DRUG OF THE DAY
tiotropium bromide
Long-acting muscarinic antagonist (LAMA)
Before opening the card, recall one use, one safety check and one counseling point.
Reveal the drug learning card
Names and formulations
- Spiriva HandiHaler: inhalation capsule for COPD; capsule is inhaled through the device, not swallowed
- Spiriva Respimat: inhalation spray for COPD and maintenance asthma in patients 6 years and older
HandiHaler and Respimat are different devices with different labeled strengths and indications; HandiHaler capsules must never be swallowed.
Common use
Once-daily maintenance bronchodilation in COPD; the Respimat product also has a maintenance asthma indication in patients 6 years and older.
Mechanism of action
Competitively and reversibly inhibits airway muscarinic receptors, particularly M3-mediated bronchoconstriction.
Important adverse effects and monitoring
- Not a rescue medicine for acute bronchospasm.
- Monitor for paradoxical bronchospasm and anticholinergic effects, including urinary retention and worsening narrow-angle glaucoma.
- Use cautiously in severe kidney impairment because exposure and anticholinergic effects may increase.
Patient counseling
- Teach the exact device and confirm inhalation technique; do not place HandiHaler capsules in the mouth.
- Seek urgent care for eye pain with visual halos or inability to urinate.
Interaction to recognize
With: other anticholinergic medicines
Why it matters: May increase additive dry mouth, urinary retention, blurred vision, or glaucoma risk.
Practical response: Avoid unnecessary duplication and review the complete medication list.
Check the original sources
- DailyMed — Spiriva Respimat prescribing information
Sections: 1 Indications and Usage; 2 Dosage and Administration; 5 Warnings and Precautions; 7 Drug Interactions; 12.1 Mechanism of Action; 17 Patient Counseling Information. Source checked 2026-09-13.
- DailyMed — Spiriva HandiHaler prescribing information
Sections: 1 Indications and Usage; 2 Dosage and Administration; 5 Warnings and Precautions; 17 Patient Counseling Information. Source checked 2026-09-13.
Selected learning points; verify current labeling for the complete prescribing information.