Category- Allopathy
Medicine Highlights
| Uses | 1. To treat emphysema 2. To manage chronic bronchitis (long term inflammation in air passage) 3. To manage COPD (Chronic Obstructive Pulmonary Disease) 4. To treat shortness of breath |
| Common Side Effects | 1. Dry mouth 2. Throat irritation 3. Cough after inhalation 4. Headache 5. Mild shakiness or trembling 6. Fast heartbeat (mild) 7. Stomach discomfort 8. Feeling nervous or restless |
| Additional Information | 1. Take it exactly as prescribed by your doctor. 2. It does not act fast enough to relieve sudden shortness of breath. Always keep a rescue inhaler for emergencies. 3. Inform your doctor if you have heart, liver, or kidney problems. |
| Storage | 1- The medicine should be stored at room temperature 2- Keep away from sunlight and moisture 3- Keep away from the reach of children |
| How to Take This Medicine | Put this capsule in rotahaler and inhale the medication through the mouth. |
Tiotropium Bromide + Formoterol Fumarate Dihydrate Uses
Tiotropium Bromide + Formoterol Fumarate are bronchodilators. It is useful for the following conditions:
- Shortness of breath
- Chronic bronchitis
- COPD (Chronic Obstructive Pulmonary Disease)
- Emphysema
Directions for use
- Make sure your rota haler is clean and dry.
- Hold it straight with the mouthpiece facing down.
- Open the rotahaler by twisting it into two parts.
- Put the rotacap in the chamber
- Close and twist until you hear a click this pierce the capsule.
- Breathe out gently (away from the device).
- Put the mouthpiece in your mouth and breathe deeply and quickly.
- Hold your breath for a few seconds, then breathe out slowly.
- Check the capsule. If powder is left, breathe in again.
- Throw away the empty capsule.
- Rinse your mouth after use (especially if your rotacap has a steroid).
Tiotropium Bromide + Formoterol Fumarate Dihydrate side effects
More Common
- Dry mouth
- Throat irritation
- Cough after inhalation
- Headache
- Mild shakiness or trembling
- Fast heartbeat (mild)
- Stomach discomfort
- Feeling nervous or restless
Less Common
- Difficulty sleeping
- Dizziness
- Muscle cramps
- Blurred vision
- Chest pain
- Allergic reaction with rash, swelling, or breathing trouble
How Tiotropium Bromide + Formoterol Fumarate Dihydrate works
Tiotropium and formoterol work together to make breathing easier. Tiotropium relaxes and widens the airways by blocking certain nerve signals that tighten the lungs. Formoterol also relaxes the airway muscles but works faster and keeps them open for many hours. When both are used together, they keep the air tubes open, reduce tightness, and help air move in and out of the lungs more smoothly. This makes breathing easier throughout the day and reduces flare-ups.
Safety Measures and Warning
Allergy/Hypersensitivity
It can cause serious allergic reactions like rash, swelling, or trouble breathing. Always inform your doctor if you have any known drug or inhaler allergy.
Heart Problems
It may cause increased heart rate or worsen abnormal heart rhythms. Inform your doctor if you have a history of heart attack, chest pain, or arrhythmias.
High Blood Pressure
This medicine can slightly raise heart rate and may worsen uncontrolled BP. Inform your doctor if your BP is not stable.
Narrow-Angle Glaucoma
It can increase eye pressure and may worsen glaucoma symptoms like eye pain or blurred vision. Avoid using it without doctor advice.
Urinary Problems
It may make it harder to pass urine in people with prostate issues or urinary retention. Use only if the doctor says it’s safe.
Severe Kidney Problems
The medicine can stay longer in the body and increase side effects. Dose adjustment or caution is needed tell your doctor if you have kidney issues.
Tiotropium Bromide + Formoterol Fumarate Dihydrate Interaction with Food Product
Tiotropium + Formoterol has no major food interactions, so you can take it with or without food. However, avoid excess caffeine (coffee, tea, energy drinks) if you feel jittery or your heartbeat becomes fast, as caffeine can worsen this feeling. Always follow your doctor’s advice if you notice any discomfort after meals.
Tiotropium Bromide + Formoterol Fumarate Dihydrate Interaction with Other Medicines
Avoid taking Tiotropium Bromide + Formoterol Fumarate Dihydrate with the following medicines, as it may increase or decrease the desired effect, or in worse cases, it could be fatal:
Tiotropium Bromide + Formoterol Fumarate Dihydrate Chemical Structure
IUPAC (International Union of Pure and Applied Chemistry)/ Chemical name
Formoterol: N-[2-hydroxy-5-[1-hydroxy-2-[1-(4-methoxyphenyl)propan-2-ylamino]ethyl]phenyl]formamide
Tiotropium Bromide: [(1R,2R,4S,5S)-9,9-dimethyl-3-oxa-9-azoniatricyclo[3.3.1.0]nonan-7-yl] 2-hydroxy-2,2-dithiophen-2-ylacetate bromide
Intake routine/cycle
Daily dose
Take Tiotropium Bromide + Formoterol Fumarate Dihydrate exactly as your doctor recommends. The dose may change based on your condition and how well you respond. Do not take more than prescribed without consulting your doctor.
Missed Dose
If you forget to take your medicine, take the medication as soon as you remember. If it’s nearly time for your next dose, skip the missed one and continue with your regular schedule. Always consult the doctor before making any changes to your dosage.
Overdose
It is not recommended to take more than the prescribed amount of Tiotropium Bromide + Formoterol Fumarate Dihydrate as overdose may cause tremors, chest pain, fast or irregular heartbeat, nervousness, dizziness, headache, muscle cramps, and high blood pressure. Seek immediate medical attention if any of these occur.
Storage
- Store the medicine at room temperature
- Keep away from sunlight and moisture
- Keep out of reach of children
Tiotropium Bromide + Formoterol Fumarate Dihydrate Summary
Tiotropium + Formoterol is used to treat long-term breathing problems like COPD, chronic bronchitis, emphysema, and persistent shortness of breath. It works by relaxing and opening the airways tiotropium blocks tightening signals in the lungs, and formoterol keeps the air passages open for many hours, making breathing easier. People who should not take it include those with severe heart problems, narrow-angle glaucoma, urinary retention, allergies to these medicines, or severe kidney issues. It is not for sudden breathing attacks. This inhaler helps you breathe better daily, reduces chest tightness, and prevents flare-ups when used regularly.
FAQ’s
What class of drug is Tiotropium bromide?
Tiotropium bromide is a long-acting bronchodilator (anticholinergic) used to keep airways open in asthma and COPD.
What is the elimination half-life of Tiotropium bromide?
The elimination half-life of Tiotropium bromide is about 25–45 hours, meaning it stays in the body for a long time and works throughout the day.
What are the side effects of Formoterol fumarate dihydrate?
Common side effects include shakiness, headache, fast heartbeat, and throat irritation. Rarely, it can cause chest pain, irregular heartbeat, or severe allergic reactions.
How does Tiotropium bromide work?
Tiotropium bromide relaxes and opens the airways by blocking certain chemicals in the lungs, making breathing easier in asthma and COPD.
Reference
- Formoterol + Tiotropium: View Uses, Side Effects and Medicines | 1mg [Internet]. 1mg. 2022 [cited 2025 Dec 3]. Available from
- Ciclesonide + Formoterol + Tiotropium: View Uses, Side Effects and Medicines | 1mg [Internet]. 1mg. 2024 [cited 2025 Dec 3]. Available from
- PubChem. Olodaterol/tiotropium bromide [Internet]. Nih.gov. PubChem; 2025 [cited 2025 Dec 2]. Available from
- Formoterol Fumarate Inhalation: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD [Internet]. www.webmd.com. Available from
- PubChem. Formoterol fumarate hydrate [Internet]. Nih.gov. PubChem; 2025. Available from
Authors
Pranathi is a final year Pharm D student at Chalapathi Institute of Pharmaceutical Sciences. She loves learning and applying her knowledge in pharmacy and has a passion for writing, which allows her to express ideas clearly and creatively. She enjoys combining her technical skills with her love for writing and communication to make a meaningful impact. Currently she is working on a research paper about “Consanguineous marriages and its impact on children’s health” which will be published by the end of 2025.