Tiotropium (Spiriva Respimat) for COPD

Tiotropium (brand name Spiriva Respimat) is a bronchodilator used as a long term, maintenance treatment in people with COPD, and for reducing COPD exacerbations. It is an anticholinergic class medicine that works by relaxing the airways to the lungs and making breathing easier.1

How does tiotropium for COPD work?

Tiotropium is a long-acting muscarinic antagonist, also known as anticholinergic. It connects to the muscarinic receptors subtypes M1 to M5. The M3 receptors are located in the muscle of the bronchi, and are responsible for bronchoconstriction. As tiotropium has affinity to the M3 receptors, it works by inhibiting them on the muscle of the bronchi, leading to bronchodilation.2

Studies of tiotropium

The Spiriva Respimat development program included ten placebo controlled trials in COPD, six of them assessed its efficacy. Spiriva Respimat 5 mcg showed significant improvement in trough FEV1 compared to placebo and less need for rescue medication.2

Indications and side effects

Tiotropium is a prescription medicine for long term use, not for sudden breath problems. It comes as a powder that is usually inhaled once daily.1 The most common side effects include dry mouth, blurred vision, constipation and painful urination, upset stomach, chest pain or cold symptoms. Medical help should be sought if allergic reaction symptoms such as hives, itching, breathing difficulties, swelling of the face, lips, tongue or throat appear.3


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  1. https://medlineplus.gov/druginfo/meds/a604018.html
  2. http://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Spiriva%20Respimat/spirivarespimat.pdf
  3. https://www.drugs.com/mtm/tiotropium-inhalation.html