Tiotropium Bromide Inhaler (Tiova) - Product information and Uses

Tiotropium Bromide Inhaler is a long acting anticholinergic bronchodilator which is used for the long-term, once daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema and for reducing COPD aggravations. The active ingredient present in Tiova Inhaler is tiotropium bromide monohydrate, which is an anticholinergic with specificity for muscarinic receptors.
Tiotropium bromide is a white or yellowish white powder which is sparingly soluble in water and soluble in methanol.

Tiotropium Bromide Inhaler - Availability And Packaging

Tiotropium Bromide Inhaler is available as Tiova Inhaler manufactured by Cipla which is packaged in in a canister containing 120 metered doses. Each actuation delivers 9 mcg of Tiotropium (as Tiotropium Bromide Monohydrate).

Tiotropium Bromide Inhaler - Dosage

The Tiotropium Bromide supplied in the canister is for Oral Inhalation.
The recommended dosage of tiotropium bromide is two inhalations of the Tiotropium Bromide Inhaler (Tiova Inhaler) once daily, inhaled via a Cipla Zerostat spacer device.

Side Effects of Tiotropium Bromide Inhaler

The most commonly reported side effect during trials of Tiotropium Bromide was dry mouth. Dry mouth was usually mild and often resolved during continued treatment.
Other reactions reported in individual patients included constipation, sinusitis, pharyngitis, non-specific chest pain, upper respiratory tract infection, increased heart rate, blurred vision, glaucoma, urinary difficulty,urinary tract infection, urinary retention, dyspepsia, and rhinitis.

Tiotropium Bromide Inhaler (Tiova Inhaler) - Contraindications

Tiova Inhaler (Tiotropium Bromide Inhalaler) is contraindicated in patients with a hypersensitivity to tiotropium bromide, atropine or its derivatives, including ipratropium, or to any other inactive ingredient of this product.

Tiotropium Bromide Inhaler During Pregnancy And Lactation

Tiotropium Bromide Inhaler should not be used in pregnant women unless the expected benefit outweighs any possible risk to the unborn child.
Tiova Inhaler should not be used in lactating women unless the expected benefit outweighs any possible risk to the infant.

Warnings And Precautions

Tiotropium Bromide Inhaler is not indicated for the initial treatment of acute episodes of bronchospasm (rescue therapy).
In case of Immediate hypersensitivity reactions, including angioedema, Tiotropium Bromide therapy should be stopped at once and alternative treatments should be considered.
Medications such as Tiotropium Bromide (Tiova) that are inhaled may cause paradoxical bronchospasm. In case this happens, treatment with Tiova should be stopped and other treatments considered.
Patients with moderate to severe renal impairment should be monitored closely for potential anticholinergic side effects.


Tiotropium Bromide Inhaler has been used simultaneously with other drugs commonly used in COPD without any increase in side effects.
These include sympathomimetic bronchodilators, methylxanthines, and oral and inhaled steroids. However, the co-administration of Tiova with other anticholinergic-containing drugs (e.g., ipratropium) has not been studied and may interact additively with concomitantly used anticholinergic medications and is therefore not recommended.

Overdosage and Overdose Symptoms of Tiotropium Bromide Inhaler

High doses of Tiova Inhaler may lead to anticholinergic signs and symptoms. However, it was observed during trials of Tiotropium Bromide that there were no systemic anticholinergic adverse effects following a single inhaled dose of up to 340 mcg of tiotropium bromide.
It was also observed that besides dry mouth, no other significant side effects were noted following a 7-day dosing of up to 170 mcg of tiotropium bromide in healthy volunteers during trials.

Additional Information

Additional Info: Prescribing Information