Thiotropii bromidum
Description
A bronchodilator, a long-acting inhaled M cholinoblocker.
Indications
Chronic obstructive pulmonary disease.
Contraindications
Increased sensitivity to atropine group drugs or components of the medication.
Dosage
Adults: For Pulv. pro inh., the usual dose is to inhale one capsule once a day. For Spiriva Respimat, the recommended dose is 5 micrograms of tiotropium, which equals two puffs from the Respimat inhaler. Inhale once a day at the same time.
Elderly: Follow the same dosage as for adults.
Renal impairment: Dose reduction is unnecessary.
Hepatic impairment: Dose reduction is unnecessary.
Adverse reactions
Most common: dry mouth, constipation; throat irritation, sinusitis, candidiasis.
Others: allergic reaction, bronchospasm; tachyarrhythmia; urinary retention, difficulty urinating; eye pain and blurred vision.
Pregnancy
There are no clinical data on the treatment of pregnant women with tiotropium bromide. Animal studies show a toxic effect related to maternal toxicity. The risk to humans is unknown. During pregnancy, use only if clearly necessary.
Breastfeeding
It remains unknown whether tiotropium bromide passes into breast milk. Despite data from rodent studies showing only a small amount of tiotropium bromide entering breast milk, using it during breastfeeding is not recommended. Moreover, tiotropium bromide has a long duration of action. Therefore, when deciding to continue or discontinue breastfeeding or treatment, one should consider both the benefits of breastfeeding to the infant and the benefits of treatment to the mother.
Warnings
Use with caution in individuals with closed-angle glaucoma, prostate hyperplasia, bladder neck obstruction, renal impairment; and also in pregnant and breastfeeding women. Inhalation powder should only be inhaled with the HandiHaler inhaler. Do not use in children. Not suitable for relieving acute bronchospasm. Do not swallow capsules. Do not exceed the recommended dose. Take care to avoid contact with eyes. Patients with cardiac arrhythmias should be treated cautiously with Spiriva Respimat. Spiriva Respimat is not recommended for patients with cystic fibrosis (CF). If patients with CF use Spiriva Respimat, their symptoms and signs may worsen (e.g., severe side effects, respiratory tract infection, exacerbation of lung disease).
Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė