent 0.03% spray	3.11USD	ml
Ipratropium 0.06% spray	2.96USD	ml
Ipratropium 0.03% spray	1.73USD	ml
Atrovent 0.03 % Spray	1.04USD	ml
Apo-Ipravent 250 mcg/ml Solution	0.58USD	ml
Mylan-Ipratropium 250 mcg/ml Solution	0.58USD	ml
Novo-Ipramide 250 mcg/ml Solution	0.58USD	ml
Pms-Ipratropium 0.03 % Spray	0.58USD	ml
Pms-Ipratropium 250 mcg/ml Solution	0.58USD	ml
Atrovent Hfa 20 mcg/dose Metered Dose Aerosol	0.1USD	metered dose aerosol

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)
US5766573	No	1992-11-28	2009-11-28
CA2151383	No	2005-02-08	2013-12-06
US6632842	No	2001-12-28	2021-12-28
US8474447	No	2010-01-17	2030-01-17
US6739333	No	2000-05-26	2020-05-26
US6983743	No	2000-05-26	2020-05-26
US6453795	Yes	1997-06-05	2017-06-05
US8733341	Yes	2011-04-16	2031-04-16
US9027967	Yes	2007-10-01	2027-10-01
US7104470	Yes	1997-04-04	2017-04-04
US7246615	Yes	1996-12-01	2016-12-01
US7896264	Yes	2005-11-26	2025-11-26
US7988001	Yes	2002-02-04	2022-02-04
US7802568	Yes	1999-08-26	2019-08-26
US6149054	Yes	1997-06-16	2017-06-16
US6726124	Yes	1997-04-04	2017-04-04
US7396341	Yes	2007-04-10	2027-04-10
US6846413	Yes	1999-02-28	2019-02-28
US6176442	Yes	1996-12-01	2016-12-01
US7837235	Yes	2008-09-13	2028-09-13
US5964416	Yes	1997-04-04	2017-04-04
US7284474	Yes	2005-02-26	2025-02-26
US6977042	Yes	1999-02-28	2019-02-28
US6988496	Yes	2000-08-23	2020-08-23

Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	230-231.5	U.S. Patent 3,505,337
water solubility	Freely soluble	Not Available

Predicted Properties

Property	Value	Source
Water Solubility	0.000701 mg/mL	ALOGPS
logP	0.21	ALOGPS
logP	-1.8	ChemAxon
logS	-5.8	ALOGPS
pKa (Strongest Acidic)	15.15	ChemAxon
pKa (Strongest Basic)	-2.7	ChemAxon
Physiological Charge	1	ChemAxon
Hydrogen Acceptor Count	2	ChemAxon
Hydrogen Donor Count	1	ChemAxon
Polar Surface Area	46.53 Å²	ChemAxon
Rotatable Bond Count	6	ChemAxon
Refractivity	105.9 m³·mol^-1	ChemAxon
Polarizability	37.43 Å³	ChemAxon
Number of Rings	3	ChemAxon
Bioavailability	1	ChemAxon
Rule of Five	Yes	ChemAxon
Ghose Filter	No	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	Yes	ChemAxon

Predicted ADMET features

Property	Value	Probability
Human Intestinal Absorption	-	0.9425
Blood Brain Barrier	+	0.8883
Caco-2 permeable	+	0.6619
P-glycoprotein substrate	Substrate	0.5085
P-glycoprotein inhibitor I	Non-inhibitor	0.8489
P-glycoprotein inhibitor II	Non-inhibitor	0.5964
Renal organic cation transporter	Inhibitor	0.6651
CYP450 2C9 substrate	Non-substrate	0.7214
CYP450 2D6 substrate	Non-substrate	0.7637
CYP450 3A4 substrate	Substrate	0.6657
CYP450 1A2 substrate	Non-inhibitor	0.8412
CYP450 2C9 inhibitor	Non-inhibitor	0.9118
CYP450 2D6 inhibitor	Non-inhibitor	0.8915
CYP450 2C19 inhibitor	Non-inhibitor	0.8783
CYP450 3A4 inhibitor	Non-inhibitor	0.9396
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.9528
Ames test	Non AMES toxic	0.7112
Carcinogenicity	Non-carcinogens	0.8979
Biodegradation	Ready biodegradable	0.5154
Rat acute toxicity	2.7983 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9596
hERG inhibition (predictor II)	Inhibitor	0.5879

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	Not Available
Predicted LC-MS/MS Spectrum - 10V, Positive	Predicted LC-MS/MS	Not Available
Predicted LC-MS/MS Spectrum - 20V, Positive	Predicted LC-MS/MS	Not Available
Predicted LC-MS/MS Spectrum - 40V, Positive	Predicted LC-MS/MS	Not Available
Predicted LC-MS/MS Spectrum - 10V, Negative	Predicted LC-MS/MS	Not Available
Predicted LC-MS/MS Spectrum - 20V, Negative	Predicted LC-MS/MS	Not Available
Predicted LC-MS/MS Spectrum - 40V, Negative	Predicted LC-MS/MS	Not Available

Taxonomy

Description: This compound belongs to the class of chemical entities known as tropane alkaloids. These are organic compounds containing the nitrogenous bicyclic alkaloid parent N-Methyl-8-azabicyclo[3.2.1]octane.
Kingdom: Chemical entities
Super Class: Organic compounds
Class: Alkaloids and derivatives
Sub Class: Tropane alkaloids
Direct Parent: Tropane alkaloids
Alternative Parents: Beta hydroxy acids and derivatives / Piperidines / Benzene and substituted derivatives / N-alkylpyrrolidines / Tetraalkylammonium salts / Carboxylic acid esters / Azacyclic compounds / Monocarboxylic acids and derivatives / Organic bromide salts / Hydrocarbon derivatives
show 6 more
Substituents: Tropane alkaloid / Beta-hydroxy acid / Monocyclic benzene moiety / Hydroxy acid / Piperidine / N-alkylpyrrolidine / Benzenoid / Tetraalkylammonium salt / Pyrrolidine / Quaternary ammonium salt
show 20 more
Molecular Framework: Aromatic heteropolycyclic compounds
External Descriptors: organic bromide salt (CHEBI:46659 )

Targets

Details1. Muscarinic acetylcholine receptor M1

Kind: Protein
Organism: Human
Pharmacological action: Yes
Actions: Antagonist

General Function: Phosphatidylinositol phospholipase c activity
Specific Function: The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name: CHRM1
Uniprot ID: P11229
Uniprot Name: Muscarinic acetylcholine receptor M1
Molecular Weight: 51420.375 Da

References

Wellington K: Ipratropium bromide HFA. Treat Respir Med. 2005;4(3):215-20; discussion 221-2. [PubMed:15987237 ]

Details2. Muscarinic acetylcholine receptor M2

Kind: Protein
Organism: Human
Pharmacological action: Yes
Actions: Antagonist

General Function: G-protein coupled acetylcholine receptor activity
Specific Function: The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name: CHRM2
Uniprot ID: P08172
Uniprot Name: Muscarinic acetylcholine receptor M2
Molecular Weight: 51714.605 Da

References

Wellington K: Ipratropium bromide HFA. Treat Respir Med. 2005;4(3):215-20; discussion 221-2. [PubMed:15987237 ]

Details3. Muscarinic acetylcholine receptor M3

Kind: Protein
Organism: Human
Pharmacological action: Yes
Actions: Antagonist

General Function: Receptor activity
Specific Function: The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name: CHRM3
Uniprot ID: P20309
Uniprot Name: Muscarinic acetylcholine receptor M3
Molecular Weight: 66127.445 Da

References

Wellington K: Ipratropium bromide HFA. Treat Respir Med. 2005;4(3):215-20; discussion 221-2. [PubMed:15987237 ]

Enzymes

Details1. Cytochrome P450 2D6

Kind: Protein
Organism: Human
Pharmacological action: Unknown
Actions: Substrate

General Function: Steroid hydroxylase activity
Specific Function: Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic...
Gene Name: CYP2D6
Uniprot ID: P10635
Uniprot Name: Cytochrome P450 2D6
Molecular Weight: 55768.94 Da

References

Keam SJ, Keating GM: Tiotropium bromide. A review of its use as maintenance therapy in patients with COPD. Treat Respir Med. 2004;3(4):247-68. [PubMed:15350163 ]

Details2. Cytochrome P450 3A4

Kind: Protein
Organism: Human
Pharmacological action: Unknown
Actions: Substrate

General Function: Vitamin d3 25-hydroxylase activity
Specific Function: Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name: CYP3A4
Uniprot ID: P08684
Uniprot Name: Cytochrome P450 3A4
Molecular Weight: 57342.67 Da

References

Keam SJ, Keating GM: Tiotropium bromide. A review of its use as maintenance therapy in patients with COPD. Treat Respir Med. 2004;3(4):247-68. [PubMed:15350163 ]

Transporters

Details1. Solute carrier family 22 member 5

Kind: Protein
Organism: Human
Pharmacological action: Unknown
Actions: Substrate

General Function: Symporter activity
Specific Function: Sodium-ion dependent, high affinity carnitine transporter. Involved in the active cellular uptake of carnitine. Transports one sodium ion with one molecule of carnitine. Also transports organic cat...
Gene Name: SLC22A5
Uniprot ID: O76082
Uniprot Name: Solute carrier family 22 member 5
Molecular Weight: 62751.08 Da

References

Nakamura T, Nakanishi T, Haruta T, Shirasaka Y, Keogh JP, Tamai I: Transport of ipratropium, an anti-chronic obstructive pulmonary disease drug, is mediated by organic cation/carnitine transporters in human bronchial epithelial cells: implications for carrier-mediated pulmonary absorption. Mol Pharm. 2010 Feb 1;7(1):187-95. doi: 10.1021/mp900206j. [PubMed:20020740 ]

Details2. Solute carrier family 22 member 4

Kind: Protein
Organism: Human
Pharmacological action: Unknown
Actions: Substrate

General Function: Symporter activity
Specific Function: Sodium-ion dependent, low affinity carnitine transporter. Probably transports one sodium ion with one molecule of carnitine. Also transports organic cations such as tetraethylammonium (TEA) without...
Gene Name: SLC22A4
Uniprot ID: Q9H015
Uniprot Name: Solute carrier family 22 member 4
Molecular Weight: 62154.48 Da

References

Nakamura T, Nakanishi T, Haruta T, Shirasaka Y, Keogh JP, Tamai I: Transport of ipratropium, an anti-chronic obstructive pulmonary disease drug, is mediated by organic cation/carnitine transporters in human bronchial epithelial cells: implications for carrier-mediated pulmonary absorption. Mol Pharm. 2010 Feb 1;7(1):187-95. doi: 10.1021/mp900206j. [PubMed:20020740 ]

Drug created on June 13, 2005 07:24 / Updated on September 01, 2017 10:26

Ipratropium bromide

Identification

Structure for DB00332 (Ipratropium bromide)

Pharmacology

Reactions:

Interactions

References

Clinical Trials

Pharmacoeconomics

Properties

Spectra

Taxonomy

Targets

References

References

References

Enzymes

References

References

Transporters

References

References