Uses

Tiotropium bromide is indicated for the long-term, once-daily maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD) and for reducing COPD exacerbations. It is also indicated for the long-term maintenance treatment of asthma in patients aged 6 years and older. It is not for relief of acute bronchospasm.

Do not use if

Contraindicated in patients with hypersensitivity to tiotropium, ipratropium, or any component of the formulation.

Side effects

Common adverse effects include dry mouth, constipation, and urinary retention. Serious reactions may include immediate hypersensitivity reactions, paradoxical bronchospasm, worsening of narrow-angle glaucoma, and cardiac arrhythmias.

Warnings

Not for use as rescue medication in acute bronchospasm. Discontinue immediately if hypersensitivity reactions, including angioedema or anaphylaxis, occur. Use with caution in patients with narrow-angle glaucoma, benign prostatic hyperplasia, or bladder neck obstruction.

How it works

Tiotropium is a long-acting antimuscarinic (anticholinergic) agent that inhibits M3 muscarinic receptors in airway smooth muscle, leading to sustained bronchodilation. Its kinetic selectivity for M3 receptors and slow dissociation rate underlie its prolonged 24-hour duration of action.

Storage

Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Avoid freezing.