Tiotropium

Generic Details

Generic Name

Tiotropium

Other Names

  • Spiriva

Drug Class

  • Anticholinergic

Chemical Formula

C19H22NO4S2

Molecular Weight

414.52 g/mol

Mechanism of Action

  • Acts as a long-acting muscarinic antagonist, specifically targeting M3 receptors in the airways, leading to bronchodilation.

Indications

  • Chronic obstructive pulmonary disease (COPD)
  • Asthma

Common Dosage Forms

  • Inhalation powder
  • Inhalation solution

Typical Dosage

  • 18 mcg once daily

Pediatric Dosage

  • Not established

Geriatric Dosage

  • Adjust dosage based on individual response and tolerability.

Side Effects

  • Dry mouth
  • Constipation
  • Blurred vision
  • Urinary retention
  • Tachycardia

Contraindications

  • Hypersensitivity to tiotropium or its components

Pregnancy Category

  • C - Risk cannot be ruled out

Lactation Safety

  • Not recommended, use with caution

Drug Interactions

  • Avoid concomitant use of other anticholinergic medications
  • Use with caution with beta-agonists

Overdose Symptoms

  • Severe anticholinergic effects such as tachycardia, agitation, urinary retention

Antidote for Overdose

  • Supportive care and symptomatic treatment

Storage Conditions

  • Store at controlled room temperature between 20°C to 25°C (68°F to 77°F)

Pharmacokinetics

  • Absorption: Well absorbed from the lungs with minimal systemic absorption
  • Distribution: Protein binding is approximately 72%
  • Metabolism: Primarily metabolized by CYP2D6 and CYP3A4 enzymes
  • Excretion: Excreted mainly through urine as metabolites

Precautions

  • Caution in patients with narrow-angle glaucoma
  • Monitor for urinary retention
  • Use with caution in patients with bladder neck obstruction

Warnings

  • Not to be used as a rescue medication for acute bronchospasm
  • Do not swallow tiotropium capsules or inhalation solution

Others

  • Avoid spraying in the eyes