Tiotropium

Identification

Summary

Tiotropium is a long-acting bronchodilator used in the management of chronic obstructive pulmonary disease (COPD).

Brand Names
Inspiolto Respimat, Spiriva, Spiriva Respimat, Stiolto
Generic Name
Tiotropium
DrugBank Accession Number
DB01409
Background

Tiotropium is a long-acting, antimuscarinic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD) and asthma.1,2,3,4,5 Tiotropium acts mainly on M3 muscarinic receptors located in the airways to produce smooth muscle relaxation and bronchodilation.1,2,3,4,5

Tiotropium is more specific for the subset of muscarinic receptors commonly found in the lungs than ipratropium.1

Tiotropium was granted FDA approval on 30 January 2004.2

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 392.512
Monoisotopic: 392.099024577
Chemical Formula
C19H22NO4S2
Synonyms
Not Available
External IDs
  • BA 679 BR
  • BA-679 BR

Pharmacology

Indication

Tiotropium powder for inhalation is indicated for the maintenance of bronchospasm in COPD and to prevent exacerbations of COPD.2 A combination tiotropium and olodaterol metered inhalation spray is indicated for maintenance of COPD.3 A tiotropium inhalation spray is indicated for the maintenance of bronchospasm in COPD, to prevent exacerbations of COPD, and to treat asthma in patients 12 or more years old.4 A tiotropium metered inhalation spray is indicated for the maintenance of bronchospasm in COPD, to prevent exacerbations of COPD, and to treat asthma in patients 6 or more years old.5

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Management ofAsthma•••••••••••••••••
Management ofAsthma•••••••••••••••••• •••••••
Used in combination to manageBronchitisCombination Product in combination with: Mometasone furoate (DB14512)••••••••••••
Used in combination to treatBronchoconstrictionCombination Product in combination with: Formoterol (DB00983)••••••••••••
Used in combination to preventBronchoconstrictionCombination Product in combination with: Formoterol (DB00983)••••••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Tiotropium is a long acting antimuscarinic that causes bronchodilation.1,2,3,4,5 The effects of tiotropium last over 24 hours and there is a wide therapeutic index as overdoses are uncommon even at doses well above the recommended maximum.2,3,4,5

Mechanism of action

Tiotropium is an antagonist of muscarinic receptors M1 to M5.1,2,3,4,5 Inhibition of the M3 receptor in the smooth muscle of the lungs leads to relaxation of smooth muscle and bronchodilation.1,2,3,4,5

TargetActionsOrganism
AMuscarinic acetylcholine receptor M3
antagonist
Humans
UMuscarinic acetylcholine receptor M1
antagonist
Humans
UMuscarinic acetylcholine receptor M2
antagonist
Humans
UMuscarinic acetylcholine receptor M4Not AvailableHumans
UMuscarinic acetylcholine receptor M5Not AvailableHumans
Absorption

33% of an inhaled solution reaches systemic circulation, while oral solutions have a bioavailability of 2-3%.1,3,4,5 A dry powder for inhalation is 19.5% bioavailable.1,2 Tiotropium metered spray for inhalation reaches a maximum concentration in 5-7 minutes.3,4,5

Volume of distribution

The volume of distribution of tiotropium is 32L/kg.1,2,3,4,5

Protein binding

Tiotropium is 72% protein bound in plasma.1,2,3,4,5

Metabolism

Tiotropium is not heavily metabolized in the body.2,3,4,5 74% of an intravenous dose is excreted in the urine as unchanged drug.2,3,4,5 Tiotropium is nonenzymatically cleaved to the inactive metabolites N-methylscopine and dithienylglycolic acid.2,3,4,5 In vitro experiments show cytochrome P-450 dependent oxidation and glutathione conjugation to further metabolites.2,3,4,5

Hover over products below to view reaction partners

Route of elimination

74% of intravenous tiotropium was excreted unchanged in urine.1,2,3,4,5 14% of a dry powder inhalation dose was excreted unchanged in the urine.1 24 hour urinary excretion after 21 days of 5µg once daily inhalation in patients with COPD is 18.6% and in patients with asthma is 12.8%.2,3,4,5

Half-life

The terminal half life of tiotropium is 24 hours in patients with COPD and 44 hours in patients with asthma.4,5

Clearance

The total clearance of tiotropium is 880mL/min in healthy subjects receiving 5µg daily.1,2 The renal clearance of tiotropium was 669mL/min.1 Patients <65 years old demonstrated a clearance of 365mL/min while patients ≥65 demonstrated a clearance of 271mL/min.2 This decreased clearance is not associated with increased AUC or Cmax.3,4,5

Adverse Effects
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Toxicity

Symptoms of overdose include altered mental status, tremors, abdominal pain, and severe constipation.2 However, doses of up to 282µg did not lead to systemic anticholinergic effects in a trial of 6 patients.3,4,5 In case of overdose, stop tiotropium and being symptomatic and supportive therapy.2,3,4,5

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Tiotropium which could result in a higher serum level.
AbametapirThe serum concentration of Tiotropium can be increased when it is combined with Abametapir.
AbataceptThe metabolism of Tiotropium can be increased when combined with Abatacept.
AbirateroneThe metabolism of Tiotropium can be decreased when combined with Abiraterone.
AcebutololThe metabolism of Tiotropium can be decreased when combined with Acebutolol.
Food Interactions
  • Take with or without food. Food is not expected to interfere with absorption.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Tiotropium bromideXX112XZP0J136310-93-5DQHNAVOVODVIMG-RGECMCKFSA-M
Tiotropium bromide monohydrateL64SXO195N411207-31-3MQLXPRBEAHBZTK-SEINRUQRSA-M
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
SpirivaCapsule18 mcgRespiratory (inhalation)Boehringer Ingelheim (Canada) Ltd Ltee2002-11-21Not applicableCanada flag
SpirivaCapsule18 ug/1Oral; Respiratory (inhalation)Lake Erie Medical &Surgical Supply Dba Quality Care Products Llc2005-10-112014-12-31US flag
SpirivaCapsule18 ug/1Oral; Respiratory (inhalation)Physicians Total Care, Inc.2004-07-14Not applicableUS flag
SpirivaCapsule18 ug/1Oral; Respiratory (inhalation)A-S Medication Solutions2005-10-11Not applicableUS flag
Spiriva HandiHalerCapsule18 ug/1Oral; Respiratory (inhalation)Boehringer Ingelheim Pharmaceuticals, Inc.2005-10-11Not applicableUS flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Lupin-tiotropiumCapsule18 mcgRespiratory (inhalation)Lupin Pharma2023-12-18Not applicableCanada flag
Tiotropium BromideCapsule18 ug/1Oral; Respiratory (inhalation)Lupin Pharmaceuticals, Inc.2023-08-16Not applicableUS flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
AERODAY 18/12 MCG INHALASYON IÇIN TOZ IÇEREN BLISTER, 60 DOZTiotropium bromide (18 mcg) + Formoterol fumarate (12 mcg)PowderRespiratory (inhalation)NEUTEC İNHALER İLAÇ SAN. VE TİC. A.Ş.2013-12-13Not applicableTurkey flag
DUESONIT 18/200 MCG INHALASYON ICIN TOZ ICEREN KAPSUL, 120 ADETTiotropium (18 mcg) + Ciclesonide (200 mcg)PowderRespiratory (inhalation)NEUTEC İLAÇ SAN. TİC. A.Ş.2012-04-26Not applicableTurkey flag
DUESONIT 18/200 MCG INHALASYON ICIN TOZ ICEREN KAPSUL, 60 ADETTiotropium (18 mcg) + Ciclesonide (200 mcg)PowderRespiratory (inhalation)NEUTEC İLAÇ SAN. TİC. A.Ş.2012-04-26Not applicableTurkey flag
DUESONIT 18/400 MCG INHALASYON ICIN TOZ ICEREN KAPSUL, 120 ADETTiotropium (18 mcg) + Ciclesonide (400 mcg)PowderRespiratory (inhalation)NEUTEC İLAÇ SAN. TİC. A.Ş.2012-04-26Not applicableTurkey flag
DUESONIT 18/400 MCG INHALASYON ICIN TOZ ICEREN KAPSUL, 60 ADETTiotropium (18 mcg) + Ciclesonide (400 mcg)PowderRespiratory (inhalation)NEUTEC İLAÇ SAN. TİC. A.Ş.2012-04-26Not applicableTurkey flag

Categories

ATC Codes
R03AL06 — Olodaterol and tiotropium bromideR03BB04 — Tiotropium bromideR03BB54 — Tiotropium bromide, combinationsR03AL10 — Formoterol and tiotropium bromide
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as morpholines. These are organic compounds containing a morpholine moiety, which consists of a six-member aliphatic saturated ring with the formula C4H9NO, where the oxygen and nitrogen atoms lie at positions 1 and 4, respectively.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Oxazinanes
Sub Class
Morpholines
Direct Parent
Morpholines
Alternative Parents
Piperidines / N-alkylpyrrolidines / Thiophenes / Tetraalkylammonium salts / Tertiary alcohols / Heteroaromatic compounds / Carboxylic acid esters / Azacyclic compounds / Oxacyclic compounds / Dialkyl ethers
show 10 more
Substituents
Alcohol / Amine / Aromatic alcohol / Aromatic heteropolycyclic compound / Azacycle / Carbonyl group / Carboxylic acid derivative / Carboxylic acid ester / Dialkyl ether / Ether
show 21 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
0EB439235F
CAS number
186691-13-4
InChI Key
LERNTVKEWCAPOY-DZZGSBJMSA-N
InChI
InChI=1S/C19H22NO4S2/c1-20(2)12-9-11(10-13(20)17-16(12)24-17)23-18(21)19(22,14-5-3-7-25-14)15-6-4-8-26-15/h3-8,11-13,16-17,22H,9-10H2,1-2H3/q+1/t11-,12-,13+,16-,17+
IUPAC Name
(1R,2R,4S,5S,7R)-7-{[2-hydroxy-2,2-bis(thiophen-2-yl)acetyl]oxy}-9,9-dimethyl-3-oxa-9-azatricyclo[3.3.1.0^{2,4}]nonan-9-ium
SMILES
[H][C@]12O[C@@]1([H])[C@]1([H])C[C@@]([H])(C[C@@]2([H])[N+]1(C)C)OC(=O)C(O)(C1=CC=CS1)C1=CC=CS1

References

Synthesis Reference

Rolf Banholzer, "Crystalline tiotropium bromide monohydrate, processes for the preparation thereof, and pharmaceutical compositions." U.S. Patent US20020169321, issued November 14, 2002.

US20020169321
General References
  1. Price D, Sharma A, Cerasoli F: Biochemical properties, pharmacokinetics and pharmacological response of tiotropium in chronic obstructive pulmonary disease patients. Expert Opin Drug Metab Toxicol. 2009 Apr;5(4):417-24. doi: 10.1517/17425250902828337 . [Article]
  2. FDA Drug Approval Package: Tiotropium Bromide Powder for Inhalation [Link]
  3. FDA Approved Drug Products: Tiotropium and Olodaterol Metered Inhalation Spray [Link]
  4. FDA Approved Drug Products: Tiotropium Inhalation Spray [Link]
  5. FDA Approved Drug Products: Tiotropium Metered Inhalation Spray [Link]
PubChem Compound
5487427
PubChem Substance
46504448
ChemSpider
19618474
BindingDB
50239981
RxNav
69120
ChEBI
90960
ChEMBL
CHEMBL1900528
ZINC
ZINC000100008319
Therapeutic Targets Database
DAP000344
PharmGKB
PA164769056
PDBe Ligand
0HK
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Tiotropium
PDB Entries
4daj / 4u14 / 4u15 / 5cxv / 5dsg / 6ol9

Clinical Trials

Clinical Trials

Pharmacoeconomics

Manufacturers
Not Available
Packagers
  • Boehringer Ingelheim Ltd.
  • Diversified Healthcare Services Inc.
  • Physicians Total Care Inc.
Dosage Forms
FormRouteStrength
PowderRespiratory (inhalation)
CapsuleOral10 Mikrogramm
PowderRespiratory (inhalation)18 mcg
PowderRespiratory (inhalation)12 mcg
Capsule; powderRespiratory (inhalation)
SuspensionRespiratory (inhalation)18 mcg
SolutionOral
SolutionRespiratory (inhalation)2.5 MICROGRAMMI/2.5MICROGRAMMI
SolutionRespiratory (inhalation)0.0025 mg/actuation
Aerosol, meteredRespiratory (inhalation)
SolutionRespiratory (inhalation)
CapsuleOral; Respiratory (inhalation)18 ug/1
PowderRespiratory (inhalation)10 mg
Powder, meteredRespiratory (inhalation)18 MCG
SolutionOral0.226 mg
CapsuleRespiratory (inhalation)18 mcg
PowderRespiratory (inhalation)
PowderRespiratory (inhalation)18 Mikrogramm
AerosolRespiratory (inhalation)
SolutionRespiratory (inhalation)2.5 MICROGRAMMI
SolutionRespiratory (inhalation)2.5 mcg
SolutionRespiratory (inhalation)2.5 mcg / act
Spray, meteredRespiratory (inhalation)1.562 ug/1
Spray, meteredRespiratory (inhalation)3.124 ug/1
SolutionRespiratory (inhalation)2.5 Mikrogramm
Aerosol, meteredRespiratory (inhalation)
SolutionRespiratory (inhalation)0.0025 mg
CapsuleRespiratory (inhalation)18 Mikrogramm
Spray, meteredRespiratory (inhalation)
Capsule, coatedRespiratory (inhalation)0.0236 mg/capsule
CapsuleRespiratory (inhalation)
CapsuleRespiratory (inhalation)
CapsuleRespiratory (inhalation)0.013 mg
Capsule, coatedRespiratory (inhalation)18 mcg
Capsule, coatedRespiratory (inhalation)1800000 mcg
Powder, meteredRespiratory (inhalation)10 MCG
SuspensionRespiratory (inhalation)0.016 %
AerosolRespiratory (inhalation)2.5 mcg/1dose
AerosolRespiratory (inhalation)
Prices
Unit descriptionCostUnit
Spiriva HandiHaler 30 18 mcg capsule Box223.07USD box
Spiriva HandiHaler 5 18 mcg capsule Box63.64USD box
Spiriva HandiHaler 6 18 mcg capsule Box41.99USD box
Spiriva 18 mcg cp-handihaler6.31USD inhaler
Spiriva 18 mcg Capsule2.2USD capsule
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5478578No1995-12-262012-12-26US flag
CA2066248No1998-08-042010-09-08Canada flag
US6908928Yes2005-06-212022-03-24US flag
US7070800Yes2006-07-042022-07-22US flag
US8022082Yes2011-09-202026-07-19US flag
USRE39820Yes2007-09-042018-07-30US flag
US7642268Yes2010-01-052022-03-24US flag
US7694676Yes2010-04-132027-09-12US flag
US6777423Yes2004-08-172022-03-24US flag
US7309707Yes2007-12-182022-03-24US flag
USRE38912Yes2005-12-062022-04-11US flag
US6453795Yes2002-09-242017-06-05US flag
US8733341Yes2014-05-272031-04-16US flag
US9027967Yes2015-05-122027-10-01US flag
US7104470Yes2006-09-122017-04-04US flag
US7246615Yes2007-07-242016-12-01US flag
US7896264Yes2011-03-012025-11-26US flag
US7988001Yes2011-08-022022-02-04US flag
US7802568Yes2010-09-282019-08-26US flag
US6149054Yes2000-11-212017-06-16US flag
US6726124Yes2004-04-272017-04-04US flag
US7396341Yes2008-07-082027-04-10US flag
US6846413Yes2005-01-252019-02-28US flag
US6176442Yes2001-01-232016-12-01US flag
US7837235Yes2010-11-232028-09-13US flag
US5964416Yes1999-10-122017-04-04US flag
US7284474Yes2007-10-232025-02-26US flag
US6977042Yes2005-12-202019-02-28US flag
US6988496Yes2006-01-242020-08-23US flag
US8044046No2011-10-252023-11-10US flag
US8034809No2011-10-112025-05-12US flag
US7220742No2007-05-222025-05-12US flag
US7491719No2009-02-172023-11-10US flag
US7056916No2006-06-062023-12-07US flag
US7727984No2010-06-012023-11-10US flag
US7786111No2010-08-312023-11-10US flag
US9010323No2015-04-212030-04-19US flag

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
logP-1.8Chemaxon
pKa (Strongest Acidic)10.35Chemaxon
pKa (Strongest Basic)-4.3Chemaxon
Physiological Charge1Chemaxon
Hydrogen Acceptor Count3Chemaxon
Hydrogen Donor Count1Chemaxon
Polar Surface Area59.06 Å2Chemaxon
Rotatable Bond Count5Chemaxon
Refractivity109.18 m3·mol-1Chemaxon
Polarizability39.52 Å3Chemaxon
Number of Rings5Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption-0.9173
Blood Brain Barrier+0.5208
Caco-2 permeable+0.5294
P-glycoprotein substrateSubstrate0.7153
P-glycoprotein inhibitor INon-inhibitor0.7514
P-glycoprotein inhibitor IINon-inhibitor0.9762
Renal organic cation transporterNon-inhibitor0.7256
CYP450 2C9 substrateNon-substrate0.6633
CYP450 2D6 substrateNon-substrate0.7533
CYP450 3A4 substrateSubstrate0.6615
CYP450 1A2 substrateNon-inhibitor0.7787
CYP450 2C9 inhibitorNon-inhibitor0.812
CYP450 2D6 inhibitorNon-inhibitor0.8368
CYP450 2C19 inhibitorNon-inhibitor0.7284
CYP450 3A4 inhibitorNon-inhibitor0.7752
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9289
Ames testNon AMES toxic0.6133
CarcinogenicityNon-carcinogens0.9221
BiodegradationNot ready biodegradable0.9319
Rat acute toxicity2.6249 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9957
hERG inhibition (predictor II)Non-inhibitor0.8947
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSsplash10-03kc-1900000000-02d8f650f9450c4bd904
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-176.4108
predicted
DeepCCS 1.0 (2019)
[M-H]-176.4108
predicted
DeepCCS 1.0 (2019)
[M-H]-176.4108
predicted
DeepCCS 1.0 (2019)
[M+H]+178.30621
predicted
DeepCCS 1.0 (2019)
[M+H]+178.30621
predicted
DeepCCS 1.0 (2019)
[M+H]+178.30621
predicted
DeepCCS 1.0 (2019)
[M+Na]+183.99887
predicted
DeepCCS 1.0 (2019)
[M+Na]+183.99887
predicted
DeepCCS 1.0 (2019)
[M+Na]+183.99887
predicted
DeepCCS 1.0 (2019)

Targets

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insights and accelerate drug research.
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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Antagonist
General Function
Receptor activity
Specific Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name
CHRM3
Uniprot ID
P20309
Uniprot Name
Muscarinic acetylcholine receptor M3
Molecular Weight
66127.445 Da
References
  1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [Article]
  2. Hansel TT, Barnes PJ: Tiotropium bromide: a novel once-daily anticholinergic bronchodilator for the treatment of COPD. Drugs Today (Barc). 2002 Sep;38(9):585-600. [Article]
  3. Barnes PJ: Tiotropium bromide. Expert Opin Investig Drugs. 2001 Apr;10(4):733-40. [Article]
  4. Barnes PJ, Belvisi MG, Mak JC, Haddad EB, O'Connor B: Tiotropium bromide (Ba 679 BR), a novel long-acting muscarinic antagonist for the treatment of obstructive airways disease. Life Sci. 1995;56(11-12):853-9. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Antagonist
General Function
Phosphatidylinositol phospholipase c activity
Specific Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name
CHRM1
Uniprot ID
P11229
Uniprot Name
Muscarinic acetylcholine receptor M1
Molecular Weight
51420.375 Da
References
  1. Hansel TT, Barnes PJ: Tiotropium bromide: a novel once-daily anticholinergic bronchodilator for the treatment of COPD. Drugs Today (Barc). 2002 Sep;38(9):585-600. [Article]
  2. Barnes PJ: Tiotropium bromide. Expert Opin Investig Drugs. 2001 Apr;10(4):733-40. [Article]
  3. Barnes PJ, Belvisi MG, Mak JC, Haddad EB, O'Connor B: Tiotropium bromide (Ba 679 BR), a novel long-acting muscarinic antagonist for the treatment of obstructive airways disease. Life Sci. 1995;56(11-12):853-9. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Antagonist
General Function
G-protein coupled acetylcholine receptor activity
Specific Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name
CHRM2
Uniprot ID
P08172
Uniprot Name
Muscarinic acetylcholine receptor M2
Molecular Weight
51714.605 Da
References
  1. Hansel TT, Barnes PJ: Tiotropium bromide: a novel once-daily anticholinergic bronchodilator for the treatment of COPD. Drugs Today (Barc). 2002 Sep;38(9):585-600. [Article]
  2. Barnes PJ, Belvisi MG, Mak JC, Haddad EB, O'Connor B: Tiotropium bromide (Ba 679 BR), a novel long-acting muscarinic antagonist for the treatment of obstructive airways disease. Life Sci. 1995;56(11-12):853-9. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Guanyl-nucleotide exchange factor activity
Specific Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name
CHRM4
Uniprot ID
P08173
Uniprot Name
Muscarinic acetylcholine receptor M4
Molecular Weight
53048.65 Da
References
  1. Glossop PA, Watson CA, Price DA, Bunnage ME, Middleton DS, Wood A, James K, Roberts D, Strang RS, Yeadon M, Perros-Huguet C, Clarke NP, Trevethick MA, Machin I, Stuart EF, Evans SM, Harrison AC, Fairman DA, Agoram B, Burrows JL, Feeder N, Fulton CK, Dillon BR, Entwistle DA, Spence FJ: Inhalation by design: novel tertiary amine muscarinic M(3) receptor antagonists with slow off-rate binding kinetics for inhaled once-daily treatment of chronic obstructive pulmonary disease. J Med Chem. 2011 Oct 13;54(19):6888-904. doi: 10.1021/jm200884j. Epub 2011 Sep 20. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Phosphatidylinositol phospholipase c activity
Specific Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the...
Gene Name
CHRM5
Uniprot ID
P08912
Uniprot Name
Muscarinic acetylcholine receptor M5
Molecular Weight
60073.205 Da
References
  1. Glossop PA, Watson CA, Price DA, Bunnage ME, Middleton DS, Wood A, James K, Roberts D, Strang RS, Yeadon M, Perros-Huguet C, Clarke NP, Trevethick MA, Machin I, Stuart EF, Evans SM, Harrison AC, Fairman DA, Agoram B, Burrows JL, Feeder N, Fulton CK, Dillon BR, Entwistle DA, Spence FJ: Inhalation by design: novel tertiary amine muscarinic M(3) receptor antagonists with slow off-rate binding kinetics for inhaled once-daily treatment of chronic obstructive pulmonary disease. J Med Chem. 2011 Oct 13;54(19):6888-904. doi: 10.1021/jm200884j. Epub 2011 Sep 20. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic...
Gene Name
CYP2D6
Uniprot ID
P10635
Uniprot Name
Cytochrome P450 2D6
Molecular Weight
55768.94 Da
References
  1. Keam SJ, Keating GM: Tiotropium bromide. A review of its use as maintenance therapy in patients with COPD. Treat Respir Med. 2004;3(4):247-68. [Article]
  2. Mosley JF 2nd, Smith LL, Dutton BN: Tiotropium Bromide/Olodaterol (Stiolto Respimat): Once-Daily Combination Therapy for the Maintenance of COPD. P T. 2016 Feb;41(2):97-102. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Keam SJ, Keating GM: Tiotropium bromide. A review of its use as maintenance therapy in patients with COPD. Treat Respir Med. 2004;3(4):247-68. [Article]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Symporter activity
Specific Function
Sodium-ion dependent, high affinity carnitine transporter. Involved in the active cellular uptake of carnitine. Transports one sodium ion with one molecule of carnitine. Also transports organic cat...
Gene Name
SLC22A5
Uniprot ID
O76082
Uniprot Name
Solute carrier family 22 member 5
Molecular Weight
62751.08 Da
References
  1. Nakamura T, Nakanishi T, Haruta T, Shirasaka Y, Keogh JP, Tamai I: Transport of ipratropium, an anti-chronic obstructive pulmonary disease drug, is mediated by organic cation/carnitine transporters in human bronchial epithelial cells: implications for carrier-mediated pulmonary absorption. Mol Pharm. 2010 Feb 1;7(1):187-95. doi: 10.1021/mp900206j. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Symporter activity
Specific Function
Sodium-ion dependent, low affinity carnitine transporter. Probably transports one sodium ion with one molecule of carnitine. Also transports organic cations such as tetraethylammonium (TEA) without...
Gene Name
SLC22A4
Uniprot ID
Q9H015
Uniprot Name
Solute carrier family 22 member 4
Molecular Weight
62154.48 Da
References
  1. Nakamura T, Nakanishi T, Haruta T, Shirasaka Y, Keogh JP, Tamai I: Transport of ipratropium, an anti-chronic obstructive pulmonary disease drug, is mediated by organic cation/carnitine transporters in human bronchial epithelial cells: implications for carrier-mediated pulmonary absorption. Mol Pharm. 2010 Feb 1;7(1):187-95. doi: 10.1021/mp900206j. [Article]

Drug created at July 17, 2007 12:36 / Updated at March 18, 2024 16:48