Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Spiriva; Belgium: Spiriva; Bulgaria: Spiriva; Cyprus: Spiriva; Czech Republic: Spiriva; Denmark: Spiriva; Finland: Spiriva; France: Spiriva; Germany: Spiriva; Greece: Spiriva;Hungary: Spiriva; Ireland: Spiriva; Italy: Spiriva; Latvia: Spiriva; Lithuania: Spiriva; Netherlands: Spiriva; Poland: Spiriva; Portugal: Spiriva; Romania: Spiriva; Slovakia: Spiriva; Slovenia: Spiriva; Spain: Spiriva; Sweden: Spiriva; UK: Spiriva.

North America

Canada: Spiriva; USA: Spiriva.

Latin America

Argentina: Spiriva; Brazil: Spiriva; Mexico: Spiriva.


Japan: Spiriva.

Drug combinations


Tiotropium Bromide: C~19~H~22~BrNO~4~S~2~. Mw: 472.42. 6β,7β-Epoxy-3β-hydroxy-8-methyl-1αH,5αH-tropanium bromide, di-2-thienylglycolate. CAS-139404-48-1.

Pharmacologic Category

Anticholinergic Agents; Antimuscarinics/Antispasmodics. (ATC-Code: R03BB04).

Mechanism of action

Blocks action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation.

Therapeutic use

Maintenance treatment of bronchospasm associated with COPD (bronchitis and emphysema).

Pregnancy and lactiation implications

Adverse events (fetal loss, decreased birth weights, delayed sexual maturation) observed in some animal studies. There are no adequate, well-controlled studies in pregnant women. Use only when expected benefit to mother outweighs potential risk to fetus. Excretion in breast milk unknown (use with caution in nursing women).

Unlabeled use


Hypersensitivity to tiotropium, atropine or its derivatives, including ipratropium, or any component of the formulation (contains lactose).

Warnings and precautions

Rarely, paradoxical bronchospasm may occur with use of inhaled bronchodilating agents. Immediate hypersensitivity reactions (urticaria, angioedema, rash, bronchospasm) reported. Not indicated for initial (rescue) treatment of acute episodes of bronchospasm. Use with caution in narrow-angle glaucoma, in myasthenia gravis, in prostatic hyperplasia or bladder neck obstruction, and in moderate-to-severe renal impairment. Avoid inadvertent instillation of powder into the eyes.



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