Pediatric Dosage of Ipratropium Bromide (Ipravent)

Dosing by Administration Route

• The American Academy of Allergy, Asthma, and Immunology recommends that children under 12 years receive 0.25-0.5 mg of ipratropium bromide every 20 minutes for 3 doses, then as needed, via nebulizer 1, 2
• Ipratropium bromide may be mixed in the same nebulizer with albuterol for enhanced bronchodilation in children under 12 years 2
• The American Academy of Pediatrics suggests that ipratropium bromide should not be used as first-line therapy, but should be added to short-acting beta-agonist (SABA) therapy for severe exacerbations in pediatric patients 1

Clinical Considerations

Efficacy

• The American Thoracic Society recommends that ipratropium bromide may be used for up to 3 hours in the initial management of severe asthma exacerbations in pediatric patients 1, 2
• The addition of ipratropium to albuterol has not been shown to provide further benefit once the patient is hospitalized, according to the American College of Chest Physicians 2

Combination with Albuterol

• The American Academy of Allergy, Asthma, and Immunology suggests that nebulizer solution (each 3-mL vial contains 0.5 mg ipratropium bromide and 2.5 mg albuterol) be administered at 1.5 mL every 20 minutes for 3 doses, then as needed, in children under 12 years 2, 3
• The American College of Allergy, Asthma, and Immunology recommends that MDI (each puff contains 18 mcg ipratropium bromide and 90 mcg albuterol) be administered at 4-8 puffs every 20 minutes as needed up to 3 hours in pediatric patients 1, 2