{"ok":true,"entry":{"slug":"tiotropium","kind":"medication","name":"tiotropium","aliases":["Spiriva"],"brands_sg":["Spiriva Respimat","Spiolto Respimat"],"class":"long-acting antimuscarinic bronchodilator","tags":["respiratory"],"use_for":"healthhub: long-term copd control · sg label adds asthma","use_after":"sg label: two puffs once daily, same time of the day","use_duration":null,"take_with":"inhaled · a separate reliever covers sudden symptoms","pros":["healthhub: opens the airways so air moves more easily","sg label: once daily, and from age 6 in asthma","us label: also reduces copd exacerbations"],"cons":["us label: not for relief of acute bronchospasm","healthhub: dry mouth, constipation, fast heart beat","healthhub: can worsen difficulty passing urine"],"dose_note":"the singapore spiriva respimat label states the ceiling plainly: 'The recommended dose for adults is 5 microgram tiotropium given as two puffs from the Respimat inhaler once daily, at the same time of the day' and 'The recommended dose should not be exceeded'; in asthma, patients 6 to 17 years old also receive 5 micrograms as two puffs once daily. the us spiriva respimat label agrees — 'Do not take more than one dose (2 inhalations) in 24 hours' — with 2 inhalations of 2.5 mcg once daily for copd and 2 inhalations of 1.25 mcg once daily for asthma. two puffs are one dose, not two doses.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["narrow-angle glaucoma (healthhub, us label)","prostate problems or difficulty passing urine (healthhub, us label)","irregular heart beats (healthhub)","allergy to atropine, ipratropium or oxitropium — sg label: contraindicated"],"clashes":[{"src":["fda_spiriva_int"],"note":"us label: additive effects; co-administration is to be avoided","with":"other anticholinergic medicines"},{"src":["fda_spiriva_int"],"note":"us label: used together without increases in adverse reactions","with":"beta-agonists, steroids, methylxanthines, antihistamines"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA — Listing of Registered Therapeutic Products (data.gov.sg open dataset, 5,511 rows, cached in full and filtered locally)","quote":"Both registered tiotropium products read 'Prescription Only' — SPIRIVA RESPIMAT RE-USABLE SOLUTION FOR INHALATION 2.5 MICROGRAM (R03BB04) and SPIOLTO RESPIMAT RE-USABLE 2.5/2.5 MICROGRAM, tiotropium with olodaterol (R03AL06)","accessed":"2026-08-27"},{"id":"ndf_spiriva","url":"https://www.ndf.gov.sg/about-drugs/product-information/SIN15885P","label":"National Drug Formulary (SG, MOH) — SPIRIVA RESPIMAT RE-USABLE SOLUTION FOR INHALATION 2.5 MICROGRAM [SIN15885P], sections 4.1–4.3, last updated 28 Jul 2026","quote":"The recommended dose for adults is 5 microgram tiotropium given as two puffs from the Respimat inhaler once daily, at the same time of the day. The recommended dose should not be exceeded.","accessed":"2026-08-27"},{"id":"hh_tio","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tiotropium","label":"HealthHub (MOH Singapore / Pharmaceutical Society of Singapore) — Tiotropium medication leaflet","quote":"Tiotropium inhaler is used for the long term treatment of people who have chronic obstructive pulmonary disease (COPD) … Tiotropium works by opening up the airways and make it easier for air to move in and out of the lungs","accessed":"2026-08-27"},{"id":"hh_tio_se","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tiotropium","label":"HealthHub — Tiotropium leaflet: precautions and common side effects","quote":"Narrow-angle glaucoma … Prostate problems or difficulty passing urine … Heart conditions such as irregular heart beats … Fast heart beat. Dry mouth. Nausea. Constipation. Headache","accessed":"2026-08-27"},{"id":"fda_spiriva_ind","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22SPIRIVA+RESPIMAT%22&limit=1","label":"US FDA label — SPIRIVA RESPIMAT (tiotropium bromide, Boehringer Ingelheim), section 1 Indications and Usage, via openFDA (effective 17 Aug 2026)","quote":"The long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), and for reducing COPD exacerbations … Limitation of Use: Not indicated for relief of acute bronchospasm","accessed":"2026-08-27"},{"id":"fda_spiriva_dose","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22SPIRIVA+RESPIMAT%22&limit=1","label":"US FDA label — SPIRIVA RESPIMAT, section 2 Dosage and Administration, via openFDA","quote":"To receive the full dosage of medication, SPIRIVA RESPIMAT must be administered as two inhalations once-daily. Do not take more than one dose (2 inhalations) in 24 hours.","accessed":"2026-08-27"},{"id":"fda_spiriva_warn","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22SPIRIVA+RESPIMAT%22&limit=1","label":"US FDA label — SPIRIVA RESPIMAT, sections 4 and 5 Contraindications, Warnings and Precautions, via openFDA","quote":"should not be used for the relief of acute symptoms … In the event of an acute attack, a rapid-acting beta2-agonist should be used … Worsening of narrow-angle glaucoma may occur … Worsening of urinary retention may occur","accessed":"2026-08-27"},{"id":"fda_spiriva_int","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22SPIRIVA+RESPIMAT%22&limit=1","label":"US FDA label — SPIRIVA RESPIMAT, section 7 Drug Interactions, via openFDA","quote":"has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids … without increases in adverse reactions … Avoid administration … with other anticholinergic-containing drugs","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:33.302383+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}