<p>Idiosyncratic reactions to lpratropium bromide are rare. Severe adverse effects due to inhibition of muscarinic receptors and ganglion blockade are theoretically possible but unlikely with the metered-dose aerosol. Regular use of ipratropium can lead to a dry mouth through inhibition of salivary flow.<br />
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Other most common adverse reactions reported are - dryness of the oropharynx (5%); cough, exacerbation of symptoms, &amp; imitation from aerosol (3%); headache (2%); nausea, dizziness, blurred vision/difficulty in accommodation &amp; drying of secretions (1%).<br />
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Less frequently reported adverse reactions include tachycardia, nervousness, paresthesias, drowsiness, co-ordination difficulty, itching, flushing, alopecia, constipation, tremor &amp; mucosal ulceration. Case of precipitation or worsening of narrow-angle glaucoma, acute eye pain &amp; hypotension also have been reported. Allergic-type reactions such as skin rash, angio-oedema of tongue, lips &amp; face, urticaria (including giant urticaria), laryngospasm and anaphylactic reaction have been also reported; with positive rechallenge in some cases.<br />
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Ipratropium bromide dose not produce adverse effects on mucociliary clearance, in contrast to atropine and other muscarinic antagonists. There is no evidence that in the therapeutic does range ipratropium bromide has any adverse effect on bronchial secretion.</p>