Generic
Tiotropium
9 brands available in the market
At a glance
Tiotropium is a long-acting anticholinergic bronchodilator used for the long-term treatment of COPD and asthma. It relaxes airway muscles by blocking M3 receptors and widens airways.
Description
Tiotropium bromide is a long-acting quaternary ammonium antimuscarinic structurally related to ipratropium. It is a nonselective competitive antagonist of muscarinic (M1-M5) receptors and causes bronchodilation by inhibiting the actions of acetylcholine at M3 receptors in the smooth muscle of the respiratory tract.
Indications
- Chronic obstructive pulmonary disease (COPD)
- Asthma
Therapeutic class
Anticholinergic Bronchodilators
Pharmacological class
Long-acting Antimuscarinic
Pharmacology
Tiotropium binds to M1-M5 muscarinic receptors, inhibiting acetylcholine action at M3 receptors, leading to relaxation of respiratory smooth muscle and bronchodilation. Its effect lasts over 24 hours.
Mechanism of action
Relaxes airway muscles and widens airways by blocking M3 receptors.
Dosage
Adult Dose (Inhalation):
- Inhaler: 2 puffs (18 mcg) once daily
- Inhalation capsule: 1 capsule (18 mcg) once daily via inhaler device, at the same time each day
Administration
- For inhalation only; do not swallow capsules
- Place capsule at the base of the rotahaler, not in the mouthpiece
- Twist mouthpiece completely until a click is heard and breathe in deeply
- Hold breath for 10 seconds; repeat if powder remains
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for the next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Blurred vision
- Increased heart rate
- Dry mouth
- Upper respiratory tract infection
- Constipation
Precautions & warnings
- Do not use for sudden breathing problems or asthma attacks
- Take at the same time each day
- Gargle with warm water after each inhalation (to avoid oral fungal infections)
- Take the first dose under medical supervision (may cause bronchospasm)
- For dry mouth, increase water intake, use sugarless candy, maintain oral hygiene
Contraindications
- Hypersensitivity to atropine and its derivatives (e.g., ipratropium)
Drug interactions
- Other anticholinergic agents
Food interactions
It is not known whether alcohol is safe with Tiotropium; consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited data suggests no significant risk; monitor baby for dry mouth, constipation, and urinary problems; consult your doctor.
Pediatric use
Indicated for children >12 years (inhaler); >18 years (capsule)
Geriatric use
No dose adjustment required in elderly
Renal / hepatic impairment
Renal Impairment: CrCl <50: Use with caution; monitor for anticholinergic effects; consult your doctor.
Hepatic Impairment: No dose adjustment needed; consult your doctor.
Overdose effects
No systemic anticholinergic effects following single inhaled doses up to 282 mcg; bilateral conjunctivitis and dry mouth with repeated 141 mcg daily doses; provide symptomatic treatment.
Storage conditions
Store below 30°C, away from direct sunlight and heat; keep out of reach of children.
Chemical structure
Tiotropium