Trihale
Generic Name
Tiotropium Bromide
Manufacturer
Incepta Pharmaceuticals (Example)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| trihale 25 mcg inhalation capsule | ৳ 70.00 | ৳ 700.00 |
Description
Overview of the medicine
Trihale 25 mcg Inhalation Capsule contains Tiotropium Bromide, a long-acting anticholinergic bronchodilator. It is used to relieve symptoms of chronic obstructive pulmonary disease (COPD) by relaxing the muscles in the airways and keeping them open, making breathing easier. It is a maintenance therapy and not for acute relief.
Uses & Indications
Dosage
Adults
One 25 mcg capsule inhaled once daily using the specific inhalation device (e.g., HandiHaler). The contents of the capsule should be inhaled, not swallowed.
Elderly
No dosage adjustment required.
Renal_impairment
No dosage adjustment required for mild to moderate renal impairment. Use with caution in severe renal impairment.
How to Take
For oral inhalation only. The capsule should be placed into the specific inhalation device (e.g., HandiHaler) and the contents inhaled as directed. Do not swallow the capsule.
Mechanism of Action
Tiotropium is a long-acting muscarinic receptor antagonist (LAMA). It works by blocking muscarinic cholinergic receptors (M1, M2, and M3) in the airways, primarily M3 receptors, leading to bronchodilation. This relaxes the smooth muscles in the airways, preventing bronchoconstriction and improving airflow.
Pharmacokinetics
Onset
Within 30 minutes, peak effect within 3 hours.
Excretion
Primarily excreted unchanged in urine (approx. 14% of inhaled dose). The remainder is excreted via feces.
Half life
Terminal elimination half-life is 5-6 days (after repeated once-daily inhalation).
Absorption
Low systemic absorption following inhalation. Oral bioavailability is low (2-3%).
Metabolism
Minimal hepatic metabolism, primarily by ester hydrolysis to inactive metabolites. CYP450 enzymes are minimally involved.
Side Effects
Contraindications
- Hypersensitivity to Tiotropium, Atropine, or its derivatives (e.g., Ipratropium, Oxitropium) or to any excipient.
- Not for acute bronchospasm relief.
Drug Interactions
Other anticholinergic drugs
Concomitant administration of other anticholinergic drugs may lead to an increase in anticholinergic side effects. Avoid co-administration.
Adrenergic agonists (e.g., Salmeterol, Formoterol)
No significant pharmacokinetic or pharmacodynamic interactions reported for co-administration with LABAs.
Storage
Store at room temperature (below 30°C), away from moisture and direct heat. Do not refrigerate or freeze. Keep out of reach of children.
Overdose
High doses may lead to anticholinergic signs and symptoms (e.g., dry mouth, blurred vision, tachycardia). Treatment is supportive and symptomatic. Consult a healthcare professional immediately.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is not known whether Tiotropium is excreted in human milk. Exercise caution when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to Tiotropium, Atropine, or its derivatives (e.g., Ipratropium, Oxitropium) or to any excipient.
- Not for acute bronchospasm relief.
Drug Interactions
Other anticholinergic drugs
Concomitant administration of other anticholinergic drugs may lead to an increase in anticholinergic side effects. Avoid co-administration.
Adrenergic agonists (e.g., Salmeterol, Formoterol)
No significant pharmacokinetic or pharmacodynamic interactions reported for co-administration with LABAs.
Storage
Store at room temperature (below 30°C), away from moisture and direct heat. Do not refrigerate or freeze. Keep out of reach of children.
Overdose
High doses may lead to anticholinergic signs and symptoms (e.g., dry mouth, blurred vision, tachycardia). Treatment is supportive and symptomatic. Consult a healthcare professional immediately.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is not known whether Tiotropium is excreted in human milk. Exercise caution when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Off-patent (generic versions available)
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. Key trials include the UPLIFT study.
Lab Monitoring
- No specific routine lab monitoring required for Tiotropium.
- Monitor for signs of glaucoma, urinary retention.
Doctor Notes
- Emphasize proper inhalation technique to patients.
- Remind patients that this is for maintenance therapy, not for acute bronchospasm relief.
- Assess for pre-existing conditions like narrow-angle glaucoma or prostatic hyperplasia before prescribing.
Patient Guidelines
- Read the patient information leaflet carefully before use.
- Ensure proper inhalation technique for optimal drug delivery.
- Do not swallow the capsule.
- Do not use for acute breathing problems; it is a maintenance therapy.
Missed Dose Advice
If a dose is missed, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once.
Driving Precautions
May cause dizziness or blurred vision, which could affect ability to drive or operate machinery. Patients should be cautious until they know how they react to the medicine.
Lifestyle Advice
- Avoid smoking.
- Maintain good hydration.
- Exercise regularly as tolerated.
- Attend regular follow-ups with your doctor.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.