Tiova Rotacap is a high-efficacy, long-acting muscarinic antagonist (LAMA) indicated for the maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. Its active ingredient, Tiotropium Bromide, provides sustained bronchodilation by targeting airway smooth muscle, significantly improving lung function and reducing exacerbation frequency. This dry powder inhaler formulation ensures consistent, reliable dosing, making it a cornerstone in long-term respiratory management protocols for enhancing quality of life and exercise tolerance in affected patients.

Features

• Contains Tiotropium Bromide 18 mcg per capsule as the active pharmaceutical ingredient
• Delivered via a Rotahaler® device for efficient pulmonary deposition
• Long-acting muscarinic antagonist (LAMA) mechanism with 24-hour duration of action
• Dry powder formulation, propellant-free and breath-actuated
• Pre-measured single-dose capsules for accuracy and convenience
• Indicated for maintenance treatment of COPD, not for acute relief

Benefits

• Provides sustained bronchodilation for 24 hours, enabling once-daily dosing and improving adherence
• Reduces frequency of COPD exacerbations and associated hospitalizations
• Enhances lung function parameters (FEV1, FVC) and exercise capacity
• Decreases dyspnea (shortness of breath) and nighttime symptoms
• Improves overall health-related quality of life scores
• Minimizes reliance on rescue medications through consistent control

Common use

Tiova Rotacap is routinely prescribed for the long-term maintenance treatment of airflow obstruction in patients diagnosed with chronic obstructive pulmonary disease (COPD). It is not indicated for the relief of acute bronchospasm. Clinical use focuses on improving baseline lung function, reducing dynamic hyperinflation, and preventing exacerbations. It may be used as monotherapy or in combination with long-acting beta-agonists (LABAs) and inhaled corticosteroids (ICS) for patients requiring escalated therapy, per GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines.

Dosage and direction

The recommended dosage for adults is the inhalation of the contents of one Tiova Rotacap (18 mcg) once daily, at the same time each day, using the Rotahaler® device. Administration steps are as follows:

1. Remove one capsule from the blister strip immediately before use.
2. Open the Rotahaler® by twisting the mouthpiece.
3. Insert the capsule into the square chamber of the Rotahaler®.
4. Close the device firmly until a click is heard.
5. Hold the Rotahaler® upright and press the piercing buttons fully once to pierce the capsule.
6. Exhale fully away from the mouthpiece, then place lips tightly around it and inhale deeply and forcefully.
7. Hold breath for up to 10 seconds to allow powder deposition in the airways.
8. Repeat inhalation if any powder remains in the capsule.
   Do not swallow the capsule. The device should be cleaned weekly with a dry cloth.

Precautions

• Not for use in the treatment of acute episodes of bronchospasm; ensure availability of a fast-acting rescue inhaler.
• Use with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction due to anticholinergic effects.
• Monitor for signs of paradoxical bronchospasm; discontinue immediately if it occurs.
• Avoid ocular exposure; wash hands after handling to prevent accidental contact with eyes.
• Assess renal function periodically in patients with moderate to severe renal impairment (creatinine clearance ≤50 mL/min).
• Pregnancy Category C: use only if potential benefit justifies potential risk to the fetus.
• Not recommended for use in pediatric populations or patients with hypersensitivity to atropine or its derivatives.

Contraindications

Tiova Rotacap is contraindicated in patients with a known hypersensitivity to tiotropium bromide, atropine or its derivatives, or any component of the formulation. It should not be used in individuals with a history of hypersensitivity reactions such as rash, urticaria, or angioedema to anticholinergic agents.

Possible side effect

Common adverse reactions (≥3% incidence) include:

• Dry mouth
• Pharyngitis
• Sinusitis
• Rhinitis
• Constipation
• Dyspepsia
• Upper respiratory tract infection
  Less common but serious side effects may include:
• Glaucoma (acute angle-closure)
• Urinary retention
• Tachycardia
• Allergic reactions including anaphylaxis
• Paradoxical bronchospasm
• Immediate hypersensitivity reactions

Drug interaction

• Concomitant use with other anticholinergic-containing drugs (e.g., ipratropium, aclidinium) may potentiate adverse effects and is not recommended.
• No clinically significant pharmacokinetic interactions observed with sympathomimetics, methylxanthines, or oral or inhaled corticosteroids.
• Caution advised when used with drugs that prolong QT interval, though risk with therapeutic doses is low.
• Minimal cytochrome P450 interaction due to predominantly renal excretion.

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

Overdose may lead to exaggerated anticholinergic effects such as:

• Severe dry mouth
• Visual disturbances
• Tachycardia
• ECG changes (e.g., prolonged QT interval)
• Urinary retention
• Glaucoma exacerbation
  Treatment is supportive and symptomatic. There is no specific antidote. Cardiac monitoring and management of anticholinergic syndrome may be required in severe cases.

Storage

Store below 25°C, in a dry place, protected from light and moisture. Keep capsules in the original blister packaging until immediately before use. Do not expose to extreme temperatures or humidity. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational and professional reference purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis, treatment decisions, and personalized therapeutic guidance. Do not initiate, modify, or discontinue medication without professional supervision. The prescribing physician should be aware of the patient’s full medical history, concurrent medications, and contraindications prior to use.

Reviews

Clinical studies and meta-analyses consistently demonstrate that Tiova Rotacap significantly improves lung function (FEV1), reduces exacerbation rates, and enhances quality of life in COPD patients. In a 1-year randomized controlled trial, patients using tiotropium showed a 16% reduction in exacerbations compared to placebo. Pulmonologists frequently note its reliability and patient compliance benefits due to once-daily dosing. Some users report mild dry mouth, but overall satisfaction is high among those with moderate to severe COPD.
— Based on aggregated clinical trial data and specialist feedback