Tiotropium and Olodaterol

What is Tiotropium and Olodaterol medicine combination

Tiotropium and olodaterol is a combination inhalation containing a long-acting muscarinic antagonist (LAMA), (tiotropium) and a long-acting beta-2 adrenergic agonist (LABA), (olodaterol) that is administered once daily.

The combination is used for the maintenance treatment of airflow obstruction in adults with chronic obstructive pulmonary disease (COPD).

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, such combinations may be used as initial therapy in patients in group D (those with a high risk of exacerbation).

Tiotropium has been shown to reduce COPD exacerbations and related hospitalizations. Long-acting beta-2 adrenergic agonists (LABAs) like olodaterol have also been associated with a reduced COPD exacerbation rate.

Combining bronchodilators with different mechanisms of action may further improve patient symptoms with a lower risk of adverse events compared to increasing the dose of a single bronchdilator.

Combination bronchodilators have a greater impact on patient reported outcomes and quality of life compared to monotherapies; however, more studies are needed to determine if combination therapy is more effective at preventing exacerbations.

Tiotropium and olodaterol is not indicated for the relief of acute deterioration of COPD, for acute bronchospasm, or for the treatment of asthma. The FDA approved tiotropium; olodaterol inhalation in 2015.

Brand Name

STIOLTO RESPIMAT

Indications

  1. chronic bronchitis
  2. chronic obstructive pulmonary disease (COPD)
  3. emphysema

For the maintenance treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. angina
  4. angioedema
  5. arrhythmia exacerbation
  6. arthralgia
  7. asthma-related death
  8. atrial fibrillation
  9. back pain
  10. blurred vision
  11. bronchospasm
  12. candidiasis
  13. chest pain (unspecified)
  14. constipation
  15. cough
  16. dehydration
  17. depression
  18. dizziness
  19. dyspepsia
  20. dysphagia
  21. dysphonia
  22. dysuria
  23. epistaxis
  24. fever
  25. gastroesophageal reflux
  26. GI obstruction
  27. gingivitis
  28. glossitis
  29. headache
  30. hypercholesterolemia
  31. hyperglycemia
  32. hypertension
  33. hypokalemia
  34. ileus
  35. infection
  36. insomnia
  37. laryngitis
  38. musculoskeletal pain
  39. myalgia
  40. ocular hypertension
  41. ocular irritation
  42. ocular pain
  43. palpitations
  44. paresthesias
  45. peripheral edema
  46. pharyngitis
  47. pruritus
  48. QT prolongation
  49. rash
  50. rhinitis
  51. sinus tachycardia
  52. sinusitis
  53. skin ulcer
  54. ST-T wave changes
  55. stomatitis
  56. supraventricular tachycardia (SVT)
  57. urinary retention
  58. urticaria
  59. visual impairment
  60. vomiting
  61. wheezing
  62. xerosis
  63. xerostomia

Monitoring Parameters

  • pulmonary function tests (PFTs)

Contraindications

  • acute bronchospasm
  • alcoholism
  • anticholinergic medications
  • asthma
  • asthma-related death
  • bladder obstruction
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • closed-angle glaucoma
  • contact lenses
  • coronary artery disease
  • diabetes mellitus
  • driving or operating machinery
  • females
  • geriatric
  • heart failure
  • hepatic disease
  • hypertension
  • hyperthyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • infants
  • labor
  • long QT syndrome
  • malnutrition
  • MAOI therapy
  • monotherapy treatment of asthma
  • myocardial infarction
  • neonates
  • ocular exposure
  • ophthalmic administration
  • paradoxical bronchospasm
  • pheochromocytoma
  • pregnancy
  • prostatic hypertrophy
  • QT prolongation
  • renal impairment
  • seizure disorder
  • seizures
  • thyroid disease
  • thyrotoxicosis
  • urinary retention
  • urinary tract obstruction

Interactions

  • Abarelix
  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Aclidinium
  • Aclidinium; Formoterol
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Anticholinergics
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atomoxetine
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azithromycin
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benztropine
  • Beta-adrenergic blockers
  • Betaxolol
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Brimonidine; Timolol
  • Budesonide; Formoterol
  • Bumetanide
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Caffeine
  • Caffeine; Ergotamine
  • Carteolol
  • Carvedilol
  • Ceritinib
  • Chlordiazepoxide; Clidinium
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clofazimine
  • Clomipramine
  • Clozapine
  • Cocaine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crizotinib
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasatinib
  • Degarelix
  • Desipramine
  • Deutetrabenazine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dicyclomine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxepin
  • Dronedarone
  • Droperidol
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Eliglustat
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Eribulin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esmolol
  • Ethacrynic Acid
  • Ezogabine
  • Fingolimod
  • Flavoxate
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Foscarnet
  • Furosemide
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydroxychloroquine
  • Hydroxyzine
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Inotuzumab Ozogamicin
  • Isocarboxazid
  • Isoflurane
  • Ivosidenib
  • Ketoconazole
  • Labetalol
  • Lapatinib
  • Lefamulin
  • Lenvatinib
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levobetaxolol
  • Levobunolol
  • Levofloxacin
  • Levomethadyl
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Linezolid
  • Liothyronine
  • Lithium
  • Lofexidine
  • Lomefloxacin
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Macimorelin
  • Maprotiline
  • Mefloquine
  • Mepenzolate
  • Meperidine; Promethazine
  • Mesoridazine
  • Methacholine
  • Methadone
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methscopolamine
  • Metoprolol
  • Metronidazole
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Monoamine oxidase inhibitors
  • Moxifloxacin
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Oxybutynin
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Penbutolol
  • Pentamidine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenylephrine; Promethazine
  • Pimavanserin
  • Pimozide
  • Pindolol
  • Pitolisant
  • Posaconazole
  • Primaquine
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propantheline
  • Propranolol
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Racepinephrine
  • Ranolazine
  • Rasagiline
  • Ribociclib
  • Ribociclib; Letrozole
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Romidepsin
  • Saquinavir
  • Scopolamine
  • Selegiline
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Siponimod
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Theophylline, Aminophylline
  • Thiazide diuretics
  • Thioridazine
  • Thyroid hormones
  • Timolol
  • Tolterodine
  • Toremifene
  • Torsemide
  • Tranylcypromine
  • Trazodone
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trihexyphenidyl
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Voriconazole
  • Vorinostat
  • Ziprasidone
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