Tiotropium

USDailyMed:Tiotropium bromide AU:B1 R03BB04(WHO) AU:S4(Prescription only)UK:POM(Prescription only)US:℞-only (1α,2β,4β,7β)-7-[(hydroxidi-2-thienylacetyl)oxy]-9,9-dimethyl-3-oxa-9-azoniatricyclo[3.3.1.02,4]nonane bromide 136310-93-5Y186691-13-4(cation) 54874265487427 367 DBSALT000348DB01409 10482095Y XX112XZP0J0EB439235FY D01929 CHEBI:90959CHEBI:90960 ChEMBL3545181ChEMBL1900528 0HK (PDBe,RCSB PDB) DTXSID5044281 Interactive imageInteractive image C[N+]1(C2CC(CC1C3C2O3)OC(=O)C(C4=CC=CS4)(C5=CC=CS5)O)C.[Br-]C[N+]1(C2CC(CC1C3C2O3)OC(=O)C(C4=CC=CS4)(C5=CC=CS5)O)C InChI=1S/C19H22NO4S2.BrH/c1-20(2)12-9-11(10-13(20)17-16(12)24-17)23-18(21)19(22,14-5-3-7-25-14)15-6-4-8-26-15;/h3-8,11-13,16-17,22H,9-10H2‍​‍‍‍​‍‍‍‍‍‍‍‍​‍,1-2H3;1H/q+1;/p-1/t11?,12-,13+,16-,17+;YKey:DQHNAVOVODVIMG-RGECMCKFSA-MYInChI=1S/C19H22NO4S2/c1-20(2)12-9-11(10-13(20)17-16(12)24-17)23-18(21)19(22,14-5-3-7-25-14)15-6-4-8-26-15/h3-8,11-13,16-17,22H,9-10H2,1-2H3/q+1/t11?,12-,13+,16-,17-/m0/s1YKey:LERNTVKEWCAPOY-FPISHFTHSA-NY Tiotropium bromide, sold under the brand nameSpirivaamong others, is a long-actingbronchodilator(LAMA: long acting muscarinic antagonist) used in the management ofchronic obstructive pulmonary disease(COPD) andasthma.Specifically it is used during periods of breathing difficulty to prevent them from getting worse, rather than to prevent them from happening.It is used by inhalation through the mouth.Onset typically begins within half an hour and lasts for 24 hours. Common side effects include a dry mouth, runny nose, upper respiratory tract infection, shortness of breath and headache.Severe side effects may includeangioedema, worseningbronchospasm, andQT prolongation.Tentative evidence has not found harm duringpregnancy, however, such use has not been well studied.It is ananticholinergicmedication and works by blockingacetylcholineaction onsmooth muscle. Tiotropium was patented in 1989, and approved for medical use in 2002.It is on theWorld Health Organization's List of Essential Medicines.In 2023, it was the 163rd most commonly prescribed medication in the United States, with more than 3million prescriptions.