Ipratropium nasal spray is available in two strengths that are used to treat different conditions. Ipratropium nasal spray 0.06% is used to relieve a runny nose caused by the common cold or seasonal allergies (hay fever) in adults and children age 5 and older. Ipratropium nasal spray 0.03% is used to relieve a runny nose caused by year-round allergic and nonallergic rhinitis (runny nose and stuffiness) in adults and children age 6 and older. Ipratropium nasal spray does not relieve nasal congestion, sneezing, or postnasal drip caused by these conditions. Ipratropium nasal spray is in a class of medications called anticholinergics. It works by reducing the amount of mucus produced in the nose.

Ipratropium comes as a spray to use in the nose. If you are using ipratropium nasal spray 0.06% to treat the common cold, it is usually sprayed in the nostrils three to four times a day for up to four days. If you are using ipratropium nasal spray 0.06% to treat seasonal allergies, it is usually sprayed in the nostrils four times a day for up to three weeks. Ipratropium nasal spray 0.03% is usually sprayed in the nostrils two to three times a day. Use ipratropium nasal spray at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ipratropium nasal spray exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not spray ipratropium nasal spray in or around your eyes. If this occurs, immediately flush your eyes with cool tap water for several minutes. If you spray the medication in your eyes, you may experience the following symptoms: blurred vision, seeing visual halos or colored images, red eyes, development or worsening of narrow-angle glaucoma (a serious eye condition that may cause loss of vision), widened pupils (black circles in the center of the eyes), sudden eye pain, and increased sensitivity to light. If you spray ipratropium in your eyes or experience any of these symptoms, contact your doctor immediately.

Do not change the size of the opening of the nasal spray as this would affect the amount of medication you receive.

To use the nasal spray, follow these steps:

1. Remove the clear plastic dust cap and the safety clip from the nasal spray pump.
2. If you are using the nasal spray pump for the first time, you must prime the pump. Hold the bottle with your thumb at the base and your index and middle fingers on the white shoulder area. Point the bottle upright and away from your eyes. Press your thumb firmly and quickly against the bottle seven times. Your pump does not have to be reprimed unless you have not used the medication for more than 24 hours; reprime the pump with only two sprays. If you have not used your nasal spray for more than seven days, reprime the pump with seven sprays.
3. Blow your nose gently to clear your nostrils if necessary.
4. Close one nostril by gently placing your finger against the side of your nose, tilt your head slightly forward and, keeping the bottle upright, insert the nasal tip into the other nostril. Point the tip toward the back and outer side of the nose.
5. Press firmly and quickly upwards with the thumb at the base while holding the white shoulder portion of the pump between your index and middle fingers. Following each spray, sniff deeply and breathe out through your mouth.
6. After spraying the nostril and removing the unit, tilt your head backwards for a few seconds to let the spray spread over the back of the nose.
7. Repeat steps 4 through 6 in the same nostril.
8. Repeat steps 4 through 7 in the other nostril.
9. Replace the clear plastic dust cap and safety clip.

If the nasal tip becomes clogged, remove the clear plastic dust cap and safety clip. Hold the nasal tip under running, warm tap water for about a minute. Dry the nasal tip, reprime the nasal spray pump, and replace the plastic dust cap and safety clip.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before using ipratropium nasal spray,

• tell your doctor and pharmacist if you are allergic to ipratropium, atropine (Atropen), any other medications, or any of the ingredients in ipratropium nasal spray. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; ipratropium oral inhalation (Atrovent HFA, in Combivent); or medications for irritable bowel disease, motion sickness, Parkinson's disease, ulcers, or urinary problems. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had glaucoma (an eye condition), difficulty urinating, a blockage in your bladder, a prostate (a male reproductive gland) condition, or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using ipratropium nasal spray, call your doctor.
• you should know that ipratropium nasal spray may cause dizziness or problems with vision. Do not drive a car or operate appliances or machinery until you know how this medication affects you.

Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze the medication.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Ipratropium nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nose dryness or irritation
• nosebleeds
• dry throat or mouth
• sore throat
• changes in taste
• headache
• diarrhea
• nausea

Some side effects can be serious. If you experience any of these symptoms, stop using ipratropium nasal spray and call your doctor immediately or get emergency medical treatment:

• rash
• hives
• itching
• swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing

Ipratropium nasal spray may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.