Summary
Ipratropium Bromide has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. ClinicalTrials.gov lists 8 registered trials linking Ipratropium Bromide to COPD: 7 have completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT00359788). The largest enrolment is 1480 participants (NCT00400153). Registration activity spans 1998 to 2017. The literature layer holds 14 publications for this pair: 5 Cochrane reviews, 1 meta-analysis, 1 systematic review, 2 randomised controlled trial publications and 5 clinical trial publications. Publication years run from 2006 to 2023. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Chronic Obstructive Pulmonary Disease ranks 505 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Effectively zero — airflow obstruction is irreversible by definition in COPD; FEV1 decline continues at 30-60 mL/year on standard care.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 80.0 (trials 30.0, literature 30.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 0 recruiting, 0 active / not yet recruiting, 7 completed, 1 other |
| Linked publications | 14 (5 Cochrane reviews, 5 clinical trial publications, 2 randomised controlled trial publications, 1 meta-analysis, 1 systematic review) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT02576626 | Single Dose Ultibro Breezhaler by Sd-DPI Versus Ipratropium/Salbutamol by Nebulizer in COPD 2015 | completed | Phase 4 | 40 |
| NCT02182856 | Ipratropium or Salbutamol Sulphate Alone or Combination Therapy Salbutamol and Ipratropium in Patients With COPD 1998 | completed | Phase 4 | 33 |
| NCT00359788 | A Trial Comparing Treatment With Tiotropium Inhalation Capsules to Combivent Inhalation Aerosol in COPD Patients. 2006 | completed | Phase 4 | 349 |
| NCT03405090 | Differential Mechanisms of Dyspnea Relief in Advanced COPD: Opiates vs. Bronchodilators 2017 | completed | Phase 4 | 20 |
| NCT00400153 | Respimat® Combivent Trial in Chronic Obstructive Pulmonary Disease (COPD) 2006 | completed | Phase 3 | 1,480 |
| NCT00274040 | Comparison of Tiotropium and Ipratropium in a Double-Blind, Double-dummy, Efficacy and Safety Study in Adults With COPD 2002 | completed | Phase 3 | 141 |
| NCT03170232 | A Pilot Study of Danirixin for Disease Progression in Chronic Obstructive Pulmonary Disease (COPD) 2017 | terminated | Phase 2 | 54 |
| NCT02232594 | Postmarketing Surveillance Study of Berodual® Metered-dose Inhaler in Chronic Obstructive Respiratory Tract Disease 2000 | completed | Not applicable | 834 |
Published literature
- Clinical trial publication Atomization efficacy of a novel micro-dose mesh nebulizer (CVS-100) versus the traditional mesh nebulizer (M102) in adults with chronic obstructive pulmonary disease: A randomized non-inferiority clinical trialQu Y, Gong Y, Li L et al. · Respiratory medicine · 2023 · PMID 37879448
- Cochrane review Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary diseaseNi H, Aye SZ, Naing C · The Cochrane database of systematic reviews · 2022 · PMID 35616126
- Clinical trial publication Comparison of the efficacy of aerosol inhalation between the ipratropium bromide and terbutaline on the patients with AECOPDXu W, Wu J, Feng Y et al. · Pakistan journal of pharmaceutical sciences · 2019 · PMID 31894040
- Clinical trial publication Nebulized Terbutaline and Ipratropium Bromide Versus Terbutaline Alone in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Noninvasive Ventilation: A Randomized Double-blind Controlled TrialBeltaief K, Msolli MA, Zorgati A et al. · Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2019 · PMID 30156361
- Clinical trial publication Development of a novel digital breath-activated inhaler: Initial particle size characterization and clinical testingKesten S, Israel E, Li G et al. · Pulmonary pharmacology & therapeutics · 2018 · PMID 30201410
- Clinical trial publication The effect of ventilator mask atomization inhalation of ipratropium bromide and budesonide suspension liquid in the treatment of COPD in acute exacerbation period on circulating levels of inflammation and prognosisJiang DH, Wang X, Liu LS et al. · European review for medical and pharmacological sciences · 2017 · PMID 29228436
- Randomized controlled trial Responsiveness to Ipratropium Bromide in Male and Female Patients with Mild to Moderate Chronic Obstructive Pulmonary DiseaseLi X, Obeidat M, Zhou G et al. · EBioMedicine · 2017 · PMID 28461224
- Randomized controlled trial Three-minute constant rate step test for detecting exertional dyspnea relief after bronchodilation in COPDBorel B, Wilkinson-Maitland CA, Hamilton A et al. · International journal of chronic obstructive pulmonary disease · 2016 · PMID 27942208
- Cochrane review Tiotropium versus ipratropium bromide for chronic obstructive pulmonary diseaseCheyne L, Irvin-Sellers MJ, White J · The Cochrane database of systematic reviews · 2015 · PMID 26391969
- Cochrane review Tiotropium versus ipratropium bromide for chronic obstructive pulmonary diseaseCheyne L, Irvin-Sellers MJ, White J · The Cochrane database of systematic reviews · 2013 · PMID 24043433
- Systematic review Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literatureMolassiotis A, Bryan G, Caress A et al. · Respiratory medicine · 2010 · PMID 20385478
- Cochrane review Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysisSingh S, Loke YK, Furberg CD · JAMA · 2008 · PMID 18812535
- Cochrane review Ipratropium bromide versus long-acting beta-2 agonists for stable chronic obstructive pulmonary diseaseAppleton S, Jones T, Poole P et al. · The Cochrane database of systematic reviews · 2006 · PMID 16856113
- Meta-analysis Tiotropium for stable chronic obstructive pulmonary disease: A meta-analysisBarr RG, Bourbeau J, Camargo CA et al. · Thorax · 2006 · PMID 16844726
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Ipratropium Bromide approved for COPD?
Ipratropium Bromide has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Ipratropium Bromide in clinical trials for COPD?
ClinicalTrials.gov lists 8 registered trials linking Ipratropium Bromide to COPD: 7 have completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT00359788). The largest enrolment is 1480 participants (NCT00400153). Registration activity spans 1998 to 2017.
What does the evidence show for Ipratropium Bromide in COPD?
Ipratropium Bromide has both completed registered trials and synthesis-level publications linked to COPD. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.