Ipratropium Side Effects: What's Normal and What's Not

Every medication comes with potential side effects, and Ipratropium (brand name Atrovent) is no exception. The good news is that most people tolerate Ipratropium well. It's been used for decades to treat COPD, chronic bronchitis, and rhinorrhea, and serious reactions are uncommon.

But it helps to know what to watch for — especially the difference between minor nuisances that go away on their own and warning signs that need medical attention.

What Is Ipratropium?

Ipratropium Bromide is a short-acting anticholinergic bronchodilator. It works by blocking certain receptors in your airways that cause muscles to tighten, helping your airways relax and open up. It comes as an inhaler (Atrovent HFA), a nebulizer solution, and a nasal spray. For a deeper dive, see our guide on what Ipratropium is and how it's used.

Common Side Effects

These side effects are reported frequently in clinical trials and are generally mild. They often improve as your body adjusts to the medication:

• Dry mouth — The most commonly reported side effect. Sipping water or chewing sugar-free gum can help.
• Headache
• Dizziness
• Cough — Paradoxically, inhaled Ipratropium can sometimes trigger a cough right after use.
• Nausea
• Bitter taste — Common with the inhaler form.
• Upper respiratory tract infection
• Bronchitis

If you're using the nasal spray formulation, you may also experience:

• Nasal dryness and irritation
• Nosebleeds (epistaxis)

Most of these side effects are mild and don't require you to stop taking the medication. However, if any side effect becomes bothersome or doesn't go away after the first week or two, let your doctor know.

Serious Side Effects: When to Call Your Doctor

Serious side effects from Ipratropium are rare, but they do happen. Contact your doctor right away — or call 911 — if you experience any of the following:

• Paradoxical bronchospasm — Your breathing suddenly gets worse right after using Ipratropium. This is the opposite of what the medication is supposed to do. Stop using it and seek emergency care immediately.
• Severe allergic reaction (anaphylaxis) — Signs include hives, swelling of the face, lips, tongue or throat, and difficulty breathing. This is a medical emergency.
• Angioedema — Swelling under the skin, especially around the eyes, lips, or throat.
• Eye problems (acute narrow-angle glaucoma) — Severe eye pain, blurred vision, seeing halos around lights, or red eyes. This can happen if the medication accidentally gets into your eyes, especially with the nebulizer.
• Urinary retention — Difficulty urinating or inability to empty your bladder completely. This is more likely in men with an enlarged prostate.
• Fast or irregular heartbeat (tachycardia/palpitations)
• Bowel obstruction symptoms — Severe constipation, abdominal pain, bloating, or vomiting.

Who's More at Risk for Side Effects?

Certain people should use Ipratropium with extra caution:

People with Narrow-Angle Glaucoma

Ipratropium can increase eye pressure. If you have glaucoma, tell your doctor before starting this medication. When using a nebulizer, use a mouthpiece instead of a face mask to reduce the chance of the mist getting into your eyes.

Men with Enlarged Prostate (BPH)

Anticholinergic medications like Ipratropium can make urinary retention worse. If you already have trouble urinating, your doctor needs to know.

People with Peanut or Soy Allergies

The Atrovent HFA inhaler contains soy lecithin. If you have a peanut or soy allergy, you should not use this formulation. The nebulizer solution and nasal spray do not contain soy.

Pregnant or Breastfeeding Women

Ipratropium is classified as Pregnancy Category B, which means animal studies have not shown risk, but there are limited human studies. It appears to be relatively safe, but discuss the risks and benefits with your doctor.

Older Adults

Elderly patients may be more sensitive to anticholinergic side effects like dry mouth, constipation, confusion, and urinary retention. If you're over 65, your doctor may monitor you more closely.

How to Manage Common Side Effects

Here are practical tips for dealing with the most frequent side effects:

For Dry Mouth

• Drink water frequently throughout the day
• Chew sugar-free gum or suck on sugar-free hard candy
• Use a mouth rinse designed for dry mouth (like Biotene)
• Rinse your mouth after using the inhaler

For Bitter Taste

• Rinse your mouth with water after each inhalation
• Brush your teeth shortly after using the inhaler

For Nosebleeds (Nasal Spray)

• Use a saline nasal spray before or after Ipratropium to keep nasal passages moist
• Aim the spray away from the nasal septum (the wall between your nostrils)
• Use a humidifier at night

For Cough After Inhalation

• Take a slow, gentle breath when inhaling the medication
• Drink a sip of water afterward
• If cough persists, ask your doctor if switching to the nebulizer form might help

For Dizziness

• Stand up slowly after sitting or lying down
• Avoid driving or operating machinery until you know how Ipratropium affects you

What About Drug Interactions?

Some side effects are more likely if you take Ipratropium with other medications that have anticholinergic properties. These include certain allergy medications, antidepressants, and bladder medications. Read our full guide on Ipratropium drug interactions to learn what to watch for.

Final Thoughts

Ipratropium is a well-established medication with a strong safety record. Most side effects are mild — dry mouth and headache being the most common. Serious reactions are rare but important to recognize, especially paradoxical bronchospasm, eye problems, and urinary retention.

The key is knowing what to watch for and communicating with your doctor if something doesn't feel right. Never stop taking a prescribed medication without talking to your healthcare provider first.

If you're currently taking Ipratropium and need help finding it in stock, Medfinder can help you locate a pharmacy near you that has it available.