⚡ Quick Answer — What is Tiova Inhaler?
Tiova Inhaler indeholder tiotropium bromide, en long-acting muscarinic antagonist (LAMA) bronchodilator that blocks parasympathetic constriction of the airways for 24 hours. Tiova Inhaler is used as once-daily maintenance therapy i chronic obstructive pulmonary disease (COPD) — and (in some markets) as add-on therapy for difficult-to-control asthma. Each inhaler delivers 9 mcg per actuation, fremstillet af Cipla at WHO-GMP certified facilities. Same active drug as international brand Spiriva. Tiova Inhaler is a controller, not a reliever — keep a SABA (Asthalin, Levolin) for acute breathlessness.
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What Is Tiova Inhaler?
Tiova Inhaler is an Indian-manufactured generic of tiotropium bromide, a long-acting anticholinergic bronchodilator. Internationally the same drug is sold as Spiriva. tiotropium bromide binds muscarinic receptors (M1 and M3) on airway smooth muscle for many hours, providing 24-hour bronchodilation with once-daily dosing. It does not cause the tremor, palpitations, or hypokalaemia of β2 agonists.
How Does Tiova Inhaler Work?
The parasympathetic nervous system maintains a baseline tone in bronchial smooth muscle through acetylcholine acting on M3 muscarinic receptors. In COPD this tone is the dominant reversible component of airflow obstruction. tiotropium bromide is a kinetically-selective M3 antagonist — it binds and dissociates slowly, giving sustained bronchodilation over 24 hours. The result is:
- Sustained bronchodilation for 24 hours from a single dose
- Reduced exacerbations in COPD by 14–28% in landmark trials (UPLIFT, POET-COPD)
- Improved exercise tolerance and reduced dyspnoea in stable COPD
- Reduced rescue inhaler use when added to ICS-LABA in severe asthma (TIOSPIR-asthma trial)
— det forstærker den normale fysiologiske respons snarere end at udløse en kunstigt.
- COPD maintenance — first-line LAMA at GOLD groups B, E (with or without LABA / ICS depending on phenotype)
- COPD exacerbation prevention
- Add-on for severe asthma not controlled by ICS-LABA (Step 5 GINA)
- Asthma-COPD overlap (ACOS)
Tiova Inhaler Dosage
| Patient | Dosis | Hyppighed |
|---|---|---|
| Adults — COPD maintenance | 18 mcg (2 actuations) | Once daily, same time |
| Severe asthma add-on | 2 actuations | En gang dagligt |
How to Use Tiova Inhaler Properly
- Ryst inhalatoren godt; fjern hætten.
- Pust helt ud væk fra enheden.
- Læbene skal lukke tæt om mundstykket.
- Tryk på beholderen ved starten på et langsomt, dybt indånding (3–5 sekunder).
- Hold vejret i 10 sekunder, og pust derefter forsigtigt ud.
- Vent 30 sekunder før næste pust, hvis nødvendigt.
- For ICS-indeholdende kombinationer: skyl munden, gurgl, og spytt ud.
- Brug en spacer til børn, ældre og under akut sygdom.
Side Effects of Tiova Inhaler
Common (anticholinergic, dose-related):
- Dry mouth (commonest — typically mild, may improve with sips of water)
- Forstoppelse
- Throat irritation, mild cough on inhalation
- Sinusitis, rhinitis, nasopharyngitis
- Mild urinary hesitancy in older men with prostate enlargement
Mindre almindelige:
- Acute angle-closure glaucoma (rare; care with mist contacting eyes)
- Urinary retention in patients with prostatic obstruction
- Tachycardia, palpitations (less common than with β2 agonists)
- Blurred vision (transient if drug contacts eyes)
- Atrial fibrillation in susceptible older patients
Serious (stop and seek emergency help):
- Severe allergic reaction / anaphylaxis / angio-oedema
- Acute eye pain with red eye, halos around lights, blurred vision (suspected glaucoma — emergency)
- Akut urinretention
- Paradoksal bronkospasme
Advarsler og forholdsregler
- {$brand} is a controller, not a reliever. Use Asthalin or Levolin for acute breathlessness.
- Use once daily, every day — protective effect is maintained only with consistent dosing.
- Avoid mist contacting the eyes — risk of acute angle-closure glaucoma in predisposed patients (narrow anterior chamber, family history). Seek immediate help if eye pain or vision change occurs.
- Prostatic obstruction: use cautiously in men with benign prostatic hyperplasia or bladder neck obstruction — risk of urinary retention.
- Nedsat nyrefunktion: tiotropium bromide is largely renally excreted; use cautiously when CrCl <50 ml/min and monitor for systemic anticholinergic effects.
- Graviditet og amning: limited data — use only if benefit clearly outweighs risk.
- Opbevaring: keep capsules in the original blister with desiccant; do not pre-load multiple capsules.
Kontraindikationer
- Known hypersensitivity to tiotropium bromide, atropine derivatives, or formulation excipients
- Severe hypersensitivity to lactose or milk proteins (DPI formulations contain lactose)
- Acute glaucoma — relative contraindication
- Severe symptomatic prostatic obstruction or bladder outlet obstruction — relative
Lægemiddelinteraktioner
| Interagerende lægemiddel | Effekt | Hvad skal der gøres |
|---|---|---|
| Other anticholinergics (oral atropine, oxybutynin, hyoscine) | Additive dry mouth, urinary retention, constipation | Monitor symptoms — combine cautiously |
| Tricykiske antidepressiva | Additive anticholinergic burden | Caution in elderly |
| Antihistamines (1st generation) | Additive anticholinergic effects | Avoid combination if possible |
Opbevaring
- Opbevares under 25°C, beskyttet mod direkte sollys og varme.
- Må ikke opbevares i køleskab. Må ikke fryses.
- Må ikke gennembore beholderen; selv en tom beholder kan eksplodere, hvis den opvarmes.
- Opbevares utilgængeligt for børn. Brug inden udløbsdatoen på trykbeholderen.
Relaterede alternativer på MedsBase
- Foracort Inhalator — budesonide + formoterol ICS-LABA
- Seretide Accuhaler — fluticason + salmeterol ICS-LABA
- Budecort Inhalator — budesonide ICS forebyggende
- Duova Inhaler — tiotropium + formoterol LAMA-LABA kombination
- Triohale Inhaler — tiotropium + formoterol + ciclesonid trippelkombination
Ofte stillede spørgsmål
Is Tiova the same as Spiriva?
Yes — both contain tiotropium 18 mcg per capsule (DPI) or 2.5 mcg per actuation (Respimat). Spiriva (Boehringer Ingelheim) is the international brand; Tiova (Cipla) and Tiotrop (Lupin) are Indian-market generics. Clinically interchangeable at equal doses.
Why is tiotropium taken once a day?
Tiotropium binds and dissociates from M3 muscarinic receptors very slowly — half-time of receptor association is over 24 hours. A single dose maintains 24-hour bronchodilation.
Does Tiova help asthma?
Yes — tiotropium is licensed as add-on therapy for severe asthma (Step 5 GINA) on top of medium-high dose ICS-LABA. The TIOSPIR-asthma trials showed reduced exacerbations and improved lung function.
Is Tiova a reliever?
No — Tiova is a controller. Onset is too slow (peak 1–3 hours) for acute use. Keep a SABA (Asthalin, Levolin) for acute attacks.
Why dry mouth on Tiova?
Anticholinergic effect is the commonest side effect of LAMA. Sips of water through the day, sugar-free chewing gum, and good oral hygiene help. Rarely severe enough to need stopping.
Can I take Tiova with my prostate medication?
Use cautiously — anticholinergics can worsen urinary hesitancy in men with prostatic obstruction. Discuss with your prescriber. If urinary retention occurs, stop and seek medical advice.
What if mist gets in my eyes?
Anticholinergic mist contacting the eye can trigger acute angle-closure glaucoma in predisposed patients. Aim away from the eyes; if eye pain, redness, or halos around lights occur, seek emergency care.
Can I take Tiova during pregnancy?
Limited data — use only if benefit clearly outweighs risk. Combination ICS-LABA is preferred in pregnancy where possible.
How long does the bronchodilator effect last?
24 hours per dose. Reduced exacerbations and improved exercise tolerance accumulate over weeks of consistent dosing.
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