Tiotropium

COPD maintenance therapy and severe asthma (as add-on to ICS/LABA).

Tiotropium blocks muscarinic M3 receptors in airway smooth muscle for a sustained period, preventing cholinergic-driven bronchoconstriction and reducing mucus production. Its long receptor occupancy means genuine 24-hour bronchodilation from a single dose.

Adults with COPD (first-line maintenance bronchodilator) and adults with severe asthma inadequately controlled on ICS/LABA. Use with caution in glaucoma and bladder outflow obstruction.

Order online and we review your request. A prescriber checks your consultation form for clinical appropriateness and contacts you if anything else is needed. Once approved, your medication is dispensed and delivered to your door.

Tracked: Tracked delivery, arrives in two working days - Free

When it arrives: Every order is sent tracked. Where this page says in post today, it goes out today. Where it says in post tomorrow, it goes out the next working day. On the rare occasions a medicine is unavailable, we will contact you to talk about timing and alternatives.

We dispense clinically equivalent generic medications where available. Prices shown are for the generic version. If you prefer the branded version, let us know in your order form and we will confirm any price difference.

Tiotropium from £74.99 per inhaler.

SABA (salbutamol): tremor, headache, palpitations, muscle cramps. ICS (beclometasone, fluticasone, budesonide): oral thrush (candidiasis), hoarseness - rinse mouth after each use. LABA (formoterol, salmeterol): tremor, palpitations, headache. High-dose ICS: bruising, adrenal suppression.

LABA: must not be used without an ICS in asthma (monotherapy increases risk of asthma death). Tiotropium: hypersensitivity to atropine derivatives.

Beta-blockers: may reduce effectiveness of salbutamol and other beta-agonists - avoid non-selective beta-blockers in asthma. Potassium-depleting diuretics: increased risk of hypokalaemia with high-dose beta-agonists.

Salbutamol and ICS: can be used in pregnancy - uncontrolled asthma is more dangerous than the medications. Do not stop preventer inhalers during pregnancy. Compatible with breastfeeding.

Use once daily at the same time each day. HandiHaler: pierce the capsule and inhale the powder. Respimat: use the soft mist device. Both require good technique - ask your pharmacist or doctor to demonstrate. Dry mouth is the most common side effect. Avoid getting the mist in your eyes.