Tiotropium bromide is used for the maintenance treatment of chronic obstructive pulmonary disease or COPD (a long-term lung disease that causes airflow obstruction making it hard to breathe).
This medicine may also be used together with other medicines to manage breathing problems caused by asthma.
It belongs to a group of medicines called "bronchodilators", which help open the airways. Tiotropium bromide helps treat asthma or chest illnesses by relaxing the airways in your lungs, and relieving chest tightness, wheezing, and cough so you can breathe more easily.
Use Tiotropium bromide exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.
Try to use this medicine at the same time each day.
Tiotropium bromide is available as a capsule for dry powder inhalation or as a solution for inhalation.
If you have been given a capsule for dry powder inhalation, a specific inhaler device will be used. Do not swallow the capsules.
To take a dose, follow these steps:
- Release the dust cap by pressing the piercing button completely.
- Open the dust cap by pulling it up, then open the mouthpiece by pulling it upward.
- Take the capsule out from the blister pack or bottle (remove the capsule only before use). Do not leave the capsule exposed to air for too long.
- Place the capsule inside the centre chamber of the inhaler device. Do not place a capsule directly into the mouthpiece. Close the mouthpiece firmly until you hear a click sound and leave the dust cap open.
- Hold the inhaler device with the mouthpiece facing upwards.
- Press and release the piercing button once.
- Breathe out completely. Avoid breathing into the mouthpiece at any time.
- Place the inhaler device in your mouth and close your lips firmly around the mouthpiece.
- Breathe in slowly and deeply until your lungs are full. As you breathe in, you should hear or feel the capsule vibrate.
- Hold your breath for as long as you can. At the same time, remove the inhaler device from your mouth then resume normal breathing.
- Repeat steps 7-10. This will ensure you receive the full dose.
- After use, open the mouthpiece again. Tip out the used capsule and dispose properly. Close the mouthpiece and dust cap for storage.
A certain brand of capsule must only be used by their specific inhaler device. Do not use any other inhaler devices for your given capsules.
If you are using the solution for inhalation for the first time, follow these steps to take a dose:
- Keep the cap closed while holding the inhaler in an upright position.
- Press the safety catch while pulling off the clear base.
- Insert the narrow end of the cartridge into the inhaler. Place the inhaler on a firm surface then push it down completely until it clicks.
- Put the clear base back until it clicks into place.
- Turn the clear base in the direction of the arrows on the label until you hear a click sound.
- Open the cap fully.
- Press the dose-release button while pointing the inhaler toward the ground.
- Close the cap. If you do not see any mist, repeat steps 5-7 until a mist becomes visible. After a mist becomes visible, repeat steps 5-7 for three more times. Your inhaler is now ready for daily use.
- Keep the cap closed then turn the clear base in the direction of the arrows on the label until you hear a click sound.
- Open the cap fully.
- Breathe out completely. Close your lips around the mouthpiece. Do not cover the air vents.
- Point the inhaler towards the back of your throat.
- Breathe in slowly and deeply through your mouth while pressing the dose-release button. Continue to breathe in slowly.
- Hold your breath for 10 seconds or as long as you can.
- Repeat steps 9-14 once more to get your full dose (total of 2 puffs).
- After getting the full dose, close the cap.
Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist to show you how to use it.
Avoid contact of the capsule powder or solution mist into the eyes. Rinse immediately with water if it gets into your eyes. Alert your doctor if you start to have any problems with your eyesight.
Tiotropium bromide must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor.
Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to use your medicine, let your doctor and pharmacist know.
Do not use Tiotropium bromide if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine, atropine, or similar medicines such as ipratropium bromide and oxitropium bromide.
Inform your doctor if you have the following conditions:
- narrow-angle glaucoma (increased pressure in the eye)
- enlarged prostate gland
- blockage in the bladder or problems in passing urine
- heart problems e.g. recent heart attack in the last 6 months, unstable or irregular heartbeat, heart failure (weakness and inability of the heart to pump blood)
- moderate to severe kidney disease
Do not use Tiotropium bromide to relieve a sudden attack of breathlessness. This medicine cannot relieve sudden chest tightness, breathlessness, or an asthma attack. Use a fast-acting reliever as prescribed by your doctor to manage such attacks.
Let your doctor know if you are pregnant or breastfeeding.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. lung function) may be done while you are being treated with Tiotropium bromide. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs and symptoms of increased pressure in the eyes, bladder problems, and allergic reactions may also be needed.
Tiotropium bromide may cause dizziness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: headache, dry mouth, constipation, indigestion, stomach pain, runny nose, sore throat, and cough.
If you develop sudden chest tightness, wheezing, or breathing difficulties after using this medicine, stop using Tiotropium bromide and inform your doctor immediately.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of allergic reactions e.g. rashes, breathlessness, swelling of the face, eyes, mouth or throat
- signs and symptoms of bladder problems e.g. pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
- signs and symptoms of increased eye pressure e.g. eye pain or discomfort, blurred vision, seeing halos or coloured images, eye redness
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using other medicines for COPD or asthma.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children. Do not freeze.
Protect the capsules for dry powder inhalation from extreme temperatures and moisture. Do not store the capsule in the inhaler device.
Medicines must not be used past the expiry date.
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