INTRODUCTION

TIOMIST contains Tiotropium bromide which belongs to a class of drugs called inhaled anticholinergic medications. It relaxes the muscles of your lungs. This helps to decrease and prevent shortness of breath. Chronic obstructive pulmonary disease, commonly known as COPD is a group of progressive lung diseases. The most common are emphysema and chronic bronchitis. Tiotropium bromide is an anticholinergic drug used to prevent bronchospasm (narrowing of the airways in the lungs) in people with bronchitis, emphysema, or COPD (chronic obstructive pulmonary disease).

It is only for the inhalational purpose; your doctor will decide how much dose you need to improve your symptoms. You should take this medicine for as long as it is prescribed for you. Before taking this TIOMIST, inform your doctor about all other medicines you are taking as many of these may make this medicine less effective or change the way it works. The common side effects are dry mouth and constipation.

USES OF TIOMIST

• Used as a maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema
• Reduce exacerbations in COPD patients

HOW TIOMIST WORKS

TIOMIST works by relaxing the muscles of your lungs which helps to decrease and prevent shortness of breath.

DIRECTIONS FOR USE

Always use this TIOMIST exactly as your doctor has directed you. It is for inhalation purpose only. This medicine must not be swallowed. Check the label for directions before use. It is usually inhaled once a day in the morning or evening. Do not use for a long period of time unless directed by your doctor. It should not be used as immediate treatment for shortness of breath or other breathing problems.

SIDE EFFECTS OF TIOMIST

HOW TO MANAGE SIDE EFFECTS

Dry mouth:

Chew sugar-free gum or suck on sugar-free hard candies to stimulate the flow of saliva. Limit your caffeine intake because caffeine can make your mouth drier. Drink small sips of water regularly.

Constipation: 

Eat fibre rich foods such as fresh fruit, vegetables and cereals, and drink plenty of water.Exercise regularly, for example, by going for a daily walk or run.

WARNING & PRECAUTIONS

INTERACTIONS

Tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription or the following:

• other anticholinergic medicines (such as diphenhydramine, benztropine, clomipramine and olanzapine)

SYNOPSIS

MORE INFORMATION

Store below 20-25°C and keep out of reach of children.

FAQs ABOUT TIOMIST

How long does TIOMIST take to work?

It starts working within 30 minutes of taking it and you may start breathing with ease after the first dose. The full benefits will be experienced within about 3 days to a week’s time.

How should I take TIOMIST?

Always take it exactly as directed by your doctor. This medicine is meant for inhalation and should not be swallowed. The recommended daily dose is to inhale the contents of one capsule once. Since the effect persists for 24 hours, try to take it at the same time each day for bestresults.

What should I avoid while taking TIOMIST?

Use carefully to prevent it from getting into your eyes. If it gets into your eyes, your vision may get blurry and the pupil in your eye may become larger (dilate). If this happens, consult your physician immediately.

REFERENCES

1. KD Tripathi MD. Anti-cholinergic drugs and drugs acting on autonomic ganglia. Essentials of Medical Pharmacology 7th ed. New Delhi, May 2013. Page - 117.

2. Brown JH, Laiken N. Muscarinic Receptor Agonists and Antagonists. Goodman & Gilman’s: The Pharmacological Basis of Therapeutics. 12th ed. New York, New York: McGraw-Hill Medical; 2011. Page: 230-31.

3. Boushey HA. Drugs Used in Asthma. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic and Clinical Pharmacology. 11th ed. New Delhi, India: Tata McGraw Hill Education Private Limited; 2009. Page:347.

4. Briggs GG, Freeman RK, editors. A Reference Guide to Fetal and Neonatal Risk: Drugs in Pregnancy and Lactation. 10th ed. Philadelphia, PA: Wolters Kluwer Health; 2015. Page: 1367-68.

5. Alcibey Alvarado-Gonzaleza, c and Isabel Arceb. Tiotropium Bromide in Chronic Obstructive Pulmonary Disease and Bronchial Asthma: Journal of clinical medicine research. Sep 25, 2015; [Accessed Dec 7, 2020] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596263/

6. F.P.V. Maesen, J.J. Smeets, T.J.H. Sledsens, F.D.M. Wald, P.J.G. Cornelissen. Tiotropium bromide, a new long-acting antimuscarinic bronchodilator: a pharmacodynamic study in patients with chronic obstructive pulmonary disease (COPD): European respiratory journal. 1995; [Accessed Dec 7, 2020] https://erj.ersjournals.com/content/erj/8/9/1506.full.pdf

7. Boehringer Ingelheim Pharmaceuticals, Inc. Nov 5, 2005; [Revised Oct 2019] [Accessed Dec 7 2020] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=820839ef-e53d-47e8-a3b9-d911ff92e6a9

8. Boehringer Ingelheim Pharmaceuticals, Inc. 2004, U.S. Food & Drug Administration [Revised Aug 2020] [Accessed Dec 7, 2020] https://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Spiriva%20Respimat/spirivarespimat.pdf

9.  Ciplamed. Sep 18, 2014; [Revised April 2019] [Accessed Dec 7, 2020] https://www.ciplamed.com/printpdf/24081

10. Boehringer Ingelheim Pharmaceuticals, Inc. 2004, [Revised Feb 2018] [Accessed Dec 7, 2020] https://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Spiriva/Spiriva.pdf

11. Ciplamed. Jan 21, 2016; [Revised May 2016] [Accessed Dec 7, 2020] https://www.ciplamed.com/printpdf/23774

USEFUL DIAGNOSTIC TESTS

• Complete Blood Count (CBC)
• Absolute Eosinophil Count