Last update Jan. 30, 2021

Tiotropium Bromide

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Long-acting anticholinergic, specific antagonist of muscarinic receptors, which inhibits the bronchoconstrictive effects of acetylcholine.
Indicated in the treatment of asthma.
Inhaled administration.

Since the last update we have not found any published data on its excretion in breast milk.

Because of a very large volume of distribution along with a very low plasma concentration reached after inhalation (AEMPS 2019, Boehringer 2017), it must be very unlikely the passage of significant amounts into breastmilk.
Its almost nil oral bioavailability (AEMPS 2019, Boehringer 2017) would hamper the pass to the infant’s plasma through the breastmilk ingested.



Experts and scientific societies consider the use of inhaled anticholinergics during breastfeeding as low risk to the infant ((Hale, Lactmed, Amir 2011, National Asthma Education 2004).

Alternatives

  • Salmeterol ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Tiotropium Bromide in other languages or writings:

Group

Tiotropium Bromide belongs to this group or family:

Tradenames

Main tradenames from several countries containing Tiotropium Bromide in its composition:

  • Aspire
  • Braltus
  • Gregal
  • Inspiolto™. Contains other elements than Tiotropium Bromide in its composition
  • Nubibron
  • Spiolto™. Contains other elements than Tiotropium Bromide in its composition
  • Spiolto (Спиолто)™. Contains other elements than Tiotropium Bromide in its composition
  • Spiriva
  • Srivasso
  • Stiolto™. Contains other elements than Tiotropium Bromide in its composition
  • Yanimo™. Contains other elements than Tiotropium Bromide in its composition

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 2 (inhal: 19) %
Molecular weight 472 daltons
Protein Binding 72 %
VD 32 l/Kg
pKa 10.35 -
Tmax 0.1 hours
24 - 44 hours

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. Chambers CD, Krishnan JA, Alba L, Albano JD, Bryant AS, Carver M, Cohen LS, Gorodetsky E, Hernandez-Diaz S, Honein MA, Jones BL, Murray RK, Namazy JA, Sahin L, Spong CY, Vasisht KP, Watt K, Wurst KE, Yao L, Schatz M. The safety of asthma medications during pregnancy and lactation: Clinical management and research priorities. J Allergy Clin Immunol. 2021 Jun;147(6):2009-2020. Abstract Full text (link to original source)
  4. Middleton PG, Gade EJ, Aguilera C, MacKillop L, Button BM, Coleman C, Johnson B, Albrechtsen C, Edenborough F, Rigau D, Gibson PG, Backer V. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J. 2020 Feb 6;55(2). pii: 1901208. Abstract Full text (link to original source) Full text (in our servers)
  5. AEMPS. Bromuro de tiotropio. Ficha técnica. 2019 Full text (in our servers)
  6. Boehringer. Tiotropium bromide. Drug Summary. 2017 Full text (in our servers)
  7. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  8. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-57. None 2004 Full text (link to original source) Full text (in our servers)

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