The Tiova Inhaler (Tiotropium Bromide) is a long-acting muscarinic antagonist (LAMA) inhaler specifically designed for the maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It offers sustained 24-hour bronchodilation with a single daily dose, significantly improving lung function, reducing exacerbation frequency, and enhancing overall quality of life for patients. Its dry powder formulation ensures consistent drug delivery, making it a cornerstone in the long-term management strategy for stable COPD.

Features

• Contains Tiotropium Bromide as the active pharmaceutical ingredient (18 mcg per inhalation)
• Delivered via a proprietary dry powder inhaler (DPI) device
• Provides 24-hour sustained bronchodilation with once-daily dosing
• Pre-measured, single-dose capsules ensure consistent dosage accuracy
• Portable, breath-actuated device requiring no propellants or coordination with inhalation
• Each blister strip contains 10 capsules; standard packaging includes 3 strips (30 doses)

Benefits

• Significantly improves forced expiratory volume in one second (FEV1) and other spirometric parameters
• Reduces the frequency and severity of COPD exacerbations, decreasing hospitalization rates
• Alleviates dyspnea (shortness of breath), enhancing exercise tolerance and daily activity performance
• Provides round-the-clock symptom control with a convenient once-daily regimen, improving adherence
• Minimizes the need for rescue medication use, offering greater disease stability
• Contributes to improved health-related quality of life scores in long-term COPD management

Common use

The Tiova Inhaler is indicated for the long-term, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). It is prescribed for patients with a confirmed diagnosis of COPD, including those with chronic bronchitis and/or emphysema, who require regular bronchodilator therapy to control symptoms and prevent exacerbations. It is not indicated for the initial relief of acute bronchospasm (i.e., as a rescue inhaler) and is used as part of a comprehensive COPD management plan that may include other bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and smoking cessation support.

Dosage and direction

The recommended dosage for adults is the inhalation of the contents of one Tiova capsule (18 mcg of Tiotropium Bromide) once daily, at the same time each day, using the Tiova Inhaler device. The capsules must only be administered via the specific inhaler and must not be swallowed. To use: open the dust cap and mouthpiece; place the capsule in the center chamber, firmly close the mouthpiece until a click is heard; press the piercing button completely once to pierce the capsule; exhale fully away from the mouthpiece; place lips tightly around the mouthpiece and inhale deeply and steadily until a rattling sound is heard; hold breath for up to 10 seconds, then exhale slowly. Repeat inhalation if any powder remains. After use, open the mouthpiece and discard the empty capsule. Close the mouthpiece and dust cap. Do not wash the inhaler device; keep it dry.

Precautions

Tiova Inhaler is not a rescue medication and should not be used for treating acute episodes of bronchospasm. Patients must have a short-acting beta2-agonist available for acute symptom relief. Immediate medical attention should be sought if paradoxical bronchospasm occurs after administration. Use with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction, as anticholinergic effects may worsen these conditions. Avoid getting the powder into the eyes, as it may cause blurring of vision or pupil dilation. Patients with severe renal impairment (creatinine clearance ≤50 mL/min) should be monitored closely, as tiotropium is primarily renally excreted. Pregnancy Category C: use only if potential benefit justifies potential risk to the fetus. Not recommended during lactation.

Contraindications

Hypersensitivity to tiotropium bromide, atropine or its derivatives, or any component of the formulation. Not indicated for the treatment of asthma. The safety and efficacy of Tiova Inhaler in pediatric patients have not been established.

Possible side effects

Common side effects (may affect up to 1 in 10 people) include dry mouth, constipation, and upper respiratory tract infection. Uncommon side effects (may affect up to 1 in 100 people) include: tachycardia, palpitations, urinary retention, blurred vision, glaucoma, dysphonia, pharyngitis, sinusitis, epistaxis, and skin rash. Rare cases of immediate hypersensitivity reactions, including angioedema, and paradoxical bronchospasm have been reported. If any unusual or severe side effects occur, patients should discontinue use and consult their physician promptly.

Drug interaction

Concurrent use with other anticholinergic-containing drugs (e.g., ipratropium, aclidinium) may potentiate anticholinergic adverse effects and is not recommended. While no clinically significant pharmacokinetic interactions have been observed with commonly prescribed COPD medications (e.g., sympathomimetic bronchodilators, methylxanthines, oral or inhaled corticosteroids), pharmacodynamic interactions leading to increased side effects are possible. Caution is advised when co-administering with drugs that are also excreted renally via active secretion.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Do not double the dose to make up for a missed one.

Overdose

An overdose of tiotropium bromide may lead to pronounced anticholinergic effects such as dry mouth, visual accommodation disturbances, tachycardia, and urinary retention. Severe overdose could potentially lead to delirium, psychosis, or seizures. Treatment is symptomatic and supportive. There is no specific antidote. Medical attention should be sought immediately in case of suspected overdose.

Storage

Store below 25°C (77°F). Keep the capsules in the blister strips and only remove immediately before use. Protect from moisture and light. Do not store in refrigerators or damp places like bathrooms. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Do not disregard professional medical advice or delay in seeking it because of something you have read here. The product information provided may not be exhaustive; always refer to the local prescribing information or package insert.

Reviews

“After switching to Tiova from my previous LAMA, my morning spirometry readings have shown a consistent and significant improvement. The once-daily dosing is foolproof and has greatly improved my compliance. I experience far fewer bad days and have not had a severe exacerbation requiring steroids in over a year.” – James R., diagnosed with emphysema, 68

“As a pulmonologist, I find Tiova to be a reliable first-line LAMA option for my moderate to severe COPD patients. The dry powder delivery system is generally well-tolerated, and the 24-hour efficacy provides solid baseline control. It integrates well into combination therapy regimens when stepped-up care is needed.” – Dr. Eleanor Vance, Pulmonologist

“The initial dry mouth was noticeable but subsided after a few weeks. The real benefit for me has been the ability to be more active with my grandchildren without constantly reaching for my rescue inhaler. My quality of life has improved dramatically since starting this maintenance therapy.” – Margaret L., COPD patient, 71