Tiotropium Bromide

What tiotropium bromide does

Tiotropium bromide is an inhaled bronchodilator, which means it keeps the breathing passages open. It sits in the anticholinergic group of medicines: it blocks the nerve signals that tell the muscle in the airway wall to tighten, so the passages stay wider and air moves in and out with less effort. It is used as maintenance treatment for COPD (chronic obstructive pulmonary disease, long-term lung damage that leaves people short of breath) and for asthma that needs steady, everyday control. A single dose keeps working for roughly 24 hours, so it suits a once-a-day routine rather than a dose taken when symptoms appear.

The tiotropium products sold here

The 9mcg inhaler is the best-known form: one inhalation a day from a small handheld device. It is sold as Spiriva, and the same inhaler is also offered under the names Tiotropium Bromide and Tiova Inhaler. Tiova Rotacap is the capsule form, supplied in bottles of 15 capsules. A capsule is loaded into its own capsule inhaler, pierced and breathed in as a fine powder; the capsules are never swallowed, and each one is used once. Both contain the same active ingredient, so the choice comes down to the device rather than the medicine.

Fitting it into the day

This is background treatment, not something to reach for when breathing suddenly worsens. It is taken at about the same time every day, on good days as well as bad ones, because its job is to stop the airways narrowing in the first place. A fast-acting reliever is still the one that handles a sudden flare. Keep capsules in their bottle until the moment you use one, and keep the device itself dry.

Alongside other inhalers

Tiotropium rarely works alone. Most people also keep a reliever such as salbutamol for sudden breathlessness, and a steroid inhaler is often added to calm inflammation in the airways. Another route is a single inhaler that combines a long-acting bronchodilator with a steroid. A second anticholinergic, ipratropium for instance, stacks up dry mouth and urinary trouble.

Dry mouth and other effects

Dry mouth tops the list and tends to ease over a few weeks. A sore or scratchy throat, a cough right after inhaling, constipation and headache come up as well. Blurred vision, a pounding heartbeat or difficulty passing urine are less usual. Urgent treatment is needed for sudden eye pain with a red eye and blurred vision, and for swelling of the lips, face or throat.