Acute overdosage by intranasal administration is unlikely since ipratropium bromide is not well absorbed systemically after intranasal or oral administration. Following administration of a 20 mg oral dose (equivalent to ingesting more than two bottles of Atrovent® (ipratropium bromide) Nasal Spray 0.06%) to 10 male volunteers, no change in heart rate or blood pressure was noted. Following a 2 mg intravenous infusion over 15 minutes to the same 10 male volunteers, plasma ipratropium concentrations of 22-45 ng/mL were observed ( > 100 times the concentrations observed following intranasal administration). Following intravenous infusion these 10 volunteers had a mean increase of heart rate of 50 bpm and less than 20 mmHg change in systolic or diastolic blood pressure at the time of peak ipratropium levels.

Oral median lethal doses of ipratropium bromide were greater than 1,001 mg/kg in mice (approximately 6,000 and 2,900 times the maximum recommended daily intranasal dose in adults and children, respectively, on a mg/m² basis), 1,663 mg/kg in rats (approximately 20,000 and 9,500 times the maximum recommended daily intranasal dose in adults and children, respectively, on a mg/m² basis) and 400 mg/kg in dogs (approximately 16,000 and 7,600 times the maximum recommended daily intranasal dose in adults and children, respectively, on a mg/m² basis).

ATROVENT Nasal Spray 0.06% is contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, or to any of the other ingredients.

Last reviewed on RxList: 12/5/2008
This monograph has been modified to include the generic and brand name in many instances.