INTRODUCTION

TIOTROPIN 9 INHALER contains Tiotropium bromide which belongs to the group of medicines called Bronchodilators. It is used in maintenance treatment of chronic obstructive pulmonary disease (COPD) and help patients breathe more easily.

Chronic obstructive pulmonary disease (COPD) is a breathing disorder in which there is progressive airflow limitation that cannot be fully reversed, characterized by long-term cough and phlegm production. Prior to the treatment, your doctor may want you to take several tests to understand your existing condition.

Before using TIOTROPIN 9 INHALER, inform your doctor if you have kidney problem or have suffered from heart attack during the last 6 months, any unstable or life-threatening irregular heart beat, severe heart failure within the past year or urinary retention (difficulty passing urine, painful urination especially in patients with prostate problems).

Also inform your doctor if you have narrow-angle glaucoma, sudden attack of breathlessness or wheezing, intolerance to certain sugar or milk protein. TIOTROPIN 9 INHALER should be used in pregnant or breastfeeding women only if specifically directed by your doctor.

TIOTROPIN 9 INHALER is not recommended for use in children and adolescents under 18 years, so consult your doctor before using it. The most common side effect of using TIOTROPIN 9 INHALER is dry mouth. Contact your doctor if any of the side effects worsen.

USES OF TIOTROPIN 9 INHALER

For maintenance treatment of chronic obstructive pulmonary disease (COPD)

HOW TIOTROPIN 9 INHALER WORKS

TIOTROPIN 9 INHALER works by opening your airways and makes it easier for air to get in and out of your lungs. Hence it helps to minimise the effects of the disease in everyday life and to be active longer.

DIRECTIONS FOR USE

Use TIOTROPIN 9 INHALER as advised by your physician. It is for inhalation use only. Do not swallow the medicine. Do not to let the medicine enter your eyes as there can be blurred vision, eye pain and/or red eyes, you should wash your eyes in warm water immediately.

Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. Do not stop using TIOTROPIN 9 INHALER unless your doctor advises you to stop.

SIDE EFFECTS OF TIOTROPIN 9 INHALER

COMMON

dry mouth

UNCOMMON

dizziness, headache
taste problems
blurred eyesight
irregular heartbeat
throat inflammation, hoarseness, cough
heart burn (gastroesophageal reflux disease)
constipation
fungal infections of the mouth and throat
rash
pain/difficulty while passing urine

RARE

trouble sleeping
faster /irregular heartbeat, feeling your heartbeat
nosebleed
larynx or sinus inflammation
blocked intestines or no bowel movements
inflammation of the gums, tongue, mouth
trouble swallowing
nausea
hypersensitivity, including immediate reactions
nettle rash, itching
infections of the urinary tract
seeing halos around lights or coloured images in association with red eyes (glaucoma)
increased pressure in the eye
nosebleed
serious allergic reaction which causes swelling of the face or throat

Stop using TIOTROPIN 9 INHALER and contact your doctor immediately if you experience any of the following side effects:

serious allergic reactions (hives, itching, rash, swelling of the face, lips, tongue or throat that may cause trouble breathing or swallowing) or other hypersensitivity reactions (Ex. sudden drop in your blood pressure or dizziness)
unexpected chest tightness, coughing, wheezing or breathlessness right after inhalation
seeing halos around lights or coloured images related to red eyes, increase in eye pressure, eye pain or discomfort, along with headache, nausea or vomiting

HOW TO MANAGE SIDE EFFECTS

Dry mouth:

Sipping water frequently or any other sugar free fluids or chewing sugar free gum helps in keeping mouth moist. If symptoms do not improve inform your doctor.

WARNING & PRECAUTIONS

PREGNANCY

TIOTROPIN 9 INHALER is not recommended for use in pregnant women or women planning or have a baby unless specifically recommended by your doctor. Consult your doctor before using it.

BREASTFEEDING

TIOTROPIN 9 INHALER is not recommended for use in breastfeeding women unless specifically recommended by your doctor. Consult your doctor before using it.

DRIVING AND USING MACHINES

Do not drive or use any machines if you experience dizziness, blurred eyesight or headache after using TIOTROPIN 9 INHALER.

KIDNEY

TIOTROPIN 9 INHALER should be used with caution patients having trouble/pain while passing urine or other kidney problems. Consult your doctor before using it.

LIVER

Safety and effectiveness of TIOTROPIN 9 INHALER in patients with liver problems has not been studied yet.

ALLERGY

Do not use TIOTROPIN 9 INHALER if you are allergic to Tiotropium or any of the other ingredients of this medicine.

LUNGS

TIOTROPIN 9 INHALER is not recommended for use in patients who have sudden attack of breathlessness or wheezing. Consult your doctor before using it.

HEART DISEASE

TIOTROPIN 9 INHALER should be used with caution in patients who had a myocardial infarction (heart attack) in past 6 months or any unstable or life-threatening irregular heartbeat or severe heart failure during the past year. Consult your doctor before using it.

OTHERS

Before using TIOTROPIN 9 INHALER, inform your doctor if you:

have narrow-angle glaucoma
have enlarged prostate
intolerance to certain sugar or milk protein

Use in Pediatrics:

TIOTROPIN 9 INHALER is not recommended for use in children and adolescents (under 18 years). Consult your doctor before using it.

INTERACTIONS

A. Drug - Drug interactions:

Before using TIOTROPIN 9 INHALER, inform your doctor if you are taking any of the following medicine:

other medicines used to widen your airways (Ex. oxitropium, ipratropium)

Overdosage:

If you or anyone else accidentally use too much of TIOTROPIN 9 INHALER, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are dry mouth, constipation, trouble passing urine, increased heartbeat or blurred eyesight.

SYNOPSIS

Drug	:	Tiotropium bromide
Pharmacological Category	:	Antimuscarinic
Therapeutic Indication	:	Maintenance treatment of COPD
Dosage Forms	:	Inhaler, Rotacap, Multihaler, Inhalation Capsule, Novocart, Inhalation, Capsule

MORE INFORMATION

Keep TIOTROPIN 9 INHALER out of reach of children
Do not store above 25°C

FAQs ABOUT TIOTROPIN 9 INHALER

Q: Can I use TIOTROPIN 9 INHALER for sudden breathing problems?

A: TIOTROPIN 9 INHALER is not a rescue medicine and is indicated for maintenance treatment of your chronic obstructive pulmonary disease, so it should not be used to treat a sudden breathing problems like breathlessness or wheezing attack. Your doctor may give you suitable alternative to use for sudden breathing problems.

Q: What if TIOTROPIN 9 INHALER accidentally gets in my eye?

A: Do not let the contents of TIOTROPIN 9 INHALER get into your eyes. This may result in worsening of narrow-angle glaucoma (an eye disease), leading to eye pain or discomfort, blurred eyesight, seeing halos around lights or coloured images related to red eyes. Eye symptoms may occur along with headache, nausea or vomiting. Stop using TIOTROPIN 9 INHALER in such case and call your doctor.

Q: Can I stop using TIOTROPIN 9 INHALER if symptoms improve?

A: Do not stop using TIOTROPIN 9 INHALER without consulting your doctor. The signs and symptoms might worsen if you do so. If you have any more doubts regarding the use of this medicine, ask your doctor.

Q: How does TIOTROPIN 9 INHALER work?

Q: Can TIOTROPIN 9 INHALER be used on infants?

A: No. TIOTROPIN 9 INHALER is used for adults and not recommended for children and adolescents below 18 years of age. Your doctor will decide the correct dose or select a suitable alternative therapy for your child.

REFERENCES

1. Barbara G. Wells, Joseph T. DiPiro, Terry L. Shwinghammer, Cecily V. DiPiro. Chronic Obstructive Pulmonary Disease. Pharmacotherapy Handbook. Ninth edition. 2015. Page-835.

2. Keating, G. M. Tiotropium bromide inhalation powder. Drugs. A Review of its Use in the Management of Chronic Obstructive Pulmonary Disease. Springer Link. December 2012. [Accessed on 27th June 2022]. https://link.springer.com/article/10.2165/11208620-000000000-00000

3. Alcibey Alvarado-Gonzaleza and Isabel Arce. Tiotropium Bromide in Chronic Obstructive Pulmonary Disease and Bronchial Asthma. NIH National library of medicine, National centre for biotechnology information. Pubmed 2015. [Accessed on 27th June 2022]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596263/#:~:text=Tiotropium%20bromide%20is%20an%20inhaled,%2Dh%20bronchodilatation%20%5B10%5D.

4. Boehringer Ingelheim Pharma GmbH & Co. KG. Electronic Medicines Compendium (EMC). [Revised in July 2021] [Accessed on 27th June 2022]. https://www.medicines.org.uk/emc/files/pil.1693.pdf

5. Cipla Ltd. Tiotropium bromide. [Revised in January 2022] [Accessed on 27th June 2022]. https://www.ciplamed.com/content/tiova-inhaler

USEFUL DIAGNOSTIC TESTS

FeNO test
Spirometry
Peak flow test
Chest X-Ray

AUTHOR DETAILS

Written By Dr. Shruthi M R, BDS
Last updated on 18 Jan 2023 | 10:25 AM(IST)

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