<p>The most frequent local undesirable effects of Ipratropium bromide nasal spray are nasal reactions including epistaxis, dryness of the nose and nasal irritation. Headache, nausea and local irritation (e.g. burning sensation) may occur as non specific reactions in association with use of Ipratropium bromide nasal spray. Potential systemic anticholinergic effects are dry mouth and dry throat. Ocular side effects, increase of heart rate and palpitations, urinary retention and gastrointestinal motility disturbances have been reported in isolated patients in association with use of Ipratropium bromide either intranasally or after oral inhalation. Allergic type reactions such as skin rash, angio-oedema of tongue, lips and face, urticaria, laryngospasm and anaphylactic reactions may occur.</p>