IPREX 20 mcg/puff Inhalar.

Overview

Iprex MDI (Metered-Dose Inhaler) contains Ipratropium Bromide 20 mcg per puff, an anticholinergic bronchodilator used in the treatment of chronic reversible airway obstruction including asthma and Chronic Obstructive Pulmonary Disease (COPD), encompassing chronic bronchitis and emphysema. Ipratropium Bromide is a quaternary ammonium compound that inhibits vagal reflexes by antagonising acetylcholine at muscarinic receptors on bronchial smooth muscle. This prevents the increase in intracellular cyclic GMP that causes bronchoconstriction, resulting in bronchodilation and relief of bronchospasm. Iprex MDI delivers 20 mcg per actuation and contains 200 metered doses per canister.

Dosage and Administration

Adults (Inhaler): The usual dose is 1–2 puffs (20 mcg/spray) three or four times daily. A single dose of up to 80 mcg (4 puffs) may be required during early treatment for maximum benefit. Additional inhalations may be taken as required, but the total should not exceed 12 puffs in 24 hours.

Children 6–12 years (Inhaler): Usually 1–2 puffs two to three times daily.

Children below 6 years (Inhaler): The usual dose is 1 puff (20 mcg) three times daily, under adult supervision.

Inhaler Administration Instructions

Remove the cap and shake the inhaler vigorously at least 6 times before each use. Breathe out fully, then place the mouthpiece between the teeth and close lips around it. While breathing in deeply and slowly, press down on the canister to release the dose. Remove the inhaler and hold breath for at least 10 seconds. Wait 1 minute between puffs and shake well before each actuation. Rinse mouth with water after use. Clean the plastic actuator at least once a week with warm water (do not immerse the metal canister).

Interaction

Iprex has been used concomitantly with sympathomimetic bronchodilators, methylxanthines, steroids, and cromolyn sodium without adverse drug reactions. There are no fully evaluated interaction studies regarding the combined effectiveness of these drugs with Iprex.

Contraindications

Iprex is contraindicated in patients with known hypersensitivity to Ipratropium Bromide, Atropine or its derivatives, or any component of the formulation. The inhaler is also contraindicated in patients with a history of hypersensitivity to soya lecithin, soybean, or peanut.

Side Effects

Common reported adverse reactions include dryness of the oropharynx (5%), cough, exacerbation of symptoms and aerosol irritation (3%), headache (2%), and nausea, dizziness, blurred vision, and drying of secretions (1%). Less frequent effects include tachycardia, nervousness, constipation, tremor, and mucosal ulceration. Cases of narrow-angle glaucoma precipitation, acute eye pain, and hypotension have been reported. Rare hypersensitivity reactions include skin rash, angioedema, urticaria, laryngospasm, and anaphylaxis.

Pregnancy and Lactation

The safety of Ipratropium Bromide during human pregnancy has not been established. The benefits must be weighed against possible hazards to the foetus. It is not known whether Ipratropium Bromide is excreted into breast milk; caution is advised when administering to nursing mothers.

Precautions and Warnings

Use with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, bladder-outflow obstruction, or cystic fibrosis. Avoid aerosol contact with eyes as this may cause blurred vision, eye pain, or precipitation of narrow-angle glaucoma. Iprex MDI is not indicated for initial treatment of acute bronchospasm where rapid response is required — faster-onset drugs may be preferable. Do not use other inhaled drugs concurrently unless specifically prescribed.

Storage Conditions

Do not store above 25°C. Keep the canister in the outer carton. Keep out of the reach of children.

Frequently Asked Questions

Q: What is Iprex 20 mcg MDI used for?
Iprex MDI (Ipratropium Bromide 20 mcg/puff) is a bronchodilator used to treat and prevent bronchospasm in Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis, emphysema, and chronic asthma. It works by blocking acetylcholine at muscarinic receptors in the airway smooth muscle, causing bronchodilation and easier breathing. It is used for maintenance therapy rather than as a fast-acting rescue inhaler.

Q: How is Iprex MDI different from salbutamol (Ventolin) inhalers?
Iprex (Ipratropium Bromide) is an anticholinergic bronchodilator that works via a different mechanism than salbutamol, a beta-2 agonist. Salbutamol acts faster and is primarily used for acute symptom relief, while Iprex provides more sustained bronchodilation and is better suited for maintenance therapy in COPD and chronic asthma. They are often used together as they complement each other's mechanism of action.