Tiotropium

Class: Antimuscarinics/Antispasmodics
VA Class: RE105
Chemical Name: di-2-thienylglycolate-6β,7β-Epoxy-3β-hydroxy-8-methyl-1αH,5αH-tropanium bromide
Molecular Formula: C₁₉H₂₂BrNO₄S₂
CAS Number: 139404-48-1
Brands: Spiriva Handihaler, Spiriva Respimat

Medically reviewed by Drugs.com on Oct 13, 2021. Written by ASHP.

Introduction

Bronchodilator; a synthetic quaternary ammonium antimuscarinic agent.

Uses for Tiotropium

COPD

Tiotropium alone (as oral inhalation powder or solution) or tiotropium/olodaterol fixed-combination therapy (as oral inhalation solution): Long-term maintenance treatment of reversible bronchospasm associated with COPD, including chronic bronchitis and emphysema.

Tiotropium alone (as oral inhalation powder or solution): Reduction of COPD exacerbations in patients with a history of exacerbations.

A long-acting bronchodilator (e.g., orally inhaled salmeterol, formoterol, tiotropium) or an inhaled corticosteroid recommended for maintenance monotherapy in patients with moderate to severe COPD (e.g., FEV₁ 30 to <80% of predicted or, alternatively, <60% of predicted) who have persistent symptoms not relieved by as-needed therapy with a selective, short-acting inhaled β₂-adrenergic agonist. Maintenance therapy with long-acting bronchodilators in such patients more effective and more convenient than regular therapy with short-acting bronchodilators. Insufficient data to favor one maintenance monotherapy over another in patients with moderate to severe COPD. In selected patients with inadequate response, may use a combination of several long-acting bronchodilators, such as tiotropium, and a long-acting β₂-adrenergic agonist.

In patients with severe to very severe COPD (e.g., FEV₁ <30 to <50% of predicted), some clinicians recommend addition of an inhaled corticosteroid to one or more long-acting bronchodilators, given separately or in fixed combination; however, benefits of combination therapy over...