Atrovent®
Metered Aerosol (CFC Free)

Ipratropium bromide

Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about Atrovent Metered Aerosol.

It does not contain all the available information.

It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor or pharmacist has weighed the risks of you using Atrovent Metered Aerosol against the benefits it is expected to have for you.

If you have any concerns about this medicine, ask your doctor or pharmacist.

This leaflet was last updated on the date at the end of this leaflet. More recent information may be available. The latest Consumer Medicine Information is available from your pharmacist, doctor or from www.medicines.org.au and may contain important information about the medicine and its use of which you should be aware.

Keep this leaflet with your medicine. You may need to read it again.

What Atrovent Metered Aerosol is used for

Atrovent Metered Aerosol opens up the air passages in people with asthma and chronic obstructive pulmonary disease (COPD).

Atrovent belongs to a group of medicines called anticholinergic bronchodilators. These medicines work by relaxing and opening up the airways, allowing more air to the lungs. It begins to act quickly after use but may take up to 2 hours to give maximum benefit.

It is for relief of symptoms and should be part of a management program that is prescribed by your doctor.

Your doctor may have prescribed Atrovent Metered Aerosol for another reason. Ask your doctor if you have any questions about why Atrovent Metered Aerosol has been prescribed for you.

Atrovent Metered Aerosol is available only with a doctor's prescription.

There is no evidence that Atrovent Metered Aerosol is addictive.

Before you use Atrovent Metered Aerosol

When you must not use it

Do not use Atrovent Metered Aerosol if you are allergic to:

• ipratropium bromide
• similar medicines which contain atropine or medicines like atropine
• any of the ingredients listed at the end of this leaflet.

Some of the symptoms of an allergic reaction may include:

• rash, itching or hives on the skin
• swelling of the face, lips, tongue or other parts of the body
• shortness of breath, wheezing or troubled breathing.

Do not use Atrovent Metered Aerosol after the expiry date (EXP) printed on the pack.

If you take this medicine after the expiry date has passed, it may not work as well.

Do not use Atrovent Metered Aerosol if the packaging is torn or shows signs of tampering.

If you are not sure whether you should start using Atrovent Metered Aerosol, contact your doctor or pharmacist.

Before you use it

Tell your doctor or pharmacist if you have allergies to:

• any other medicines
• any other substances, such as foods, preservatives or dyes.

Tell your doctor or pharmacist if you are pregnant or intend to become pregnant.

Care is recommended during pregnancy, particularly in the first three months. Your doctor or pharmacist will discuss the possible risks and benefits of using Atrovent Metered Aerosol during pregnancy.

Tell your doctor or pharmacist if you are breast-feeding or plan to breast-feed.

Your doctor or pharmacist will discuss the possible risks and benefits of using Atrovent Metered Aerosol during breastfeeding.

Tell your doctor or pharmacist if you have or have had any of the following medical conditions:

• glaucoma (high pressure in the eye)
• difficulty or pain when passing urine
• constipation
• cystic fibrosis.

If you have not told your doctor or pharmacist about any of the above, tell them before you start using Atrovent Metered Aerosol.

Using other medicines

Tell your doctor or pharmacist if you are using any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Atrovent Metered Aerosol may interfere with each other. Your doctor and pharmacist may have more information on medicines to be careful with or avoid while using Atrovent Metered Aerosol.

How to use Atrovent Metered Aerosol

Each puff must be properly inhaled through the mouth for Atrovent Metered Aerosol to work. At the end of this leaflet you will find instructions on how to use Atrovent Metered Aerosol correctly.

If you are not sure how to use an inhaler, ask your doctor or pharmacist.

Children should only use their inhaler on medical advice and with the help of an adult.

If you find it difficult to breathe in and use your inhaler at the same time, talk to your doctor or pharmacist. They may be able to recommend another method.

Never spray Atrovent Metered Aerosol in or around your eyes. Should this occur, immediately flush your eyes with cold tap water for several minutes.

How much to use

The usual doses for adults and children are stated below.

• Adults:
  2-4 puffs, three to four times daily (at regular intervals), up to a maximum of 16 puffs a day.
• Children 6 to 12 years:
  1 to 2 puffs three to four times daily (at regular intervals), up to a maximum of 8 puffs a day.
• Children under 6 years:
  1 puff three times daily (at regular intervals).

Your doctor will decide the right dose for you. Depending on your condition and specific needs, your doctor may advise you to take a different dose.

When to use it

If your doctor has advised you to use Atrovent Metered Aerosol regularly, then use it at about the same time each day.

Using it at the same time each day will help you remember when to use it.

If you forget to use it

If you forget to use your Atrovent Metered Aerosol, use it as soon as you remember, and then go back to using your medicine as you would normally.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to use your medicine, ask your pharmacist for some hints.

How long to use it

Atrovent Metered Aerosol helps control your condition, but does not cure it. Therefore you must continue using the medicine for as long as your doctor or pharmacist tells you.

Do not stop using it unless your doctor or pharmacist tells you to even if you feel better.

If you take too much (overdose)

Telephone your doctor or pharmacist or the Poisons Information Centre (telephone 13 11 26) if you think that you or anyone else may have used too much Atrovent Metered Aerosol. Do this even if there are no signs of discomfort or poisoning.

You may need urgent medical attention.

If you use too much Atrovent Metered Aerosol, you may have a fast or irregular heart beat, dry mouth or blurred vision.

While you are using Atrovent Metered Aerosol

Things you must do

Tell your doctor or pharmacist immediately if:

• your breathing suddenly becomes more difficult after using Atrovent Metered Aerosol.

This may be a sign of an allergic reaction.

• you develop eye pain or discomfort, or any disturbances with your sight (blurred vision, visual halos or coloured images).

This may mean that you have developed a serious eye condition called narrow-angle glaucoma. This can happen if the mist gets in your eyes.

If you find that the usual dose of Atrovent Metered Aerosol is not giving as much relief as before, or you need to use it more often, contact your doctor so that your condition can be checked.

This is important to ensure your breathing problem is controlled properly.

If you have Asthma Action Plan that you have agreed with your doctor, follow it closely at all times.

Continue using Atrovent Metered Aerosol for as long as your doctor or pharmacist tells you.

Visit your doctor regularly to check on your asthma condition.

Make sure you keep Atrovent Metered Aerosol with you at all times.

Tell any other doctors, dentists, and pharmacists who are treating you that you are using Atrovent Metered Aerosol.

If you are about to start any new medicine, tell your doctor or pharmacist that you are using Atrovent Metered Aerosol.

If you plan to have surgery (which requires a general anaesthetic), tell your doctor or dentist that you are using Atrovent Metered Aerosol.

If you become pregnant while using Atrovent Metered Aerosol tell your doctor or pharmacist.

Things you must not do

Do not take any other medicines for your breathing problems without checking with your doctor.

Do not give Atrovent Metered Aerosol to anyone else, even if they have the same condition as you.

Do not use Atrovent Metered Aerosol to treat any other complaints unless your doctor or pharmacist tells you to.

Do not stop using Atrovent Metered Aerosol or lower the dosage, without checking with your doctor or pharmacist.

Things to be careful of

Be careful driving or operating machinery until you know how Atrovent Metered Aerosol affects you.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using Atrovent Metered Aerosol.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor or pharmacist to answer any questions you may have.

If you get any side effects, do not stop using the Atrovent Metered Aerosol without first talking to your doctor or pharmacist.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

• headache
• dizziness
• dry mouth
• nausea, vomiting
• a change in bowel movements
• (e.g. constipation, diarrhoea)
• throat irritation, cough

These are the more common side effects of Atrovent Metered Aerosol. Mostly these are mild and short-lived.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at the nearest hospital:

• difficulty breathing or worsening of your breathing problems
• fast or irregular heart beat
• pounding heart beat
• symptoms of an allergic reactions such as rash, itching or hives on the skin; swelling of the face, lips, tongue or other parts of the body; shortness of breath, wheezing or troubled breathing.
• if it is accidentally sprayed into the eye, you may get eye problems such as increased pressure in the eye, painful, stinging and dilated pupils, blurred vision, see colours of lights. You may be developing glaucoma, which will need treatment straight away.

These are serious side effects. You may need urgent medical attention or hospitalisation.

Other side effects not listed above may occur in some patients. Tell your doctor or pharmacist if you notice anything else that is making you feel unwell.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

After using Atrovent Metered Aerosol

Cleaning

Clean and dry your inhaler each time you use it.

It is important to keep your inhaler clean and dry. It may not work as well if it gets dirty. Follow the instructions at the end of this leaflet for cleaning your inhaler.

Storage

Keep your inhaler in a cool dry place where the temperature stays below 25°C.

Do not store Atrovent Metered Aerosol or any other medicine in the bathroom or near a sink.

Do not leave it in the car on hot days or on window sills. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor or pharmacist tells you to stop using Atrovent Metered Aerosol or it has passed its expiry date, ask your pharmacist what to do with any that are left over.

Do not puncture the container or throw it into a fire.

Product description

What it looks like

Atrovent Metered Aerosol is supplied in a canister containing 200 doses.

Ingredients

Each Atrovent Metered Aerosol dose contains 21 micrograms ipratropium bromide as the active ingredient.

Other ingredients:

• citric acid - anhydrous,
• purified water
• absolute ethanol and
• norflurane

Atrovent Metered Aerosol does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.

Manufacturer

Atrovent Metered Aerosol is made in Germany and supplied in Australia by:
Boehringer Ingelheim Pty Limited
(ABN 52 000 452 308)
78 Waterloo Road
NORTH RYDE NSW 2113

Australian Registration Number:
AUST R 91129

This leaflet was revised on
7 September 2010.

®= Registered Trademark

© Boehringer Ingelheim Pty Limited 2010

Directions for Use

The mouthpiece has been designed for use with the Atrovent Metered Aerosol canister so that you always get the right amount of medicine. The mouthpiece must never be used with any other metered aerosol canister. The Atrovent Metered Aerosol canister must not be used with any mouthpiece other than the one supplied with this product.

How to use the metered aerosol

Note:
Before first use of a new inhaler, prime it by activating twice into the atmosphere.
Before use if the inhaler has not been used for 3 days, reprime by activating once into the atmosphere.

1. Remove the protective cap from the short end of the mouthpiece.
2. Hold the inhaler with the arrow on the canister pointing upwards. Do not spray into or around the eyes.
3. Breathe out fully, to the end of a normal breath.
4. Place the open end of the mouthpiece between the lips but not past the teeth.
5. Breathe in slowly through the mouth and at the same time firmly press the canister down once. Do not stop breathing when you press on the canister - continue to take a full, deep breath.
6. Hold your breath for about ten seconds if possible, then breathe out slowly. Remove the inhaler from your mouth.
7. If a second or subsequent inhalation is necessary, start again from instruction 3.

Replace the protective cap on the mouthpiece.

How to check how full your inhaler is

Your inhaler makes almost no sound when it is shaken, so it is difficult to know when your inhaler is nearly empty.

If you use your Atrovent Metered Aerosol regularly, you can keep a record of the number of times you use it, so you will know when to replace it.

However if you do not want to keep a record, you can check how full your Atrovent Metered Aerosol is by:

• filling a small bowl with water, and
• removing the canister from the mouthpiece and putting it into the bowl.

The amount in the canister can be estimated by observing its position in the water.

When the nozzle of the canister floats near the surface, it is time to get a new Atrovent Metered Aerosol.

Care and Cleaning

In order to obtain the best service from your Atrovent Metered Aerosol, these simple directions on maintenance should be carefully observed.

One of the most common causes of failure of the metering device of the inhaler to function is a dirty or blocked mouthpiece.

Always replace the protective cap on the mouthpiece after use to prevent the inside of the mouthpiece and canister from becoming dusty.

The mouthpiece of the Atrovent Metered Aerosol should be kept clean by washing regularly in warm soapy water, rinsing in clear water and drying on a clean tissue.

Remember to take out the canister before you wash the mouthpiece.

When removing the canister from the mouthpiece pull out carefully to avoid bending the thin plastic stem.

Never press the thin plastic stem of the canister against a firm surface to check for function.

This may bend the stem and lead to malfunction of the inhaler.

Using Atrovent Metered Aerosol with a spacer

Your doctor or pharmacist may suggest that you use a device called a 'spacer' with your inhaler, to help you use your inhaler more effectively.

A spacer is a holding chamber into which you spray your inhaler before inhaling. Follow the instructions supplied with the spacer, to use your inhaler and spacer together properly.

Before first using your spacer, wash it with warm water and a small amount of detergent. Allow it to dry without rinsing, or drying with a cloth. Repeat this cleaning process at least once every month.

This will help keep your spacer clean and to work properly.

Make sure you breathe in and out through the spacer after each puff from your inhaler. If you need to be shown how to use your spacer, or if you are having difficulties using your spacer, discuss this with your pharmacist.

Published by MIMS/myDr June 2011

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