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Tiotropium cautions — GPhC CRA MCQ

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HardRespiratory TherapeuticsTiotropium cautionsGPhC CRA

A 76-year-old man with COPD is prescribed tiotropium Respimat. He has narrow-angle glaucoma, benign prostatic enlargement and reports worsening urinary hesitancy since starting treatment. What is the most appropriate alternative?

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Correct answer: ERefer to the prescriber to review antimuscarinic suitability and urinary symptoms

Tiotropium is an inhaled antimuscarinic and can aggravate urinary retention, especially in men with prostatic enlargement. Caution is also relevant in narrow-angle glaucoma, particularly with ocular exposure. The prescriber should review benefit, inhaler technique and adverse effects. Adding another antimuscarinic would increase the risk of urinary retention.

Reference: BNF; NICE CKS COPD