This information is for parents of a child who has asthma. It tells you about ipratropium from an inhaler, a treatment for more severe asthma attacks. It is based on the best and most up-to-date research.
Does it work?
Yes. Using ipratropium with other treatments can help children who are having a severe asthma attack.
Usually, a quick-relief inhaler will help bring your child's asthma attack under control. But if the attack is severe and this doesn't work, your child might need treatment in hospital. In hospital, your child may be given ipratropium at the same time as a quick-relief inhaler. This combination should work better than a quick-relief inhaler on its own.
What is it?
Ipratropium is a treatment for severe asthma attacks. It's used in hospital together with quick-relief inhalers, such as salbutamol and terbutaline. Your child's doctor may suggest ipratropium if quick-relief inhalers don't work on their own.
The brand name for ipratropium is Atrovent. Your child breathes it in through an inhaler, spacer, or nebuliser. They'll probably be given several doses, 20 or 30 minutes apart. To learn more about inhalers, spacers, and nebulisers, see How to take asthma drugs).
How can it help?
Adding ipratropium to treatment with a quick-relief inhaler: 
Can help bring the asthma attack under control
Can improve how well your child's lungs are working and help them breathe more easily
Can improve their symptoms enough to go home (or stay home), and reduce their chances of being admitted to hospital from the accident and emergency department.
One study shows that ipratropium works best in the early stages of an asthma attack. Once your child is getting better, adding ipratropium to their other treatments probably won't help. 
How does it work?
Ipratropium and the quick-relief treatments salbutamol and terbutaline quickly open up your child's airways. During an asthma attack, the muscles in your child's airways go into spasm, making the airways narrower. Ipratropium and quick-relief treatments such as salbutamol relax the muscles, widen the airways, and make it easier for your child to breathe.
Although ipratropium and quick-relief treatments do the same thing, they do it in different ways.   So, for some children, using both treatments together works better than using one on its own.
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. The drug may increase wheezing in some children. It can also make your heart beat faster. 
We cannot say for certain whether taking ipratropium bromide together with salbutamol or terbutaline increases the chances of side effects. Most studies found no increase in side effects, even in children who had several doses of ipratropium. 
Take care that your child does not spray the ipratropium inhaler into their eyes. It can cause blurred vision, and increase the pressure inside the eye. 
How good is the research on ipratropium from an inhaler to treat more severe asthma attacks?
There is reasonably good evidence that taking ipratropium along with salbutamol or terbutaline can help relieve an asthma attack in some children.  
A good review of the research looked at the results of 13 separate studies.  It found that taking ipratropium with a quick-relief inhaler worked better than a quick-relief inhaler on its own.
For references related to Asthma in children click here