Drug interactions
Ipratropium + Physostigmine
Severity: Moderate
Ipratropium and Physostigmine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Physostigmine inhibits cholinesterase and increases acetylcholine, which can reverse the effects of antimuscarinics such as ipratropium. It can also cause bronchospasm and increased secretions, which may worsen airway disease.
What this interaction means in plain words
Ipratropium and Physostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Pharmacodynamic antagonism between a cholinesterase inhibitor and a muscarinic antagonist.
What to do
Monitor respiratory status and ipratropium effectiveness. Use physostigmine cautiously in patients with asthma or COPD and have atropine available.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ipratropium and Physostigmine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Ipratropium
- Aclidinium + Ipratropium Moderate
- Benztropine + Ipratropium Moderate
- Bethanechol + Ipratropium Moderate
- Cevimeline + Ipratropium Moderate
- Chlorpromazine + Ipratropium Moderate
- Clomipramine + Ipratropium Moderate
Frequently asked questions
Can I take Ipratropium with Physostigmine?
MediHelp rates the interaction as moderate. Ipratropium and Physostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Physostigmine inhibits cholinesterase and increases acetylcholine, which can reverse the effects of antimuscarinics such as ipratropium. It can also cause bronchospasm and increased secretions, which may worsen airway disease.
How serious is the interaction between Ipratropium and Physostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor respiratory status and ipratropium effectiveness. Use physostigmine cautiously in patients with asthma or COPD and have atropine available.
What other medicines interact with Ipratropium?
MediHelp also lists interactions of Ipratropium with, for example, Aclidinium, Benztropine, Bethanechol. The full list is on the Ipratropium page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
