What Atrovent looks like and contents of the pack

Your medicine comes with a nebuliser. This changes Atrovent into a mist for you to breathe in. Atrovent are available in cartons containing 20 and 60 single dose units.

Manufacturer and Licence Holder

This medicine is manufactured by Laboratoire Unither, Zl de Longpre, 10 rue Andre Durouchez, 80084 Amiens Cedex 2, France and is procured from within the EU. Product Licence Holder LTT Pharma Limited, B98 ORE and repackaged by Lexon (UK) Limited Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 ORE.

PL 33723/0116

Atrovent is a registered trademark of Boehringer Ingelheim Pharma GmbH & Co. KG.

Revision date: 05/02/15

Blind or partially sighted?

Is this leaflet hard to see or read? Phone LTT Pharma Limited,

Tel: 01527 505414 for help.

PATIENT INFORMATION LEAFLET

Atrovent® UDVs 250 micrograms /1ml Nebuliser Solution

(ipratropium bromide)

Read all of this leaflet carefully before you start using this medicine

•    Keep this 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. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

•    If any of the side effects gets troublesome or serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Your medicine is called Atrovent UDVs 250 micrograms /1 ml Nebuliser Solution throughout the remainder of this leaflet it will be referred to as Atrovent.

In this leaflet:

1,    What Atrovent are and what they are used for

2,    Before you use Atrovent

3,    How to use Atrovent

4,    Possible side effects

5,    How to store Atrovent

6,    Further information

You use Atrovent with a device called a 'nebuliser'. This changes your medicine into a mist for you to breathe in.

Atrovent contains a medicine called ipratropium bromide. This belongs to a group of medicines called bronchodilators. It is used to make breathing easier for people who have breathing difficulties, such as in chronic asthma or chronic obstructive pulmonary disease (COPD).

Atrovent can be taken at the same time as medicines called 'beta2-agonist bronchodilators' such as salbutamol.

Atrovent works by opening up your airways.

Do not use Atrovent if:

•    You are allergic (hypersensitive) to ipratropium bromide or any of the other ingredients in Atrovent (listed in Section 6 below)

•    You are allergic (hypersensitive) to medicines that are similar to Atrovent, such as atropine

Do not use this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before using Atrovent.

Take special care with Atrovent

Check with your doctor or pharmacist before using your medicine if:

•    You have cystic fibrosis

•    You have glaucoma or have been told that you may develop it

•    You are a man who has prostate problems

•    You have problems passing water (urine)

•    You are pregnant, likely to get pregnant or if you are breast-feeding

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before using Atrovent.

Using other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription and herbal medicines. This is because Atrovent can affect the way some other medicines work. Also some other medicines can affect the way Atrovent works.

In particular, tell your doctor or pharmacist if you are taking any of the following:

•    Medicines for breathing problems called 'beta-agonists' such as salbutamol

•    Medicines for breathing problems called 'xanthine preparations' such as theophylline or aminophylline

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before using Atrovent.

Pregnancy and breast-feeding

Talk to your doctor before using this medicine if you are pregnant, likely to get pregnant or are breast-feeding.

Driving and using machines

You may feel dizzy, or have difficulty in focusing, or blurred vision while taking Atrovent. If this happens do not drive or use any tools or machines.

Always use Atrovent exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Follow these instructions to get the best results. If anything is unclear after reading this leaflet, ask your doctor or pharmacist.

How many dose units

Adults (including the elderly) and children over 12 years

•    The usual dose is the contents of 1 to 2

single dose units (250-500 micrograms), three to four times a day

•    For acute attacks of breathlessness use 2 single dose units (500 micrograms)

•    If breathlessness does not go away or gets worse consult your doctor

Children 6-12 yrs

•    1 single dose unit (250 micrograms) up to a total daily dose of 4 single dose units (1 mg)

•    The time between doses should be decided by your doctor

Children 0-5 years for treatment of acute asthma only

•    % to 1 single dose unit (125-250 micrograms) up to a total daily dose of 4 single dose units (1 mg)

•    The time between doses should be not be less than 6 hours

When children are using this medicine they must be supervised by a responsible adult.

Do not swallow or give this medicine by injection.

Do not use your nebuliser to take Atrovent and ‘disodium cromoglycate inhalation solutions’ which have the preservative ‘benzalkonium chloride’ at the same time.

Do not use more than your doctor has told you

See your doctor straight away if:

•    You feel that your medicine is not working as well as usual

•    You need to use the nebuliser more than your doctor has recommended

Your doctor may need to check how well your medicine is working. In some cases your doctor may need to change your medicine.

How to use your nebuliser

Read through numbers 1 to 6 first, before starting to use your nebuliser.

1. Get your nebuliser ready by following the manufacturer's instructions. Ask your doctor if you are not sure how to use it.

2.    • Open the pouch and remove the strip of unit dose vials. Carefully separate a new dose unit from the strip.

•    Do not use it if it is already open.

3.    • Twist off the top

•    Always hold it upright while you do this

4.    • Squeeze all the contents of the dose unit into the nebuliser chamber

•    Your doctor will tell you if you need to use a different amount

•    If you have also been prescribed a medicine called a 'short-acting beta2-agonist nebuliser solution' such as salbutamol the liquids can be mixed in the same nebuliser chamber

•    If your doctor has told you that your medicine needs to be diluted, you will be given 'sterile sodium chloride 0.9%’ solution. Your doctor will tell you how to do this

5.    Use your nebuliser as directed by your doctor.

6.    • After you have finished, dispose of any

leftover medicine carefully

•    Follow the manufacturer's instructions on how to clean your nebuliser

•    It is important to keep your nebuliser clean

Use a mouthpiece or a tight fitting mask. If any of the liquid or mist accidentally gets into your eyes you may get painful, stinging or red eyes, dilated pupils, blurred vision, see colours or lights. If this happens, talk to your doctor for advice. If you get problems with your eyes at any other time, talk to your doctor for advice.

If you use more Atrovent than you should

If you use more of this medicine than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you.

If you forget to use Atrovent

•    If you forget a dose, use it as soon as you remember

•    However, if it is nearly time for the next dose, skip the missed dose

•    Do not use a double dose to make up for a forgotten dose

4. POSSIBLE SIDE EFFECTS

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

Stop using Atrovent and see a doctor straight away, if you notice any of the following serious side effects - you may need urgent medical treatment:

•    If after using Atrovent you are wheezy or have other difficulties in breathing, do not use any more (unless you have been told to by your doctor).

•    Allergic reactions - the signs may include skin rash and itching (affects less than 1 in 100 people). In severe cases the signs include swelling of your mouth and face, sudden difficulties in breathing and reduction of your blood pressure. Tightening of your throat (affects less than 1 in 100 people)

•    Palpitations (fast or uneven heart beats) or quickening of the heart rate (affects less than 1 in 100 people)

•    Increased heart rate or irregular heart rhythm such as atrial fibrillation (affects less than 1 in 1000 people)

Stop using this medicine and see your doctor straight away if you have any of these side effects.

Other side effects include:

Common (affects less than 1 in 10 people)

•    Headache, dizziness

•    Dry mouth, feeling sick (nausea), stomach upset or discomfort

•    Cough and throat irritation when you have just used Atrovent.

Uncommon (affects less than 1 in 100 people)

•    Itching, skin rash

•    Unexpected tightness of the chest, swelling of the throat, dry throat

•    Blurred vision, dilated pupils, glaucoma, painful, stinging, red or swelling of the eyes, see colour or lights

•    Diarrhoea, constipation or being sick

•    Mouth or lip sores

•    Problems passing water (urine), especially if you already have problems passing urine

Rare (affects less than 1 in 1000 people)

•    Difficulty focusing

•    Nettle rash (urticaria)

If any of the liquid or mist accidentally gets into your eyes you may get painful, stinging or red eyes, dilated pupils, blurred vision, see colours or lights. If this happens, talk to your doctor for advice. If affected, do not drive or use any tools or machines. If you get problems with your eyes at any other time, talk to your doctor for advice.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

By reporting side effects, you can help provide more information on the safety of this medicine.

•    Do not use this medicine after the expiry date which is stated on the carton and the vial label. The expiry date refers to the last day of the month.

•    Do not store above 25°C.

•    Protect from light

•    Keep container in the outer carton.

•    Keep out of the sight and reach of children.

•    If your medicine becomes discoloured or shows any other signs of deterioration, consult your pharmacist who will tell you what to do.

•    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. FURTHER INFORMATION

What Atrovent contains

Atrovent contains a nebuliser solution. Each single dose unit contains 250 micrograms of the active ingredient ipratropium bromide as Ipratropium Bromide monohydrate Ph.Eur. in 1 ml of solution.

The other ingredients are: sodium chloride, hydrochloric acid and purified water.

Ref: LTT116/050215/1/B

What Ipratropium Bromide looks like and contents of the pack

Your medicine comes with a nebuliser. This changes Ipratropium Bromide into a mist for you to breathe in. Ipratropium Bromide are available in cartons containing 20 and 60 single dose units.

Manufacturer and Licence Holder

This medicine is manufactured by Laboratoire Unither, Zl de Longpre, 10 rue Andre Durouchez, 80084 Amiens Cedex 2, France and is procured from within the EU. Product Licence Holder LTT Pharma Limited, B98 ORE and repackaged by Lexon (UK) Limited Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 ORE

PL 33723/0116

Revision date: 05/02/15

Blind or partially sighted?

Is this leaflet hard to see or read? Phone LTT Pharma Limited,

Tel: 01527 505414 for help.

Ipratropium Bromide 250 micrograms/1ml Nebuliser Solution

Read all of this leaflet carefully before you start using this medicine

•    Keep this 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. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

•    If any of the side effects gets troublesome or serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Your medicine is called Ipratropium Bromide 250 micrograms /1 ml Nebuliser Solution throughout the remainder of this leaflet it will be referred to as Ipratropium Bromide.

In this leaflet:

1,    What Ipratropium Bromide are and what they are used for

2,    Before you use Ipratropium Bromide

3,    How to use Ipratropium Bromide

4,    Possible side effects

5,    How to store Ipratropium Bromide

6,    Further information

You use Ipratropium Bromide with a device called a 'nebuliser'. This changes your medicine into a mist for you to breathe in.

Ipratropium Bromide contains a medicine called ipratropium bromide. This belongs to a group of medicines called bronchodilators. It is used to make breathing easier for people who have breathing difficulties, such as in chronic asthma or chronic obstructive pulmonary disease (COPD).

Ipratropium Bromide can be taken at the same time as medicines called 'beta₂-agonist bronchodilators' such as salbutamol.

Ipratropium Bromide works by opening up your airways.

Do not use Ipratropium Bromide if:

•    You are allergic (hypersensitive) to ipratropium bromide or any of the other ingredients in Ipratropium Bromide (listed in Section 6 below)

•    You are allergic (hypersensitive) to medicines that are similar to Ipratropium Bromide, such as atropine

Do not use this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before using Ipratropium Bromide.

Take special care with Ipratropium Bromide

Check with your doctor or pharmacist before using your medicine if:

•    You have cystic fibrosis

•    You have glaucoma or have been told that you may develop it

•    You are a man who has prostate problems

•    You have problems passing water (urine)

•    You are pregnant, likely to get pregnant or if you are breast-feeding

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before using Ipratropium Bromide.

Using other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription and herbal medicines. This is because Ipratropium Bromide can affect the way some other medicines work. Also some other medicines can affect the way Ipratropium Bromide works.

In particular, tell your doctor or pharmacist if you are taking any of the following:

•    Medicines for breathing problems called 'beta-agonists' such as salbutamol

•    Medicines for breathing problems called 'xanthine preparations' such as theophylline or aminophylline

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before using Ipratropium Bromide.

Pregnancy and breast-feeding

Talk to your doctor before using this medicine if you are pregnant, likely to get pregnant or are breast-feeding.

Driving and using machines

You may feel dizzy, or have difficulty in focusing, or blurred vision while taking Ipratropium Bromide. If this happens do not drive or use any tools or machines.

Always use Ipratropium Bromide exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Follow these instructions to get the best results. If anything is unclear after reading this leaflet, ask your doctor or pharmacist.

How many dose units

Adults (including the elderly) and children over 12 years

•    The usual dose is the contents of 1 to 2 single dose units (250-500 micrograms), three to four times a day

•    For acute attacks of breathlessness use 2 single dose units (500 micrograms)

•    If breathlessness does not go away or gets worse consult your doctor

Children 6-12 yrs

•    1 single dose unit (250 micrograms) up to a total daily dose of 4 single dose units (1 mg)

•    The time between doses should be decided by your doctor

Children 0-5 years for treatment of acute asthma only

•    % to 1 single dose unit (125-250 micrograms) up to a total daily dose of 4 single dose units (1 mg)

•    The time between doses should be not be less than 6 hours

When children are using this medicine they must be supervised by a responsible adult.

Do not swallow or give this medicine by injection.

Do not use your nebuliser to take Ipratropium Bromide and ‘disodium cromoglycate inhalation solutions’ which have the preservative ‘benzalkonium chloride’ at the same time.

Do not use more than your doctor has told you

See your doctor straight away if:

•    You feel that your medicine is not working as well as usual

•    You need to use the nebuliser more than your doctor has recommended

Your doctor may need to check how well your medicine is working. In some cases your doctor may need to change your medicine.

How to use your nebuliser

Read through numbers 1 to 6 first, before starting to use your nebuliser.

1. Get your nebuliser ready by following the manufacturer's instructions. Ask your doctor if you are not sure how to use it.

2.    • Open the pouch and remove the strip of unit dose vials. Carefully separate a new dose unit from the strip.

•    Do not use it if it is already open.

3.    • Twist off the top

•    Always hold it upright while you do this

4.    • Squeeze all the contents of the dose unit into the nebuliser chamber

•    Your doctor will tell you if you need to use a different amount

•    If you have also been prescribed a medicine called a 'short-acting beta₂-agonist nebuliser solution' such as salbutamol the liquids can be mixed in the same nebuliser chamber

•    If your doctor has told you that your medicine needs to be diluted, you will be given 'sterile sodium chloride 0.9%’ solution. Your doctor will tell you how to do this

5.    Use your nebuliser as directed by your doctor.

6.    • After you have finished, dispose of any

leftover medicine carefully

•    Follow the manufacturer's instructions on how to clean your nebuliser

•    It is important to keep your nebuliser clean

Use a mouthpiece or a tight fitting mask. If any of the liquid or mist accidentally gets into your eyes you may get painful, stinging or red eyes, dilated pupils, blurred vision, see colours or lights. If this happens, talk to your doctor for advice. If you get problems with your eyes at any other time, talk to your doctor for advice.

If you use more Ipratropium Bromide than you should

If you use more of this medicine than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you.

If you forget to use Ipratropium Bromide

•    If you forget a dose, use it as soon as you remember

•    However, if it is nearly time for the next dose, skip the missed dose

•    Do not use a double dose to make up for a forgotten dose

4. POSSIBLE SIDE EFFECTS

Like all medicines, Ipratropium Bromide can cause side effects, although not everybody gets them.

Stop using Ipratropium Bromide and see a doctor straight away, if you notice any of the following serious side effects - you may need urgent medical treatment:

•    If after using Ipratropium Bromide you are wheezy or have other difficulties in breathing, do not use any more (unless you have been told to by your doctor).

•    Allergic reactions - the signs may include skin rash, itching (affects less than 1 in 100 people). In severe cases the signs include swelling of your mouth and face, sudden difficulties in breathing and reduction of your blood pressure. Tightening of your throat (affects less than 1 in 100 people)

•    Palpitations (fast or uneven heart beats) or quickening of the heart rate (affects less than 1 in 100 people)

•    Increased heart rate or irregular heart rhythm such as atrial fibrillation (affects less than 1 in 1000 people)

Stop using this medicine and see your doctor straight away if you have any of these side effects.

Other side effects include:

Common (affects less than 1 in 10 people)

•    Headache, dizziness

•    Dry mouth, feeling sick (nausea), stomach upset or discomfort

•    Cough and throat irritation when you have just used Ipratropium Bromide

Uncommon (affects less than 1 in 100 people)

•    Itching, skin rash

•    Unexpected tightness of the chest, swelling of the throat, dry throat

•    Blurred vision, dilated pupils, glaucoma, painful, stinging, red or swelling of the eyes, see colours or lights

•    Diarrhoea, constipation or being sick

•    Mouth or lip sores

•    Problems passing water (urine), especially if you already have problems passing urine

Rare (affects less than 1 in 1000 people)

•    Difficulty focusing

•    Nettle rash (urticaria)

If any of the liquid or mist accidentally gets into your eyes you may get painful, stinging or red eyes, dilated pupils, blurred vision, see colours or lights. If this happens, talk to your doctor for advice. If affected, do not drive or use any tools or machines. If you get problems with your eyes at any other time, talk to your doctor for advice.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

By reporting side effects, you can help provide more information on the safety of this medicine.

•    Do not use this medicine after the expiry date which is stated on the carton and the vial label. The expiry date refers to the last day of the month.

•    Do not store above 25°C.

•    Protect from light

•    Keep container in the outer carton.

•    Keep out of the sight and reach of children.

•    If your medicine becomes discoloured or shows any other signs of deterioration, consult your pharmacist who will tell you what to do.

•    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. FURTHER INFORMATION

What Ipratropium Bromide contains

Ipratropium Bromide contains a nebuliser solution. Each single dose unit contains 250 micrograms of the active ingredient ipratropium bromide as Ipratropium Bromide monohydrate Ph.Eur. in 1 ml of solution.

The other ingredients are: sodium chloride, hydrochloric acid and purified water.

Ref: LTT116/050215/2/B