Overview
Tiotropium bromide is a long-acting anticholinergic bronchodilator used for maintenance treatment of chronic obstructive pulmonary disease (COPD) and asthma. It works by blocking muscarinic receptors in the airways, leading to bronchodilation and reduced symptoms. The medication is administered via inhalation once daily using the RESPIMAT device.
Mechanism of Action
Tiotropium is a long-acting antimuscarinic agent that inhibits M3 muscarinic receptors in bronchial smooth muscle, leading to bronchodilation. It has a longer duration of action than ipratropium due to slower dissociation from the receptor.
Indications
- Maintenance treatment of chronic obstructive pulmonary disease (COPD)
- Maintenance treatment of asthma in adults and pediatric patients 6 years and older
Common Doses
- 2.5 mcg per inhalation
- 5 mcg per dose (2 inhalations)
Dosage
Administer two inhalations once daily using the RESPIMAT inhaler. Do not exceed one dose (2 inhalations) in 24 hours. The inhaler requires priming before first use and after periods of non-use (3 days or 21 days).
Contraindications
- Hypersensitivity to tiotropium, ipratropium, or any component of the product
Side Effects
- Dry mouth/throat
- Dry nasal mucosa
- Upper respiratory tract infection
- Cough
- Headache
- Sinusitis
- Pharyngitis
- Immediate hypersensitivity reactions
- Paradoxical bronchospasm
Interactions
- No clinically significant drug interactions have been identified with tiotropium
- Concurrent use with other anticholinergic medications may increase anticholinergic effects
Counseling Points
- Use once daily at the same time each day
- Do not exceed two inhalations in 24 hours
- Prime inhaler before first use and after periods of non-use
- Rinse mouth after inhalation to reduce dry mouth
- Seek medical attention if experiencing difficulty breathing, eye pain, or urinary retention
- Do not use for acute bronchospasm