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ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION

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How to use ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the Patient

Atrovent Monodosis 500 micrograms/2 ml solution for inhalation by nebulizer

ipratropium bromide

Read this package leaflet carefully before you start using this medicine, because it contains important information for you.

  • Keep this package leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this package leaflet. See section 4.

Contents of the package leaflet

  1. What is Atrovent Monodosis and what is it used for
  2. What you need to know before you start using Atrovent Monodosis
  3. How to use Atrovent Monodosis
  4. Possible side effects
  5. Storage of Atrovent Monodosis
  6. Contents of the pack and further information

1. What is Atrovent Monodosis and what is it used for

Atrovent Monodosis belongs to a group of medicines called anticholinergic bronchodilators, which work by relaxing the muscle of the bronchi, making it easier to breathe.

Atrovent Monodosis 500 micrograms/2 ml solution for inhalation by nebulizer is a medicine used to treat bronchospasm associated with chronic obstructive diseases in adults and children over 12 years of age.

Atrovent Monodosis may be administered with beta-adrenergics (other bronchodilator medicines, such as salbutamol) in the treatment of acute bronchospasm that causes reversible airway obstruction, in cases where treatment with a beta-adrenergic medicine does not provide sufficient bronchodilation.

Doctor consultation

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2. What you need to know before you start using Atrovent Monodosis

Do not use Atrovent Monodosis

  • If you are allergic (hypersensitive) to ipratropium bromide, to substances similar to ipratropium such as atropine or its derivatives, or to any of the other ingredients of Atrovent Monodosis.
  • In acute episodes of bronchospasm (breathing difficulties) where a rapid response is required.

Warnings and precautions

Talk to your doctor or pharmacist before starting to use Atrovent Monodosis:

-If you have a predisposition to narrow-angle glaucoma (increased pressure inside the eye), prostatic hyperplasia (enlargement of the prostate) or urinary flow obstruction (difficulty urinating).

-There have been isolated cases of eye complications, such as mydriasis (pupil dilation), narrow-angle glaucoma (increased pressure inside the eye), and eye pain when ipratropium bromide, alone or in combination with a beta-2 adrenergic agonist (medicines that dilate bronchial muscles, such as salbutamol), has penetrated the eyes due to improper application.

-Eye pain or discomfort, blurred vision, halos (diffuse lights), or colored images associated with eye redness due to conjunctival congestion and corneal edema (swelling) may be signs of increased intraocular pressure (narrow-angle glaucoma). If any combination of these symptoms appears, you should consult your doctor immediately to initiate treatment with a miotic eye drop (which causes pupil contraction and decreases intraocular pressure).

-You should avoid the product coming into contact with the eyes during nebulization, especially in patients who have a predisposition to increased intraocular pressure, so it is recommended to use a mouthpiece or face mask.

-Patients with cystic fibrosis (a disease that alters the secretions of mucous and sweat glands, affecting several organs) may be more prone to gastrointestinal motility disorders.

-In exceptional cases, immediate hypersensitivity reactions (rapid allergic reactions) may occur after administration of Atrovent Monodosis, such as urticaria, angioedema (sudden swelling of the skin or mucous membranes), skin rash, bronchospasm (contraction of bronchial muscles that makes breathing difficult), and oropharyngeal edema (swelling of the mouth and pharynx).

-As with other drugs administered by inhalation, Atrovent Monodosis may cause paradoxical bronchospasm, which can be life-threatening. If this occurs, treatment should be discontinued immediately and the doctor informed to replace with an alternative treatment.

Other medicines and Atrovent Monodosis

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines.

It is not recommended to administer Atrovent Monodosis simultaneously for a long period with other anticholinergic drugs.

Beta-adrenergics (e.g., salbutamol) and xanthine derivatives (e.g., theophylline) are other bronchodilator medicines and may enhance the bronchodilator effect. Atrovent Monodosis may increase the anticholinergic effects of other medicines.

Atrovent Monodosis can be administered with other medicines commonly used in the treatment of reversible airway obstruction, including beta-adrenergic medicines (e.g., salbutamol), methylxanthines (e.g., theophylline), steroids, and sodium cromoglycate, without the appearance of interactions that require dose adjustment.

The simultaneous administration of nebulized ipratropium bromide and beta-mimetics may increase the risk of acute glaucoma in patients with a history of narrow-angle glaucoma (increased intraocular pressure).

The inhalation solutions of Atrovent Monodosis and sodium cromoglycate that contain benzalkonium chloride as a preservative should not be administered simultaneously in the same nebulizer, due to the risk of precipitation.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

Although preclinical studies have not shown any risk, the safety of this medicine during pregnancy has not been established. Therefore, the usual precautions in the use of medicines during this period should be observed, especially during the first three months.

It is not known whether ipratropium bromide can pass into breast milk. However, it is unlikely to be ingested by the infant in significant amounts, especially since the preparation is administered by inhalation. Nevertheless, it should be administered with caution to breastfeeding women.

Driving and using machines

No studies on the effects on the ability to drive and use machines have been conducted. However, it is warned that side effects such as dizziness, eye difficulties in focusing, pupil dilation, and blurred vision may occur during treatment with Atrovent. Therefore, caution is recommended when driving and using machines.

3. How to use Atrovent Monodosis

Follow the instructions for administration of this medicine exactly as indicated by your doctor or pharmacist. If you are in doubt, consult your doctor or pharmacist again.

Remember to use your medicine.

Your doctor will determine the duration of treatment.

If you think the effect of Atrovent Monodosis is too strong or too weak, tell your doctor or pharmacist.

The solution of Atrovent Monodosis can be inhaled (inhaled) using devices called ultrasonic, electric, manual (e.g., Bird, De Vilbiss, Pari) nebulizers, or with assisted breathing at intermittent positive pressure. If there is a wall oxygen supply, the solution should be administered with a flow of 6-8 liters per minute.

It is recommended that the particle size of the nebulized solution be between 1 and 10 microns, although approximately 50% of the total aerosol mass should be contained in particles less than 5 microns.

If necessary, the solution can be diluted with physiological saline.

Guidelines for the use of monodose vials

Monodose vials should only be used for inhalation with suitable nebulizer devices and should not be administered orally.

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Text indicating figure number one with typographic style in bold and italicHand holding syringe injecting medication into skin fold of abdomen

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Hand holding syringe with needle inserted at an angle into skin fold of lower abdomen

  1. Prepare the nebulizer for inhalation according to the manufacturer's instructions or those of your doctor. The instructions for use of the nebulizer device will be provided by the manufacturer.
  2. Separate a monodose vial (see fig. 1).
  1. To open the vial, turn the top part until it comes off (see fig. 2).
  1. Empty the contents of the monodose vial, pressing, into the nebulizer reservoir (see fig. 3).

Dilute with saline solution to a final volume of 2-4 ml.

  1. Assemble the nebulizer and inhale following the manufacturer's instructions for the nebulizer.
  2. After inhalation, remove the remaining solution from the nebulizer reservoir and clean it.

Since the monodose vials do not contain preservatives, it is important that their contents be used immediately after opening the vial to avoid contamination. Partially used, opened, or damaged monodose vials should be discarded.

The administration of Atrovent Monodosis solution should be adapted to the individual needs of each patient; patients should be under medical supervision during treatment. It is recommended not to exceed the recommended daily dose for both acute and maintenance treatment. The recommended doses are:

Adults and children over 12 years of age

Maintenance treatment

1 monodose vial, 3-4 times a day.

Acute attacks

In cases where only a beta-adrenergic medicine is used, it may not provide sufficient bronchodilation. In these cases, Atrovent Monodosis can be administered in combination with an inhaled beta-adrenergic (e.g., salbutamol), whose dose will be established by the doctor.

The dose of Atrovent Monodosis, in this case, is one monodose vial; repeated doses can be administered until the patient stabilizes.

As a general rule, the recommended daily dose should not be exceeded during treatment. Daily doses of more than 2 mg (more than 4 monodose vials) should only be administered under medical supervision.

You should consult your doctor whenever you do not achieve significant improvement or your condition worsens, in order to determine a new treatment. In case of acute dyspnea or rapidly worsening dyspnea (breathing difficulties), you should consult your doctor immediately.

If you use more Atrovent Monodosis than you should

No specific manifestations of overdose have been described. Due to the wide therapeutic margin of Atrovent Monodosis and the inhalatory administration of the preparation, it is not expected to appear serious anticholinergic symptoms.

In case of minor anticholinergic symptoms such as dry mouth, visual accommodation disorders (eye problems focusing), and tachycardia (increased heart rate), the treatment to be followed should be to alleviate the symptoms.

If you have used more Atrovent Monodosis than you should, consult your doctor, pharmacist, or call the Toxicology Information Service, phone 91 562 04 20, indicating the medicine and the amount ingested.

If you forget to use Atrovent Monodosis

Do not use a double dose to make up for forgotten doses.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Medicine questions

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4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Frequent side effects (occurring in at least 1 in 100 patients) are headache (cephalalgia), dizziness, cough, throat irritation, nausea, dry mouth, gastrointestinal motility disorders (e.g., change in bowel habits, gastroesophageal reflux, dyspepsia (indigestion)).

Uncommon side effects (occurring in at least 1 in 1,000 patients) are

hypersensitivity, anaphylactic reaction (severe allergic reaction), blurred vision, mydriasis (pupil dilation), increased intraocular pressure, halos (diffuse lights), or colored images associated with eye redness (glaucoma), eye pain, halos (diffuse lights), eye redness, corneal edema (swelling of the cornea), palpitations, supraventricular tachycardia, constipation, diarrhea, vomiting, stomatitis (inflammation of the mouth), oral edema (swelling of the mouth), rash, pruritus (itching), angioedema (swelling of the face, lips, mouth, tongue, or throat that can cause difficulty swallowing or breathing), and urinary retention.

Rare side effects (occurring in at least 1 in 10,000 patients) are bronchospasm (chest tightness, wheezing, or shortness of breath), paradoxical bronchospasm (narrowing of the bronchial walls due to inhalation itself), laryngeal contraction, pharyngeal edema (swelling of the throat), throat dryness, visual accommodation disorder (difficulty focusing), urticaria, increased heart rate, and atrial fibrillation.

Very rare side effects (occurring in less than 1 in 10,000 patients) are tremors, metallic or unpleasant taste, nasal congestion, insomnia, unusual fatigue or weakness, and hypotension.

If you experience any side effect that is severe or if you notice any side effect not mentioned in this package leaflet, tell your doctor or pharmacist.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this package leaflet. You can also report side effects directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Atrovent Monodosis

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date stated on the packaging. The expiry date is the last day of the month indicated.

Do not store above 30°C. Store in the original packaging.

Medicines should not be disposed of via wastewater or household waste. Return the vials and medicines you no longer need to the pharmacy's SIGRE collection point. Ask your pharmacist how to dispose of the vials and medicines you no longer need. This will help protect the environment.

6. Contents of the pack and further information

Composition of Atrovent Monodosis

  • The active substance is ipratropium bromide. Each 2 ml monodose vial contains 522 micrograms of ipratropium bromide monohydrate (equivalent to 500 micrograms of anhydrous ipratropium bromide).
  • The other ingredients are sodium chloride, hydrochloric acid, and purified water.

Appearance and packaging of the product

Atrovent Monodosis 500 micrograms/2 ml is a solution for inhalation by nebulizer presented in boxes of 20 monodose vials with 2 ml of solution for inhalation by nebulizer and in a clinical pack with 100 monodose vials of 2 ml of solution for inhalation by nebulizer.

Marketing authorization holder

Boehringer Ingelheim España, S.A.

Prat de la Riba, 50

08174 Sant Cugat del Vallès (Barcelona)

Spain

Manufacturer

Laboratoire Unither

Zone Industrialle de Longpré

10 rue Andre Durouchez

80084 AMIENS Cedex 2

France

This package leaflet was approved in April 2019

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/.

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Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance. His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation. Patients commonly consult Dr Daniel Cichi for: 

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
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  • sexually transmitted infections, erectile dysfunction;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders, weight loss, hair loss;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.

Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.

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Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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Doctor

Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
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  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Frequently Asked Questions

Is a prescription required for ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION?
ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION?
The active ingredient in ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION is ipratropium bromide. This information helps identify medicines with the same composition but different brand names.
Who manufactures ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION?
ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION is manufactured by Boehringer Ingelheim Espana S.A.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to ATROVENT MONODOSIS 500 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION?
Other medicines with the same active substance (ipratropium bromide) include ATROALDO 20 micrograms/PUFF pressurized inhalation solution, ATROVENT 20 micrograms PRESSURIZED INHALATION SOLUTION, ATROVENT MONODOSIS 250 mcg / 2ml SOLUTION FOR NEBULIZER INHALATION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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