Introduction

This information is for parents of a baby or young child with wheezing. It tells you about ipratropium from an inhaler, a treatment used to prevent wheezing in babies and young children. It is based on the best and most up-to-date research.

Does it work?

We don't know. Ipratropium is normally used as an extra treatment for severe asthma attacks (where your child may need hospital treatment). There hasn't been much research on whether it can help prevent asthma attacks in babies and young children.

What is it?

Ipratropium is usually used as an extra treatment for children who need to go to hospital for a severe asthma attack. It's given if a quick-relief inhaler, such as salbutamol or terbutaline, doesn't work on its own. It helps to open up your child's airways. You may hear doctors call ipratropium a bronchodilator. That's because it dilates (opens up) the bronchial tubes (airways).

Researchers are also interested in whether ipratropium can help prevent wheezing in young children, but more studies need to be done.

Ipratropium comes in a form that your child breathes in, which means the medicine gets right to the lungs, which is where it is needed. The brand name for the inhaler is Atrovert. Ipratropium also comes as a liquid that is used with a nebuliser (see below). The brand names for this are Ipratropium Steri-Neb and Respontin.

An inhaler is a device that holds the medicine. The most common type is a metered-dose inhaler (MDI). This is a small plastic device with a slot for an aerosol canister that has the drug inside. Pressing the canister releases the exact dose of the medicine as a cloud of tiny droplets that your child slowly breathes in through his or her mouth.

Young children sometimes have trouble using an inhaler. A device called a spacer is usually used to make it easier for them. To read more, see How to take asthma drugs.

How can it help?

We don't know if it can help. There's no evidence that breathing in ipratropium can help to prevent wheezing in young children, whether the wheezing is caused by asthma or not. ^[41]

How does it work?

Ipratropium quickly opens up your child's airways. It does this by relaxing the muscles that can go into spasms (tighten suddenly) when your child inhales something he or she is sensitive to (an asthma trigger). Having clear airways makes it easier to breathe.

Ipratropium stops a chemical called acetylcholine working. It latches on to cells in the airways and prevents acetylcholine from tightening up the muscles in the air passages.

Can it be harmful?

If your child takes ipratropium, he or she may get a dry mouth, nose, and throat, as the drug can stop the body from making enough mucus in these airways. The drug may actually increase wheezing in some children.

In the studies we looked at, these side effects did not seem to be a problem.

How good is the research on ipratropium from an inhaler to prevent wheezing in babies and young children?

There's no evidence that breathing in ipratropium can help prevent wheezing in very young children. ^[42]

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