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It should be recognized that paradoxical bronchospasm, when associated with inhaled formulations, frequently occurs with the first use of a new canister.

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Patients completed a daily worksheet indicating each dose of investigational drug and rescue medication (albuterol) taken.

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In clinical trials, Atrovent was well tolerated and has been shown to have minimal side effects such as transient nasal dryness and epistaxis (nasal bleeding) in less than 10% of patients.

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Ipratropium bromide and albuterol sulfate demonstrated significantly better changes in FEV 1, as measured from baseline to peak response, when compared with either albuterol sulfate or ipratropium bromide.

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It is in the 15 February 2005 issue of Annals of Internal Medicine (volume 142, pages 233-239).

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