Tioriva Inhalation Capsule 18 mcg (Spiriva)
Tioriva Inhalation Capsule 18 mcg (Spiriva) is a long-acting muscarinic antagonist (LAMA) used in the management of chronic obstructive pulmonary disease (COPD) and other bronchopulmonary conditions. It is inhaled through the mouth and is approved for both preventative or maintenance therapies.
Uses
Tioriva Inhalation Capsule 18 mcg (Spiriva) is prescribed for those with COPD, chronic bronchitis, and bronchial asthma who are either partially or totally dependent on supplemental oxygen therapy. It is a preventive drug used to manage symptoms associated with COPD and other bronchopulmonary disorders, such as:
- Shortness of breath
- Wheezing
- Coughing
- Excess mucus production
| Brand Name | Tioriva |
|---|---|
| Type | Inhalation Capsule |
| Weight | 18 mcg |
| Generic | Tiotropium |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Available in | English বাংলা |
Mechanism of Action
Tioriva Inhalation Capsule 18 mcg (Spiriva) acts by blocking muscarinic receptors in the airways, resulting in a bronchodilator effect. This relaxes the airway smooth muscle resulting in widened airways and improved breathing. It also has an anti-inflammatory action, which reduces congestion and excess mucus production.
How Long Does it Take to Work?
The effects of tiotropium (Spiriva) usually take effect after 30 to 60 minutes of inhalation and can last up to 24 hours. However, some people may experience relief from symptoms almost immediately.
Absorption
Tioriva Inhalation Capsule 18 mcg is rapidly and completely absorbed after inhalation through the mouth. Peak plasma concentrations occur within 1 to 2 hours post-inhalation.
Route of Elimination
Tioriva Inhalation Capsule 18 mcg is partially metabolized to desisopropyl- and desmethyltiotropium and is mostly eliminated through urine. It has a terminal elimination half-life of around 24 hours.
Dosage
Adult over 18 years: The recommended dose of Tiotropium Dry Powder Inhaler capsule is 18 mcg (1 capsule) once-daily, with the device.The contents of the Tiotropium Dry Powder Inhaler capsules are only for oral inhalation and should only be used with the device.
No dosage adjustment is required for geriatric, hepatically-impaired, or renally-impaired patients. However, patients with moderate to severe renal impairment given Tiotropium capsule should be monitored closely for anticholinergic effects.
The recommended dosage of tiotropium (Spiriva) is 18 mcg (9 mcg capsule) administered once daily as a single inhalation.
Administration
Tioriva Inhalation Capsule 18 mcg (Spiriva) should be administered as one inhalation once daily through the Respimat inhaler. Before use, the patient should rinse their mouth with water and spit out any excess water. The Respimat inhaler should be released twice into the mouth and the patient should breathe in deeply and slowly for as long as possible.
Side Effects
Common side effects may include dry mouth, coughing, throat irritation and headache. More serious side effects may include chest pain, blurred vision, fast heart rate or difficulty urinating.
Toxicity
The toxic dose of tiotropium (Spiriva) is not well established; however, it is thought to be relatively low due to the form of delivery (inhalation) which minimizes the risk of systemic toxicity. However, patients should be monitored for any signs of toxicity such as irregular heart rate, tremor, confusion or restlessness.
Precautions
Tioriva Inhalation Capsule 18 mcg should be used with caution in patients with glaucoma, difficulty urinating due to enlarged prostate, or uncontrolled narrow-angle glaucoma due to an increased risk of urinary retention and eye pressure. It should also be used with caution in pregnant or breastfeeding women, as safety has not been established in this population.
Interactions
Tioriva Inhalation Capsule 18 mcg (Spiriva) has the potential to interact with other drugs, such as anticholinergics and antihypertensives, so patients should be monitored for any potential interaction. Other drugs that may interact with tiotropium include theophylline, quinidine, and medications for depression or seizures. It should also be used with caution in patients taking medications for glaucoma.
Disease Interaction
Tioriva Inhalation Capsule 18 mcg (Spiriva) may worsen symptoms of certain diseases, such as narrow-angle glaucoma, urinary retention, and asthma. Patients with any of these conditions should be closely monitored while taking tiotropium.
Drug Interaction
Certain drugs may interact with tiotropium (Spiriva) and should be used with caution. These include anticholinergics, antihypertensives, and medications for depression or seizures. Theophylline, ephedrine, and quinidine may increase the level of tiotropium in the body and should be used with caution while taking tiotropium.
Food Interactions
Tioriva Inhalation Capsule 18 mcg should be taken at least 1 hour before or 2 hours after meals, as food may decrease the absorption of the medication. Avoid acidic foods, such as citrus fruits, as they may reduce efficacy.
Pregnancy Use
There are no human data available about the use of tiotropium (Spiriva) in pregnancy, therefore it is not recommended for use in this population. Animal studies have shown it to be unsafe when administered to pregnant animals, so it should not be used during pregnancy unless it is essential.
Lactation Use
There is no data available on the use of tiotropium (Spiriva) in lactating women, therefore it is not recommended for use in this population. If it must be used, monitoring for any adverse effects in the infant is recommended.
Acute Overdose
There is no data on the effects of an acute overdose of tiotropium (Spiriva). In the event of an overdose, monitoring for signs of toxicity such as irregular heart rate, tremor, confusion or restlessness is recommended.
Contraindication
Tioriva Inhalation Capsule 18 mcg should not be used in those with hypersensitivity, urinary obstruction, narrow-angle glaucoma, or paralytic ileus. It should also be used with caution in those with severe renal impairment, as it is not well studied in this population.
Use Direction
Tioriva Inhalation Capsule 18 mcg (Spiriva) should be administered as one inhalation once daily through the Respimat inhaler. Before use, the patient should rinse their mouth with water and spit out any excess water. The Respimat inhaler should be released twice into the mouth and the patient should breathe in deeply and slowly for as long as possible.
Storage Condition
Tioriva Inhalation Capsule 18 mcg (Spiriva) should be stored at room temperature away from direct sunlight and damp conditions. It is important to keep the medication out of reach of children and pets.
Volume of Distribution
Tioriva Inhalation Capsule 18 mcg has a volume of distribution of 43 L. It is highly bound to plasma proteins, but still distributes well into all tissues.
Half Life
The half life of tiotropium (Spiriva) is approximately 24 hours.
Clearance
Tioriva Inhalation Capsule 18 mcg is cleared by both renal and non-renal routes. Non-renal clearance is mainly through the liver, while renal clearance is via glomerular filtration. The overall clearance of tiotropium is 2.1 L/hr.
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