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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with anticholinergics incl. triple combinations with corticosteroids
olodaterol and tiotropium bromide
R03AL06
Forms & Strengths
- Respimat soft mist inhaler: 5 µg olodaterol + 18 µg tiotropium per actuation (single inhalation)
Adult Dosing
- 1 inhalation (5 µg olodaterol/18 µg tiotropium) once daily, same dose for all adult COPD patients; may be taken with or without food
Pediatric Dosing
- Not approved for use in patients <18 years; safety and efficacy not established
Indications
- Maintenance treatment of chronic obstructive pulmonary disease (COPD) to improve lung function and reduce exacerbations
Mechanism of Action
- Olodaterol: selective long‑acting β2‑adrenergic agonist → relaxes airway smooth muscle via increased cAMP
- Tiotropium bromide: long‑acting muscarinic antagonist (M3‑selective) → inhibits acetylcholine‑mediated bronchoconstriction
Contraindications
- Known hypersensitivity to olodaterol, tiotropium, or any excipients
- Severe hypersensitivity to other anticholinergic agents
Adverse Reactions
- Headache
- Upper respiratory tract infection
- Dry mouth
- Cough
- Throat irritation
- Urinary retention
- Tremor
- Palpitations or tachycardia
- Dyspepsia
- Nausea
Drug Interactions
- Concomitant use of non‑selective β‑blockers may diminish bronchodilator effect of olodaterol
- Concurrent use of other anticholinergic drugs may increase anticholinergic burden (dry mouth, urinary retention)
- Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) may increase olodaterol plasma levels – monitor for cardiovascular effects
- Use with other long‑acting bronchodilators (LABA/LAMA) not recommended due to additive risk of tachyarrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use