Tiotropium — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Tiotropium?
Tiotropium is a long-acting muscarinic antagonist (LAMA) bronchodilator used for chronic obstructive pulmonary disease (COPD) and severe asthma. This medication is funded by Pharmac for COPD.
What is Tiotropium Used For?
Tiotropium is the cornerstone long-acting bronchodilator for COPD — reducing breathlessness, improving exercise tolerance, and reducing exacerbation risk. It is also approved as add-on therapy for severe, uncontrolled asthma.
How Does Tiotropium Work?
Tiotropium selectively and competitively blocks muscarinic M3 receptors in the bronchial smooth muscle, blocking acetylcholine-mediated bronchoconstriction and reducing mucus secretion. This results in sustained bronchodilation lasting 24 hours with once-daily dosing.
How to Take Tiotropium
Inhaled once daily via the Handihaler® device (18 mcg capsule for inhalation) or Respimat® soft mist inhaler (5 mcg, 2 puffs once daily). Rinse mouth after use to reduce throat irritation. Do not swallow the Handihaler capsules — they are for inhalation only.
Common Side Effects of Tiotropium
- Dry mouth (most common — usually mild)
- Constipation
- Urinary hesitancy or retention
- Blurred vision (if accidentally sprayed in eyes)
- Throat irritation
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Acute urinary retention (particularly in men with BPH — use with caution)
- Acute narrow-angle glaucoma (avoid spray contact with eyes — can precipitate acute glaucoma)
- Paradoxical bronchospasm (rare — stop immediately and seek medical care)
- Severe allergic reactions
Drug Interactions
Tiotropium may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Other anticholinergic medicines (additive anticholinergic effects — dry mouth, urinary retention, constipation)
New Zealand Prescribing Information
Tiotropium (Spiriva® Handihaler® 18 mcg capsules; Spiriva® Respimat® 2.5 mcg soft mist inhaler) is funded by Pharmac for COPD. For patients with COPD who are inadequately controlled on tiotropium alone, addition of a long-acting beta-2 agonist (e.g., salmeterol, formoterol) provides additional benefit. The Respimat® inhaler is available for patients who find the Handihaler® difficult to use.
Frequently Asked Questions
How is tiotropium different from my reliever inhaler?
Tiotropium is a long-acting preventer (controller) inhaler taken once daily — not a reliever. It does not work quickly enough to relieve acute breathlessness. Always use your short-acting reliever (salbutamol) for sudden breathlessness. Continue tiotropium every day even when feeling well.
Can I use tiotropium if I have an enlarged prostate?
With caution — tiotropium can worsen urinary hesitancy or cause acute urinary retention in men with benign prostatic hyperplasia (BPH). Inform your doctor if you have prostate problems before starting.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: