tiotropium bromide monohydrate at a glance
Medicine class
Long-acting antimuscarinic bronchodilator, also called an anticholinergic bronchodilator.
Main roles
Maintenance treatment for COPD and add-on maintenance treatment for qualifying severe asthma.
Selected device
An inhalation-solution cartridge used only with the reusable Respimat soft-mist inhaler.
Sudden symptoms
It does not replace a rapid-acting reliever inhaler.
What is tiotropium bromide monohydrate used for?
The selected product is licensed for maintenance treatment, not immediate symptom relief.
Maintenance relief of COPD symptoms in adults.
Add-on maintenance treatment for severe asthma from age 6 years after at least one severe exacerbation in the preceding year.
For asthma, it is added to anti-inflammatory treatment and must not be used alone.
How does tiotropium bromide monohydrate work?
Tiotropium blocks muscarinic receptors, particularly M3 receptors on airway muscle. This reduces airway tightening and produces prolonged bronchodilation.
tiotropium bromide monohydrate preparations and strengths
Inhaled preparation
Route: Inhaled
Strengths: 2.5 micrograms
Capsule
Route: Oral
Strengths: 18 micrograms
How to take tiotropium bromide monohydrate
Use only by inhalation with the correct Respimat device. Read the pack instructions and ask a healthcare professional to check your technique. Children should use the device with adult help.
Breathe out away from the device, seal your lips around the mouthpiece without covering the air vents, then inhale slowly and deeply while pressing the release button.
Avoid directing the mist into your eyes.
Keep the cap closed between uses and clean the mouthpiece, including its inner metal part, with a damp cloth or tissue.
Replace the cartridge according to the device indicator and pack instructions.
Routine mouth-rinsing is not required solely because of tiotropium.
tiotropium bromide monohydrate side effects
Common or expected effects
- Dry mouth; persistent dryness may contribute to dental problems.
Get urgent medical advice
- Sudden wheezing or worsening breathing immediately after inhalation.
- Painful red eye, blurred vision or coloured halos.
- Difficulty passing urine or painful urination.
- Fast or irregular heartbeat or troublesome palpitations.
- Severe constipation, abdominal swelling or vomiting.
- Angioedema, anaphylaxis or another immediate hypersensitivity reaction.
tiotropium bromide monohydrate in pregnancy
NHS guidance says inhaled tiotropium can be used during pregnancy because controlling asthma or COPD is important. The selected product information advises precautionary avoidance because human data are very limited. Ask the prescriber to review treatment rather than stopping it without advice.
tiotropium bromide monohydrate while breastfeeding
NHS guidance considers inhaled tiotropium compatible with breastfeeding because transfer and infant absorption are expected to be very low. The selected product information recommends an individual assessment of benefits and treatment need. Discuss continued use with the prescriber and seek advice if the baby feeds poorly.
tiotropium bromide monohydrate interactions
Important interactions are uncommon, but combined anticholinergic effects are a concern.
Other anticholinergic medicines, including ipratropium or oxitropium
Concurrent use has not been adequately studied and is not recommended because anticholinergic adverse effects may increase.
Inhaled corticosteroids and long-acting beta2 agonists
These have been used with tiotropium without evidence that they alter tiotropium exposure.
Herbal and complementary products
Evidence is insufficient, so check new products with a pharmacist or prescriber.
Common questions about tiotropium bromide monohydrate
Answers are fully visible for fast scanning and source review.
Is tiotropium bromide monohydrate a steroid?
No. It is a long-acting antimuscarinic bronchodilator that relaxes airway muscle.
Can it treat a sudden asthma or COPD attack?
No. It is maintenance treatment and does not replace a rapid-acting reliever.
Can children use it?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.