Onset and duration of inhibition of ipratropium bromide nasal spray on methacholine-induced nasal secretions


  • Publication No. 105 from the Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.

Dr R. M. Naclerio, The Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA


We performed a randomized, double-blind, placebo-controlled cross-over study with two different concentrations of ipratropium bromide (Atrovent®) nasal spray to evaluate its onset and duration of inhibition. Twenty-four subjects with perennial rhinitis participated in the trial. Fifteen minutes to 12 hours after administration of ipratropium bromide (42 or 168 μg/nostril) or placebo nasal spray, methacholine challenges were performed and nasal secretion weights measured. After placebo administration the effect of methacholine remained unchanged over the 12-h-period. Both the 42 and 168 μg/nostril doses significantly inhibited the nasal hypersecretions induced by methacholine challenge within 15 min of treatment (P < 0.05). The 168 μg dose of ipratropium bromide continued to significantly reduce secretion weights through 6 hours, but the effectiveness of the 42 μg dose disappeared within 3 h. In addition to having a longer duration, the 168 μg/nostril dose produced approximately twice the inhibitory effect of the 42 μg dose.