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User:Mr. Ibrahem/Tiotropium

< User:Mr. Ibrahem
Tiotropium
Clinical data
Trade namesSpiriva, Braltus, others[1]
Other namesTiotropium bromide
AHFS/Drugs.comMonograph
MedlinePlusa604018
License data
Pregnancy
category
Routes of
administration		Inhalation by mouth
Legal status
Legal status
Pharmacokinetic data
Bioavailability19.5% (inhalation)
MetabolismLiver 25%
(CYP2D6, CYP3A4)
Elimination half-life5–6 days
ExcretionKidney
Identifiers
  • (1α,2β,4β,7β)-
    7-[(hydroxidi-2-thienylacetyl)oxy]-9,9-dimethyl-
    3-oxa-9-azoniatricyclo[3.3.1.02,4]nonane bromide
Chemical and physical data
FormulaC19H22BrNO4S2
Molar mass472.41 g·mol−1
3D model (JSmol)
  • 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+; checkY
  • Key:DQHNAVOVODVIMG-RGECMCKFSA-M checkY

  • InChI=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/s1 checkY
  • Key:LERNTVKEWCAPOY-FPISHFTHSA-N checkY
  (verify)

Tiotropium, sold under the brand name Spiriva among others, is a long-acting bronchodilator used in the management of chronic obstructive pulmonary disease (COPD) and asthma.[5][1] Specifically it is used to try to prevent periods of worsening rather than for those periods themselves.[5] It is used by inhalation through the mouth.[5] Onset typically begins within half an hour and lasts for 24 hours.[5]

Common side effects include a dry mouth, runny nose, upper respiratory tract infection, shortness of breath and headache.[5] Severe side effects may include angioedema, worsening bronchospasm, and QT prolongation.[5] Tentative evidence has not found harm during pregnancy, however, such use has not been well studied.[2] It is an anticholinergic medication and works by blocking acetylcholine action on smooth muscle.[5]

Tiotropium was patented in 1989, and approved for medical use in 2002.[6] It is on the World Health Organization's List of Essential Medicines.[7] In the United States the wholesale cost was about US$14 per dose as of 2019.[8] In the United Kingdom a dose costs the NHS about 0.86 pounds as of 2019.[1] In 2017, it was the 82nd most commonly prescribed medication in the United States, with more than nine million prescriptions.[9][10] There is no generic version available in the United States as of 2019.[11]

References

edit
  1. ^ a b c British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 247–248. ISBN 9780857113382.
  2. ^ a b c "Tiotropium Use During Pregnancy". Drugs.com. Archived from the original on 31 January 2019. Retrieved 31 January 2019. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  3. ^ "Tiotropium (Braltus) 10mcg Inhalation Powder - Summary of Product Characteristics (SmPC)". (emc). 1 February 2019. Archived from the original on 1 December 2020. Retrieved 14 April 2020. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  4. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 23 January 2021. Retrieved 9 September 2020. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  5. ^ a b c d e f g "Tiotropium Bromide Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 14 October 2018. Retrieved 31 January 2019. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  6. ^ Fischer, Jnos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 447. ISBN 9783527607495. Archived from the original on 29 August 2021. Retrieved 10 May 2020.
  7. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  8. ^ "NADAC as of 2019-01-30". Centers for Medicare and Medicaid Services. Archived from the original on 27 March 2019. Retrieved 31 January 2019. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  9. ^ "The Top 300 of 2020". ClinCalc. Archived from the original on 18 March 2020. Retrieved 11 April 2020. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  10. ^ "Tiotropium - Drug Usage Statistics". ClinCalc. Archived from the original on 3 July 2020. Retrieved 11 April 2020. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
  11. ^ "Generic Spiriva Availability". Drugs.com. Archived from the original on 22 April 2019. Retrieved 31 January 2019. {{cite web}}: More than one of |archivedate= and |archive-date= specified (help); More than one of |archiveurl= and |archive-url= specified (help)
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