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Bronchodilator

Tiotropium

Brand names: Spiriva, Spiriva Respimat

Tiotropium is a long-acting muscarinic antagonist (LAMA) inhaler used for maintenance bronchodilation in COPD and as add-on therapy in some asthma.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

For oral inhalation only. Two inhalations of STIOLTO RESPIMAT once-daily at the same time of day. ( 2 ) 2.1 Recommended Dosage The recommended dosage of STIOLTO RESPIMAT is two inhalations once-daily at the same time of the day. Do not use STIOLTO RESPIMAT more than two inhalations every 24 hours. 2.2 Administration Information For oral inhalation only. Prior to first use, the STIOLTO RESPIMAT cartridge is inserted into the STIOLTO RESPIMAT inhaler and the unit is primed. When using the unit for the first time, patients are to actuate the inhaler toward the ground until an aerosol cloud is visible and then repeat the process three more times. The unit is then considered primed and ready for …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-06-30. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It blocks airway muscarinic receptors to give sustained bronchodilation; it is a maintenance treatment, not a reliever.

Prescribing in practice

  • It is for regular daily use, not for acute symptom relief.
  • Use caution in narrow-angle glaucoma and bladder-outflow obstruction (antimuscarinic effects); avoid the mist/powder getting into the eyes.
  • Inhaler technique and device differ between products — train the patient.

Monitoring

Review symptoms, exacerbation frequency and inhaler technique.

Counselling the patient

  • Use it every day for maintenance — keep your reliever for sudden breathlessness.
  • Dry mouth can occur; keep it out of your eyes.
  • Report eye pain or visual changes, or difficulty passing urine.

Evidence & guidelines

LAMAs are central to COPD maintenance and an add-on option in asthma per NICE NG115/NG80.

Reference: GOLD COPD Guidelines 2024; UPLIFT Trial NEJM 2008; NICE; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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