Tiotropium interactions
Full monograph for TiotropiumCheck it against another medicine
Medicines
518 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Aclidinium Bromide + Formoterol Fumarate | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Amitriptyline Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxide | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Aripiprazole | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Atropine Sulfate (Injection) | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Beclometasone + Formoterol + Glycopyrronium | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Bethanechol Chloride | Moderate | Antagonism | Anticholinergic agents and other agents with significant anticholinergic activity (e.g., clozapine, class IA antiarrhythmics especially disopyramide) may… | 2 sources — open the full entry |
| Budesonide + Glycopyrronium Bromide + Formoterol Fumarate | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…3 documented mechanisms | 12 sources — open the full entry |
| Chlorpheniramine Maleate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Chlorpromazine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Cinnarizine + Dimenhydrinate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Clomipramine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Clozapine | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Cyclizine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Cyclobenzaprine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Darifenacin | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Dextromethorphan + Phenylephrine + Triprolidine | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Dextromethorphan + Pseudoephedrine + Triprolidine | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Dicycloverine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Diphenhydramine + Dextromethorphan + Levomenthol | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Diphenhydramine + Levomenthol | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Diphenhydramine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Diphenhydramine Hydrochloride + Zinc Acetate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Doxepin (Oral) | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Doxepin (Topical) | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Eluxadoline | Moderate | Synergy | The risk of constipation and serious constipation-related adverse reactions may be increased when eluxadoline is used with other drugs that are also associated… | 3 sources — open the full entry |
| Fesoterodine Fumarate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Flavoxate Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Fluphenazine + Nortriptyline | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Fluphenazine Decanoate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Formoterol Fumarate + Glycopyrrolate + Budesonide | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…3 documented mechanisms | 12 sources — open the full entry |
| Glycopyrronium BromideInhalation capsuleInjectionOral solutionRespirator Solution | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Glycopyrronium Bromide + Formoterol Fumarate | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Guaifenesin + Levomenthol + Diphenhydramine | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Haloperidol | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Homatropine Hydrobromide | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 8 sources — open the full entry |
| Hydroxyzine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Hyoscine Butylbromide | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Hyoscine Hydrobromide | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Imipramine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Indacaterol + Glycopyrronium | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Indacaterol + Glycopyrronium + Mometasone Furoate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Ipratropium Bromide | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Maprotiline Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Meclizine + Pyridoxine | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Meclizine Hydrochloride | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Naphazoline Hydrochloride + Pheniramine Maleate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 8 sources — open the full entry |
| Nortriptyline | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Olanzapine | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Pheniramine Maleate | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 8 sources — open the full entry |
Conditions
Conditions in which Tiotropium needs care, as documented in this source.
Angioedema
ModerateAngioedema has been reported during therapy with inhaled anticholinergic agents. Therapy with these agents should be administered cautiously in patients at risk of developing angioedema and if such reaction occurs during treatment, therapy should be stopped at once and alternative treatments should be considered. In addition, therapy with Spiriva HandiHaler should be used with caution in patients with severe hypersensitivity to milk proteins as the product contains the inactive ingredient, lactose monohydrate.
2 sources
- "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim (2002):
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
Anticholinergic Syndrome
ModerateAclidinium, ipratropium, umeclidinium, and tiotropium are anticholinergic agents. Although systemic effects are uncommon due to the poor absorption of quaternary ammonium compounds from gastrointestinal and nasal mucosa, worsening of urinary retention or angle-closure glaucoma has been reported. Increased intraocular pressure and precipitation or exacerbation of angle-closure glaucoma may also occur due to inadvertent contact of the eye with aerosolized or nebulized drug. Accordingly, therapy with quaternary ammonium compounds should be administered cautiously in patients with urinary retention/obstruction or angle-closure glaucoma. Measures should be taken whenever possible to minimize ocular exposure to these drugs, such as keeping eyes closed during oral inhalation or use of a mouthpiece rather than face mask during nebulization. Patients should be advised to contact their physician if they experience urinary difficulty (especially in patients with prostatic hyperplasia or bladder neck obstruction); or signs and symptoms of angle-closure glaucoma (e.g., eye pain or discomfort; blurred vision; visual halos; colored images in association with red eyes from conjunctival congestion or corneal edema).
11 sources
- Gross NJ "Ipratropium bromide." N Engl J Med 319 (1988): 486-94
- Milford CA, Mugliston TA, Lund VJ, Mackay IS "Long-term safety and efficacy study of intranasal ipratropium bromide." J Laryngol Otol 104 (1990): 123-5
- Lozewicz S "Bladder outflow obstruction induced by ipratropium bromide." Postgrad Med J 65 (1989): 260-1
- Pras E, Stienlauf S, Pinkhas J, Sidi Y "Urinary retention associated with ipratropium bromide." DICP 25 (1991): 939-40
- Massey KL, Gotz VP "Ipratropium bromide." Drug Intell Clin Pharm 19 (1985): 5-12
- Pakes GE, Brogden RN, Heel RC, Speight TM, Avery GS "Ipratropium bromide: a review of its pharmacological properties and therapeutic efficacy in asthma and chronic bronchitis." Drugs 20 (1980): 237-66
- "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim (2002):
- "Product Information. Atrovent Nasal (ipratropium nasal)." Boehringer-Ingelheim
Show all 11 sourcesShow fewer sources
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
- "Product Information. Tudorza Pressair (aclidinium)." Forest Pharmaceuticals (2012):
- "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
Hepatic Insufficiency
ModerateThe effects of hepatic impairment on the pharmacokinetics of tiotropium have not been studied. Caution is recommended when prescribing this agent to patients with impaired liver function.
1 source
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
Kidney Diseases
ModerateTiotropium is primarily eliminated unchanged by the kidney. Renal impairment has been associated with increased plasma drug concentrations and reduced drug clearance after both intravenous infusion and dry powder inhalation. Mild renal impairment (CrCl 50 to 80 mL/min), which is often seen in elderly patients, increased tiotropium systemic exposure (AUC) by 39% following intravenous infusion. In COPD patients with moderate to severe renal impairment (CrCl < or equals to 50 mL/min), tiotropium AUC increased 82% following intravenous administration, which was confirmed by plasma concentrations after dry powder inhalation. Although generally well tolerated, therapy with ipratropium should be administered cautiously in patients with moderate to severe renal impairment. Monitoring for renal function is recommended. Patients should be advised of and monitored for potentially increased systemic adverse effects such urinary retention.
1 source
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
Tachycardia
ModerateCases of supraventricular tachycardia and atrial fibrillation have been reported with the use of inhaled anticholinergic agents in patients with COPD/Asthma. Care and monitoring of cardiac function is recommended when prescribing these agents to patients at risk.
2 sources
- "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim (2002):
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
Therapeutic duplication
Drug classes that overlap with Tiotropium, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Formoterol/glycopyrrolate
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Phenohytro
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Urolet mb
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Chlorpheniramine/methscopolamine/phenylephrine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Phosphasal
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Glycopyrrolate/indacaterol
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Sympak ii
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Motofen
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Librax
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Trelegy ellipta
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): B & o supprettes
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Butabarbital/hyoscyamine/phenazopyridine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Hyoscyamine/phenyltoloxamine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Duodote
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Duaklir pressair
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Tussigon
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Budesonide/formoterol/glycopyrrolate
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Albuterol/ipratropium
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Vi-atro
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Anoro ellipta
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Glycopyrrolate/neostigmine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Prosed ds