Tiova Inhaler (Tiotropium Bromide) is a long-acting muscarinic antagonist (LAMA) inhaler 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, helping to improve lung function, reduce exacerbations, and enhance overall quality of life for patients. Its dry powder formulation ensures consistent drug delivery, making it a cornerstone in long-term COPD management strategies under professional supervision.

Features

• Contains Tiotropium Bromide (18 mcg per inhalation)
• Delivered via a breath-actuated, single-dose dry powder inhaler (DPI)
• Provides 24-hour sustained bronchodilation
• Pre-measured, capsule-based dosing for accuracy
• Portable, pocket-sized device for convenience
• Does not require shaking or coordination with actuation
• Capsules are stored in a blister pack to protect from moisture
• Each inhaler device is reusable with replaceable capsules

Benefits

• Significantly improves forced expiratory volume (FEV1) and overall lung function
• Reduces the frequency and severity of COPD exacerbations
• Decreases breathlessness and improves exercise tolerance
• Enhances quality of life by enabling greater daily activity participation
• Simplifies dosing regimen with once-daily administration
• Minimizes the need for rescue inhalers through sustained symptom control

Common use

Tiova Inhaler is indicated for the long-term, once-daily maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). It is not intended for the relief of acute bronchospasm or as a rescue medication. It is commonly prescribed for patients with moderate to severe COPD who require regular bronchodilator therapy to manage persistent symptoms such as dyspnea, cough, and sputum production. It may be used alone or in combination with other maintenance therapies, such as long-acting beta-agonists (LABAs) or inhaled corticosteroids (ICS), depending on the severity of the condition and the clinician’s assessment.

Dosage and direction

The recommended dosage for Tiova Inhaler is the inhalation of the contents of one capsule (18 mcg tiotropium) once daily, at the same time each day, using the Tiova Inhaler device.
Directions for use:

1. Open the dust cap and mouthpiece.
2. Pull the piercing button fully outward until it clicks.
3. Place the capsule in the chamber.
4. Close the mouthpiece firmly until a click is heard.
5. Exhale fully away from the device.
6. Place lips tightly around the mouthpiece and inhale deeply and steadily.
7. Hold breath for up to 10 seconds, then exhale slowly.
8. Repeat inhalation if any powder remains.
9. Open the mouthpiece and discard the used capsule.
10. Close the mouthpiece and dust cap.

Do not swallow the capsule. The device should be kept dry and cleaned regularly as per the instructions provided.

Precautions

• Not for use in the treatment of acute bronchospasm. Always keep a fast-acting rescue inhaler available.
• Use with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction due to anticholinergic effects.
• May cause paradoxical bronchospasm; if this occurs, discontinue use immediately and consider alternative therapy.
• Patients with severe renal impairment (creatinine clearance ≤50 mL/min) should be monitored closely.
• Avoid getting the powder in the eyes, as it may cause blurred vision or pupil dilation.
• Do not use as a substitute for oral or inhaled corticosteroids if they are part of the patient’s regimen.
• Inform your healthcare provider of any history of heart problems, including arrhythmias.

Contraindications

Tiova Inhaler 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 patients with a history of hypersensitivity reactions such as rash, urticaria, or angioedema to anticholinergic agents.

Possible side effects

Common side effects may include:

• Dry mouth
• Constipation
• Upper respiratory tract infection
• Pharyngitis
• Sinusitis
• Non-specific chest pain

Less common but serious side effects may include:

• Acute narrow-angle glaucoma (eye pain, blurred vision, visual halos)
• Urinary retention (difficulty urinating)
• Tachycardia or palpitations
• Allergic reactions (rash, itching, swelling)
• Paradoxical bronchospasm (immediate wheezing or shortness of breath after inhalation)

Drug interaction

Tiotropium may interact with other anticholinergic medications (e.g., ipratropium, aclidinium, glycopyrrolate), potentially increasing the risk of side effects such as dry mouth, urinary retention, or constipation. Concurrent use with beta-adrenergic drugs may potentiate cardiovascular effects. Use caution when administering with other drugs that are excreted renally or affect renal function. Always inform your healthcare provider of all medications, including over-the-counter drugs and supplements.

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 dose, skip the missed dose and resume the regular dosing schedule. 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, urinary retention, and constipation. In case of suspected overdose, discontinue the medication and seek immediate medical attention. Supportive and symptomatic treatment is recommended; there is no specific antidote for tiotropium overdose.

Storage

Store at room temperature (15–30°C) in a dry place. Keep the capsules in the original blister pack and only remove immediately before use. Protect from moisture and light. Do not store in bathrooms or damp areas. 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 purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or stopping any medication. Do not disregard or delay seeking medical advice based on content provided here. Individual patient needs and responses may vary.

Reviews

“After switching to Tiova, my patients with moderate COPD have shown consistent improvement in FEV1 and reduced exacerbation rates. The once-daily dosing supports adherence.” – Dr. A. Reynolds, Pulmonologist
“Easy to use and carry. I feel more in control of my breathing throughout the day.” – James L., COPD patient
“As a respiratory therapist, I find the Tiova device intuitive for patients to learn. The dry powder formulation is reliable.” – Maria T., RRT
“Noticeably reduced my reliance on my rescue inhaler. Minimal side effects—just some dry mouth.” – Susan D., long-term user
“Effective maintenance therapy in our clinical experience, particularly for patients who struggle with MDI coordination.” – Clinical Nurse Specialist, Respiratory Unit