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Although no formal drug interaction studies have been performed, tiotropium inhalation powder or tiotropium bromide has been used concomitantly with other drugs commonly used in the treatment of COPD and asthma (Spiriva Respimat only), including sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leucotriene modifiers, cromones and anti-IgE treatment without adverse drug reactions or clinical evidence of drug interactions.
Common concomitant medications (LABA, ICS and their combinations) used by patients with COPD were not found to alter the exposure to tiotropium.
Spiriva: Limited information about co-administration of other anticholinergic drugs with Tiotropium bromide (Spiriva) is available from two clinical trials: Acute single dose administration of ipratropium bromide with chronically administered Tiotropium bromide (Spiriva) in COPD patients (n=64) and healthy volunteers (n=35) was not associated with an increase in adverse events, changes in vital signs or electrocardiographic findings. However, chronic co-administration of other anticholinergic drugs with Tiotropium bromide (Spiriva) has not been studied and is, therefore, not recommended.
Spiriva Respimat: The chronic co-administration of tiotropium bromide with other anticholinergic drugs has not been studied. Therefore, the chronic co-administration of other anticholinergic drugs with Tiotropium bromide (Spiriva Respimat) is not recommended.
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