Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Spiriva Respimat, Spiriva HandiHaler
Synonyms :
tiotropium
Class :
Anticholinergics, Respiratory
Brand Name :
Spiriva Respimat, Spiriva HandiHaler
Synonyms :
tiotropium
Class :
Anticholinergics, Respiratory
Dosage Forms & StrengthsÂ
Capsule; Spiriva HandihalerÂ
18mcgÂ
Inhalational solution; Spiriva RespimatÂ
1.25mcg/actuationÂ
2.5mcg/actuationÂ
Chronic Obstructive Pulmonary Disease (COPD)Â
It is indicated in the maintenance of bronchospasm that is linked to COPD, helping in COPD exacerbations
Spiriva Handihaler- 2 inhalations from a capsule orally each day through the HandiHaler device
Spiriva Respimat- 2 actuation of 2.5 mcg each, inhaled orally daily
For long-term indication, use once daily, as the maintenance of asthma in people more than 12 years
Spiriva Respimat- 2 actuation of 1.25 mcg each, inhaled orally daily
Dose Modifications
In the case of CrCl<50ml/min, use the drug only when the benefits are more than the potential risks
Dosage Forms & StrengthsÂ
Inhalational solution; Spiriva RespimatÂ
1.25mcg/actuationÂ
For long-term indication, use once daily, as the maintenance of asthma in people more than 6 years
Spiriva Respimat- 2 actuations of 1.25 mcg each, inhaled orally daily
Refer to the adult dosingÂ
tiotropium: they may increase the CNS depressant effect of CNS Depressants
tiotropium: they may increase the CNS depressant effect of CNS Depressants
tiotropium: they may increase the CNS depressant effect of CNS Depressants
tiotropium: they may increase the CNS depressant effect of CNS Depressants
tiotropium: they may increase the CNS depressant effect of CNS Depressants
tiotropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
tiotropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
tiotropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
tiotropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
tiotropium: they may increase the bradycardic effect of Bradycardia-Causing Agents
they increase the anticholinergic effect of tiotropium
they increase the anticholinergic effect of tiotropium
they increase the anticholinergic effect of tiotropium
they increase the anticholinergic effect of tiotropium
they increase the anticholinergic effect of tiotropium
it decreases the rate of elimination of pidotimod
tiotropium: they may decrease the therapeutic effect of antihistamines
tiotropium: they may decrease the therapeutic effect of antihistamines
tiotropium: they may decrease the therapeutic effect of antihistamines
tiotropium: they may decrease the therapeutic effect of antihistamines
dexchlorpheniramine, dextromethorphan, and phenylephrine
tiotropium: they may decrease the therapeutic effect of antihistamines
anticholinergic agents increase the effect of tiotropium
anticholinergic agents increase the effect of tiotropium
anticholinergic agents increase the effect of tiotropium
anticholinergic agents increase the effect of tiotropium
anticholinergic agents increase the effect of tiotropium
may increase the anti-cholinergic effect
may increase the anticholinergic effect of anticholinergic agents
may increase the anticholinergic effect of anticholinergic agents
may increase the anticholinergic effect of Anticholinergic Agents
may increase the anticholinergic effect of Anticholinergic Agents
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect
tiotropium: they may increase the hypertensive effect of sympathomimetics
tiotropium: they may increase the hypertensive effect of sympathomimetics
tiotropium: they may increase the hypertensive effect of sympathomimetics
tiotropium: they may increase the hypertensive effect of sympathomimetics
tiotropium: they may increase the hypertensive effect of sympathomimetics
tiotropium: they may enhance the serum concentration of CYP3A4 Inhibitors
tiotropium: they may enhance the serum concentration of CYP3A4 Inhibitors
tiotropium: they may enhance the serum concentration of CYP3A4 Inhibitors
tiotropium: they may enhance the serum concentration of CYP3A4 Inhibitors
tiotropium: they may enhance the serum concentration of CYP3A4 Inhibitors
tiotropium may decrease the excretion rate of ioxilan, potentially resulting in a higher serum level
may increase the risk or severity of hypertension when combined
Actions and Spectrum:Â
Actions:Â
Spectrum:Â
Frequency definedÂ
>10%Â
Upper respiratory tract infection (41%)Â
Sinusitis (11%)Â
Dry mouth (16%)Â
1-10%Â
Abdominal painÂ
Angina pectorisÂ
Allergic reactionÂ
CataractÂ
ConstipationÂ
Chest pain (nonspecific)Â
DyspepsiaÂ
DysphoniaÂ
DepressionÂ
EdemaÂ
EpistaxisÂ
HypercholesterolemiaÂ
HyperglycemiaÂ
Gastroesophageal refluxÂ
Herpes zosterÂ
InfectionÂ
MoniliasisÂ
MyalgiaÂ
LaryngitisÂ
Leg painÂ
ParesthesiaÂ
PharyngitisÂ
Skeletal painÂ
Stomatitis (including ulcerative stomatitis)Â
RashÂ
RhinitisÂ
Urinary tract infectionÂ
VomitingÂ
<1%Â
AngioedemaÂ
Supraventricular tachycardiaÂ
Urinary retentionÂ
FibrillationÂ
Black Box Warning:Â
NoneÂ
Contraindication/Caution:Â
ContraindicationsÂ
CautionsÂ
Pregnancy consideration:Â Â
Few data is available regarding the usage of drug during pregnancy. Untreated asthma during pregnancy can lead to the risk of preeclampsia in infants and prematurity in infants.Â
Breastfeeding warnings:Â Â
No data is available regarding the excretion of drug in breast milk.Â
Pregnancy category:Â
Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester.Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: No data is available for the drug under this category.Â
Pharmacology:Â
Pharmacodynamics:Â
The primary pharmacodynamic effect of tiotropium is bronchodilation. By relaxation of smooth muscles in the airways, tiotropium helps to widen the bronchi and bronchioles, improving airflow and reducing airway resistance. This leads to improved lung function and reduced symptoms such as wheezing, shortness of breath, and cough.Â
Pharmacokinetics:Â
AbsorptionÂ
The bioavailability is 19.5%Â
The onset of action takes place in 30 minutesÂ
Duration of action is greater than 24 hoursÂ
The time to achieve peak effect is 1-4 hourÂ
DistributionÂ
Protein-bound is 72%Â
Volume of distribution is 32 L/kgÂ
MetabolismÂ
Drug gets metabolized in the liver by CYP450-dependent oxidation and following glutathione conjugation.Â
Elimination and ExcretionÂ
The half-life is 5-6 daysÂ
The rate of total body clearance is 880 mL/minÂ
The drug is excreted in the urineÂ
Administration:Â
Open the inhaler device according to the manufacturer’s instructions. Some inhalers require priming before the first use. Follow the priming instructions if necessary. Exhale away from the inhaler to empty your lungs as much as possible before using the inhaler.Â
Hold inhaler upright with the mouthpiece pointing towards you. Ensure that the mouthpiece is clean and free from obstructions. Fix the inhaler in the lips as seal.
Slowly take deep breath through your mouth, and at the same time, press down the dose-release button on the inhaler to release the medication. After inhaling the medication, remove the inhaler from your mouth. Hold your breath for some time and then exhale slowly and gently.Â
Patient information leafletÂ
Generic Name: tiotropiumÂ
Pronounced: tye-oh-troe-pee-umÂ
Why do we use tiotropium?Â
tiotropium is primarily used as a maintenance treatment for respiratory conditions. It is taken regularly, usually once daily, to provide sustained bronchodilation and symptom control over an extended period. It treats COPD and asthma.
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