Dilriva 18 mcg

Description

Indications
Dilriva is indicated for the long-term treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It helps manage the symptoms of COPD and improves airflow in affected patients.
Take the medicine according to the advice of a registered physician.

Pharmacology
Tiotropium is a long-acting, antimuscarinic agent, commonly referred to as an anticholinergic. It has a similar affinity for the subtypes of muscarinic receptors, M1 to M5. In the airways, Tiotropium works by inhibiting M3-receptors in the smooth muscle, leading to bronchodilation. This antagonistic effect is both competitive and reversible, as demonstrated with receptors from human and animal origins, and isolated organ preparations. In preclinical studies, both in vitro and in vivo, Tiotropium prevented methacholine-induced bronchoconstriction in a dose-dependent manner, with effects lasting longer than 24 hours. The bronchodilation from inhalation of Tiotropium is primarily localized in the airways.

Dosage & Administration
For adults over 18 years: The recommended dose of Tiotropium Dry Powder Inhaler capsule is 18 mcg (1 capsule) once daily using the device.

The contents of the Tiotropium Dry Powder Inhaler capsules are intended for oral inhalation only and should be used exclusively with the device.

No dosage adjustment is required for elderly patients or those with liver or kidney impairments. However, patients with moderate to severe renal impairment should be closely monitored for anticholinergic effects.
Take the medicine according to the advice of a registered physician.

Interaction
An interaction study was conducted with Tiotropium (14.4 mcg intravenous infusion over 15 minutes) and cimetidine (400 mg three times daily) or ranitidine (300 mg once daily). Co-administration of cimetidine with Tiotropium led to a 20% increase in AUC (area under the curve) over 0-4 hours, a 28% reduction in renal clearance, but no significant changes in Cmax or excretion in urine. Co-administration with ranitidine did not affect the pharmacokinetics of Tiotropium.

Contraindications
Tiotropium is contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, including ipratropium, or to any component of this product.

Side Effects
The most commonly reported side effect is dry mouth, which is generally mild and often resolves with continued use. Other possible side effects, consistent with anticholinergic effects, may include constipation, increased heart rate, blurred vision, glaucoma, urinary difficulty, and urinary retention.

Pregnancy & Lactation
Pregnancy Category C. There are no well-controlled studies on Tiotropium in pregnant women. It should be used during pregnancy only if the potential benefits justify the risks to the fetus. The safety and efficacy of Tiotropium have not been studied during labor and delivery.

Precautions & Warnings
As an anticholinergic drug, Dilriva may worsen symptoms in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction. It should be used with caution in such patients.

Overdose Effects
High doses of Dilriva may cause anticholinergic symptoms. However, no systemic anticholinergic adverse effects were observed after a single inhalation dose of up to 282 mcg in six healthy volunteers. In a study of 12 healthy volunteers, repeated once-daily inhalation of 141 mcg caused bilateral conjunctivitis and dry mouth.

Therapeutic Class
Anticholinergic bronchodilators

Storage Conditions
Dilriva Dry Powder Inhaler capsules must not be swallowed. Store below 30°C, away from direct sunlight and heat. Keep out of reach of children.