Ipratropium Steri-Neb

Ipratropium Steri-Neb contains ipratropium bromide in a nebuliser solution, used for the management of reversible bronchospasm in chronic obstructive pulmonary disease (COPD) and severe acute asthma.

Ipratropium is an anticholinergic (antimuscarinic) bronchodilator that works by blocking acetylcholine receptors in the airway smooth muscle, preventing bronchoconstriction and reducing mucus secretion.

In COPD, ipratropium is one of the mainstays of bronchodilator therapy, providing reliable relief of breathlessness and wheeze.

In acute severe asthma, nebulised ipratropium is frequently used in combination with a beta-2 agonist such as salbutamol to achieve greater bronchodilation than either agent alone.

The Steri-Neb format provides unit-dose vials of sterile solution ready for use in a nebuliser without further dilution.

Ipratropium has a slower onset of action than salbutamol (typically 15 to 30 minutes), but its effects last longer (four to six hours).

This makes it a useful maintenance bronchodilator in COPD and a valuable adjunct in the acute management of severe airway obstruction.

Use the nebuliser solution as directed by your doctor or respiratory specialist. Open one Steri-Neb unit dose and squeeze the contents into the nebuliser chamber.

Breathe in the mist through the mouthpiece or face mask until the solution has been completely nebulised, which usually takes five to ten minutes.

Rinse your mouth with water afterwards to reduce the risk of dry mouth.

Do not allow the nebulised solution to come into contact with the eyes, as ipratropium may cause blurred vision or worsening of narrow-angle glaucoma.

Adults: 250 to 500 micrograms nebulised three to four times daily. In acute severe asthma, 500 micrograms may be given alongside nebulised salbutamol as often as every four to six hours.

Children over 12 years: 250 to 500 micrograms up to three times daily. Children under 12: 250 micrograms up to three times daily.

Dosing in acute settings may differ and should follow local hospital protocols.

Common side effects include dry mouth, headache, and cough. Uncommon effects include nausea, dizziness, tremor, and urinary retention, particularly in elderly men with prostatic enlargement.

If the nebuliser mist enters the eyes, it may cause pupil dilation, blurred vision, and a rise in intraocular pressure, which can be hazardous for patients with narrow-angle glaucoma.

Paradoxical bronchospasm (a worsening of wheeze immediately after nebulisation) is rare but requires prompt treatment. Allergic reactions are very rare.

Protect the eyes from the nebuliser mist. Use a mouthpiece rather than a face mask where possible to minimise ocular exposure. If a face mask is used, ensure it fits closely.

Inform your doctor if you have glaucoma, prostatic hyperplasia, or bladder outflow obstruction.

Ipratropium should not be used as the sole rescue treatment in acute asthma; it is most effective when combined with a fast-acting beta-2 agonist.

If paradoxical bronchospasm occurs, stop nebulisation immediately and use an alternative bronchodilator.

Ipratropium Steri-Neb is contraindicated in patients with known hypersensitivity to ipratropium bromide, atropine or its derivatives, or any excipient.

It should be used with caution in narrow-angle glaucoma, prostatic hyperplasia, and bladder neck obstruction.