Titan 18 mcg (Inhalation Capsule)

Indications

• Long-term treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD)
• Treatment of chronic bronchitis and emphysema

Pharmacology

• Long-acting antimuscarinic agent
• Inhibition of M3-receptors at the smooth muscle
• Bronchodilation through prevention of methacholine-induced bronchoconstriction
• Site-specific bronchodilation effect

Dosage & Administration

• Recommended dose of 18 mcg (1 capsule) once-daily
• For adults over 18 years
• Use with the device
• No dosage adjustment for geriatric, hepatically-impaired, or renally-impaired patients
• Close monitoring for anticholinergic effects in patients with moderate to severe renal impairment

Interaction

• 20% increase in AUC 0-4 hour with concomitant administration of cimetidine
• 28% decrease in renal clearance with concomitant administration of cimetidine
• No significant change in pharmacokinetics with concomitant administration of ranitidine

Contraindications

• History of hypersensitivity to atropine or its derivatives
• Hypersensitivity to ipratropium or any component of the product

Side Effects

• Most commonly reported adverse drug reaction: dry mouth
• Other reported reactions: constipation, increased heart rate, blurred vision, glaucoma, urinary difficulty, urinary retention

Pregnancy & Lactation

• Pregnancy Category C
• Use during pregnancy only if potential benefit justifies potential risk to the fetus
• Safety and effectiveness not studied during labor and delivery

Precautions & Warnings

• May worsen symptoms of narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction
• Use with caution in patients with any of these conditions

Overdose Effects

• Anticholinergic signs and symptoms with high doses
• No systemic anticholinergic adverse effects following single inhaled dose of up to 282 mcg in healthy volunteers
• Bilateral conjunctivitis and dry mouth seen following repeated once-daily inhalation of 141 mcg

Therapeutic Class

• Anticholinergic bronchodilators

Storage Conditions

• Do not swallow the dry powder inhaler capsules
• Avoid storage in direct sunlight or heat
• Store below 30°C
• Keep away from children

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