Aeron 500

Aeron 500 - Precautions | Dosage | Side Effects

This article was medically reviewed by M.Pharm, Marko Tanaskovic on Tue, 14 Apr 2020. To read more about an author, click here.

Aeron 500 contains an active substance called ipratropium bromide and belongs to a group of anticholinergic bronchodilators. Bronchodilators are drugs that work by widening the airways (the bronchi) and make it easier to breathe. Aeron 500 is used to ease breathing in patients with bronchitis or asthma.

The mechanism of action of this drug is based on binding to muscarinic receptors in the smooth muscle of the bronchi and the antagonism of the effect of acetylcholine, which is released in the lungs.

Aeron 500 should not be used as initial treatment for acute episodes of bronchospasm. In these instances, it is necessary to administer treatment that will give a rapid therapeutic response. Aeron 500 should only be used in patients who have already achieved a therapeutic response and should only serve as a maintenance treatment. Consult with your doctor to obtain more details.

Pharmacokinetics

According to the US Food and Drug Administration, the half-life of elimination is 2 hours after inhalation, while the percentage of plasma protein binding is only 0-9%. It is also stated that most of the dose is ingested and then excreted via feces.

There are no pharmacokinetic studies to provide valid data in patients with impaired renal or hepatic function, and doctors are advised to take caution in dosing in such patients.

Contraindications

According to the National Center for Biotechnology Information, Aeron 500 (ipratropium) is contraindicated in patients who are allergic to ipratropium or atropine. Atropine is a drug that has a similar chemical structure to ipratropium. Therefore, patients who are allergic to these substances should not use Aeron 500.

Keep in mind that even though Aeron 500 is used to ease the breathing, people who are allergic to ipratropium may experience shortness of breath. If you notice any symptoms of an allergy (skin rash, swelling, angioedema, shortness of breath, etc.), discontinue this drug immediately and consult your doctor.

Precautions

Aeron 500 should not be used in patients who:

  • Have narrow-angle glaucoma. Cases of glaucoma have been reported in patients using ipratropium. In a controlled, double-blind study which enrolled 46 patients, ipratropium bromide did not increase intraocular pressure in patients with glaucoma when administered alone. However, the data have shown that increase in intraocular pressure occurs if ipratropium is administered with another a drug called salbutamol, which is also commonly used in treating asthma and bronchitis. Therefore, caution is advised in patients who have glaucoma or high intraocular pressure
  • Have prostatic hyperplasia (prostate enlargement) or bladder obstruction. The case report presented in the Postgraduate Medical Journal cites an example of a man with bladder obstruction which occurred due to the use of Aeron 500 (ipratropium). Therefore, this medicine should be avoided in patients who have prostate or bladder problems

Animal studies at doses much higher than those used in humans have not shown any carcinogenic or mutagenic effects.

Use of Aeron 500 During Pregnancy and Breastfeeding

The FDA marks this drug as category B because animal studies have shown no fetotoxic effects. Specifically, ipratropium bromide has been used at doses up to 10,000 times higher than those used in humans, and these studies have shown that this drug does not cause any toxic effects on the fetus.

However, there are no human studies and the Aeron 500 should be used with caution during pregnancy.

It is unknown whether the Aeron 500 is excreted into the breast milk, and breastfeeding should be avoided while you are being treated with this medicine.

Dosage Instructions

Your doctor will prescribe you the appropriate dose. The dose largely depends on your condition, age and weight. You should never change (increase or decrease) the dose of the drug on your own.

Interactions

Dangerous (clinically significant) interactions with other drugs have not been described in available literature. However, there are medicines that should not be used concomitantly with Aeron 500:

  • Tricyclic antidepressants, such as: amitriptyline, imipramine, nortriptyline, clomipramine, protriptyline and others. Concomitant use with these medicines may increase the risk of side effects: difficulty urinating, swelling, blurred vision, tachycardia and others
  • Clozapine and olanzapine - antipsychotics. Concomitant use with these drugs leads to an increased risk of toxic effects
  • Amoxapine - an antidepressant
  • Dimenhydrinate - an anticholinergic antiemetic (used in treating vomiting)

Tell your doctor about any medicines you are using.

Side Effects

Aeron 500 can cause the following side effects:

  • Headache
  • Flu-like symptoms
  • Dyspepsia
  • Change in taste
  • Dizziness
  • Dry mouth
  • Coughing
  • Sinus inflammation
  • Upper respiratory tract infection
  • Blurred vision
  • Increased intraocular pressure
  • Glaucoma
  • Eye pain
  • Eye swelling
  • Rapid heartbeat
  • Paradoxical bronchospasm (narrowing of the bronchi leading to difficulty in breathing)
  • Urinary retention
  • Allergic reaction

Tell your doctor if you notice any side effects.

Overdose

There are not many reported cases of Aeron 500 overdose, probably because of the high therapeutic index of this drug. In the event of an overdose, the expected signs would be dry mouth and rapid heartbeat. If you notice these symptoms, contact your doctor as there is a possibility that you are not using this medicine properly.

References

  1. FDA
  2. NCBI
  3. Malani JT, Robinson GM, Seneviratne EL. Ipratropium bromide induced angle closure glaucoma. N Z Med J. 1982. 95(718): 749.
  4. Kalra L, Bone MF. The effect of nebulized bronchodilator therapy on intraocular pressures in patients with glaucoma. Chest. 1988. 93(4): 739-41.
  5. S. Lozewicz. Bladder outflow obstruction induced by ipratropium bromide. Postgraduate Medical Journal. 1989. 65(762): 260-1.

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