Tiotrop
Generic Name
Tiotropium Bromide 18 mcg Inhalation Capsule
Manufacturer
Generic Pharmaceutical Company
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tiotrop 18 mcg inhalation capsule | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Tiotropium is a long-acting muscarinic antagonist (LAMA) used for the maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is administered via inhalation.
Uses & Indications
Dosage
Adults
One 18 mcg capsule inhaled once daily using the HandiHaler device.
Elderly
No dosage adjustment required.
Renal_impairment
No dosage adjustment required for mild to moderate renal impairment. Use with caution in severe renal impairment (creatinine clearance < 50 mL/min).
How to Take
For oral inhalation only. The capsule must be placed into the HandiHaler device and the breath-actuated mechanism used to inhale the powder. Do not swallow the capsule.
Mechanism of Action
Tiotropium is an anticholinergic (more specifically, an antimuscarinic) agent. It selectively binds to M1, M2, and M3 muscarinic receptors. In the airways, it inhibits M3 receptors on smooth muscle cells, leading to bronchodilation. Its prolonged duration of action is due to its slow dissociation from the M3 receptors.
Pharmacokinetics
Onset
Within 30 minutes
Excretion
Primarily excreted unchanged in urine (about 74% of IV dose, 14% of inhaled dose). Fecal excretion accounts for the remaining non-renal clearance.
Half life
Terminal half-life is 25-30 hours after once-daily inhalation in COPD patients.
Absorption
Low systemic absorption; peak plasma concentrations reached 5-7 minutes after inhalation. Absolute bioavailability is 19.5% for inhalation.
Metabolism
Minimally metabolized by ester cleavage to inactive metabolites, followed by glucuronidation and oxidation. Cytochrome P450 enzymes play a minor role.
Side Effects
Contraindications
- Hypersensitivity to tiotropium, ipratropium, or any component of the formulation
- Acute bronchospasm (not for rescue therapy)
Drug Interactions
Other anticholinergics
Concurrent administration of tiotropium with other anticholinergic drugs has not been studied and is therefore not recommended.
Beta-agonists, corticosteroids, xanthines
No clinically significant interactions observed.
Storage
Store at controlled room temperature (20-25°C), away from moisture and light. Do not refrigerate or freeze. Keep out of reach of children.
Overdose
High doses may lead to anticholinergic signs and symptoms such as dry mouth, blurred vision, tachycardia, and urinary retention. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Use in pregnancy only if the potential benefit justifies the potential risk to the fetus (Category C). Exercise caution when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, check specific product packaging.
Availability
Pharmacies worldwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Molecular patent expired, formulation patents may exist
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated tiotropium's efficacy in improving lung function, reducing exacerbations, and improving quality of life in COPD patients.
Lab Monitoring
- Routine monitoring of lung function (e.g., FEV1) is recommended.
- Monitor for signs of anticholinergic side effects (e.g., urinary retention, acute glaucoma).
Doctor Notes
- Emphasize proper inhalation technique using the HandiHaler device.
- Educate patients that this is a maintenance medication, not a rescue inhaler for acute symptoms.
- Monitor for signs of glaucoma or urinary retention, especially in at-risk patients.
Patient Guidelines
- Use the HandiHaler device exactly as instructed by your doctor or pharmacist.
- Do not swallow the capsule; it is for inhalation only.
- Keep the device clean and dry.
- Do not use for sudden breathing problems (it is a maintenance medication).
Missed Dose Advice
If a dose is missed, take it as soon as possible. Do not take two doses in one day. Return to your regular once-daily schedule the next day.
Driving Precautions
May cause dizziness or blurred vision. Patients should be cautioned about engaging in activities such as driving or operating machinery if they experience these symptoms.
Lifestyle Advice
- Avoid smoking to improve COPD symptoms.
- Maintain a healthy lifestyle with regular exercise and a balanced diet.
- Avoid triggers that worsen respiratory symptoms.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.