Introduction

Topium Rotacap is an anticholinergic medicine. It is used in the treatment of chronic obstructive pulmonary disease and asthma. Topium Rotacap is only for the inhalational purpose, so do not swallow the capsule. The first dose is given under medical supervision to prevent the side effects happen during first use. For better results, it is suggested to take it at the same time every day. The dose and how often you take it depends on what you are taking it for. Your doctor will decide how much you need to improve your symptoms. You should take this medicine for as long as it is prescribed for you. It does not prevent the already started breathing trouble or asthma attack, hence always carry your medical inhaler with you for emergency. The most common side effects of this medicine include nose dryness or itching, nose bleed, and dry mouth or throat. If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them. To overcome dry mouthness, it is advised to increase water intake, carry sugar candy or maintain good oral hygiene. Before taking this medicine, let your doctor know if you have liver or kidney disease, or if you are pregnant or breastfeeding. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works.

Uses of Topium Rotacap

• Chronic obstructive pulmonary disease (COPD)
• Asthma

Side effects of Topium Rotacap

• Blurred vision
• Increased heart rate
• Dryness in mouth
• Upper respiratory tract infection
• Constipation

How to use Topium Rotacap

Rotacaps must not be swallowed. Check the label for directions before use. Place the capsule at the base of rotahaler, not in the mouthpiece. Twist the mouthpiece completely until your hear a click and breathe in deeply through the mouthpiece. Hold your breath for up to 10 seconds. If some powder remains in the rotahaler repeat the process.

How Topium Rotacap works

Topium Rotacap is an anticholinergic medication. It works by relaxing the muscles in the airways and widens the airways. This makes breathing easier.

What if you forget to take Topium Rotacap?

If you miss a dose of Topium Rotacap, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Indication

Tiotropium is indicated for the long term once daily maintenance treatment of bronchospasm and dyspnoea associated with, chronic obstructive pulmonary disease (COPD), including, chronic bronchitis and emphysema.

Adult Dose

Inhalation Chronic obstructive pulmonary disease Adult: As Inhaler: 2 puffs (18mcg) once daily. As inhalation cap: 1 cap (18 mcg) daily via inhaler device, at the same time each day.

Child Dose

Inhalation Chronic obstructive pulmonary disease Child> 12 years: As Inhaler: 2 puffs (18mcg) once daily. Child> 18 years: As inhalation cap: 1 cap (18 mcg) daily via inhaler device, at the same time each day.

Renal Dose

Renal impairment: CrCl (ml/min) Dosage Recommendation <50 Use w/ caution.

Contraindication

Hypersensitivity to atropine and its derivatives (e.g. ipratropium).

Mode of Action

Tiotropium bromide, a long-acting quaternary ammonium antimuscarinic, is structurally related to ipratropium. It is a nonselective competitive antagonist of muscarinic (M1-M5) receptors and causes bronchodilation by inhibiting the actions of acetylcholine and other cholinergic stimuli at M3 receptors in the smooth muscle of the respiratory tract.

Precaution

Not intended for use as initial treatment for acute bronchospasm and as monotherapy for asthma. Patient w/ narrow-angle glaucoma, prostatic hyperplasia/bladder neck obstruction, cystic fibrosis. History of MI (<6 mth), or unstable or life threatening cardiac arrhythmia w/in the past yr. Moderate to severe renal impairment (CrCl ≤50 mL/min). Pregnancy and lactation. Patient Counselling This drug may cause dizziness and blurred vision, if affected, do not drive or operate machinery. Monitoring Parameters Monitor pulmonary function.

Side Effect

>10% Upper respiratory tract infection (41%),Dry mouth (16%),Sinusitis (11%) 1-10% Abdominal pain,Allergic reaction,Angina pectoris (including aggravated angina pectoris),Cataract,Chest pain (nonspecific),Constipation,Depression,Dyspepsia,Dysphonia,Edema,Epistaxis,Gastroesophageal reflux,Herpes zoster,Hypercholesterolemia,Hyperglycemia,Infection,Laryngitis,Leg pain,Moniliasis,Myalgia,Paresthesia,Pharyngitis,Rash,Rhinitis,Skeletal pain,Stomatitis (including ulcerative stomatitis),Urinary tract infection,Vomiting <1% Angioedema,Fibrillation,Supraventricular tachycardia,Urinary retention

Interaction

Other anticholinergic agents.