Treatment and management of watery rhinorrhoea
Medicine Classification:
Pharmacy Only
Customer Declaration:
I agree to use strictly as directed and if symptoms persist or if I suffer any adverse effects I will contact my Doctor or Pharmacist.
By ordering this product I acknowledge that I have read and understand the information regarding the product and agree to use it solely for my personal use
Purpose:
For the treatment and management of watery rhinorrhoea
Ingredients:
Ipratropium bromide 21mcg/puff
General:
Atrovent Nasal 0.03% Aqueous is an aqueous, isotonic solution, adjusted to pH 4.0-5.0, for nasal administration.
Atrovent Nasal Aqueous is a topical anticholinergic preparation which contains ipratropium bromide at a dosage of 21 mcg per puff. This inhibits vagally-mediated reflexes by antagonising the action of acetylcholine at muscarinic receptors.
Watery, colourless rhinorrhoea is a characteristic and annoying symptom in perennial rhinitis, allergic rhinitis and vasomotor rhinitis. The serous and seromucous glands of the nose have been shown to be almost exclusively innervated by the parasympathetic nervous system. Nasal provocation trials in perennial rhinitis patients using Atrovent Nasal Aqueous showed a rapid dose-dependent increase in inhibition of methacholine-induced nasal hypersecretion. On this basis a parasympathetic inhibitor is a logical therapeutic approach.
Other studies have demonstrated a clinically significant decrease watery hypersecretion but it does not alter physiologic nasal functions such as sense of smell, mucociliary clearance or the warming and humidification capacity of the nose.
Atrovent Nasal Aqueous has a high therapeutic ratio and is well tolerated at the dosages recommended, without significant effect on other body systems. The onset of action is rapid, occurring within minutes with a duration of action of approximately 6-8 hours.
While Atrovent Nasal 0.03% Aqueous is ideally suited for regular maintenance therapy, occasional use will be of value in patients with infrequent attacks of watery rhinorrhoea especially prior to exposure to known provocative factors such as temperature changes, certain foods and exercise.
Indications:
For the treatment and management of perennial rhinitis, allergic rhinitis and vasomotor rhinitis when characterised by watery rhinorrhoea
Contradictions:
Know hypersensitivity to atropine or its derivatives, or to any of the ingredients of Atrovent Nasal Aqueous (sodium chloride, benzalkonium chloride, disodium edetate dihydrate)
Precautions:
Generally, caution is advocated in the use of anticholinergic agents in patients with bladder neck obstruction or prostatic hypertrophy. However, there have been no reports of exacerbation of this condition nor urinary retention. There have been isolated reports of ocular complications such as mydriasis, eye-pain and acute angle glaucoma as a result of direct eye contact of ipratropium bromide formulations, either alone, or in combination with an adrenergic beta-2 agonist. Eye pain or discomfort, blurred vision, visual halos or coloured images in association with red eyes may be signs of acute-closure glaucoma. Should any combination of these symptoms develop, treatment with miotic drops should be initiated and specialist advise sought immediately.
Patients must be warned against the accidental release of the contents into the eye, and should be instructed in the correct administration of Adrovent Nasal Aqueous
Use in Pregnancy:
The safety of Atrovent Nasal Aqueous administration during pregnancy has not yet been established and as with any medicine, the expected benefits must be weighted against any possible risk to the foetus
Use in Lactation:
It is unlikely that the Ipratropium bromide in breast milk would reach an infant to any important extent. However caution is recommended
Side effects:
Generally, side effects are unlikely to occur at therapeutic dosages, but if they do, they are usually mild to moderate and transient. Some patients may experience dryness of the nasal mucosa or eplstaxis but this can resolve either spontaneously or following a dosage reduction. A small percentage of patients may report dry mouth.
Blurring vision, precipitation or worsening of narrow-angle glaucoma or eye pain may result of Atrovent Nasal Aqueous is sprayed directly into the eye.
There is no evidence of tachyphylaxis with regular use, or nasal rebound upon discontinuation of regular therapy
Interactions:
The concomitant use of Atrovent Nasal Aqueous with other drugs commonly prescribed for allergic and non-allergic rhinitis (antihistamines, decongestants and nasal steroids) does not increase the incidence of nasal or non-nasal side effects. Anticholinergic adverse events with chronic use of Atrovent Nasal Aqueous are rare, limited to local adverse events of dryness of nose and mouth, and are not increased by concomitant use of medicines with anti-cholinergic properties
Overdosage:
Acute overdosage by intranasal administration is unlikely since ipratropium bromide is not well absorbed systemically after intranasal or oral administration. Should signs of serious anticholinergic toxicity appear, cholinesterase inhibitors may be considered.
Presentation:
Pump-activated, metered-dose container of 15mL containing 180 metered doses. Each metered dose contains 21mcg ipratropium bromide
Instructions for use
Do not spray around the eyes
To use:
1. Remove protective cap
2. Before using the spray pump for the first time, activate repeatedly until an even spray mist is released. When using regularly, no priming of the spray is needed
3. Blow nose thoroughly before using the nasal spray
4. Insert the spray adapter into the nostril and activate the spray pump while breathing in gently through the nose. Administer two sprays and then repeat in the other nostril
5. Replace protective cap after use
It is recommended that the spray adapter be wiped after each use
Note:
If the nasal tip becomes clogged, remove the clear plastic dust cap. Hold the nasal tip under running warm tap water for about a minute. Dry the nasal tip , reprime the nasal spray pump and replace the dust cap
Warning:
Store below 25°C
Avoid freezing
Keep spray away from eyes
Dosage:
2 puffs up each nostril 2-3 times daily as directed
Medicines have benefits and some may have risks.Always read the label and use only as directed. If symptoms persist or you have side effects, see your healthcare professional.
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