NHS Dudley Health Economy Medicines Formulary
Home > 3 Respiratory system > 3.1 Bronchodilators > 3.1.2 Antimuscarinic bronchodilators

3.1.2 Antimuscarinic bronchodilators

General guidance 

  • Inhaled ipratropium may be useful in the management of chronic asthma in patients who already require high-dose inhaled corticosteroids. Their use in other situations in asthma has now been largely superseded by other agents.
  • Ipratropium is generally more effective in relieving bronchoconstriction associated with chronic obstructive airways disease than in relieving asthma.
  • Inhaled ipratropium may be helpful in moderate to sever asthma in children when given along with a beta2-receptor agonist.

Recommended drugs

Ipratropium ££

Tiotropium £££

Spiolto respimat  £££

Anoro Ellipta 

Incruse Ellipta 

Trelegy Ellipta 




Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary


Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

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