Medicine & USMLE

Ipratropium vs Tiotropium

Respiratory Pharm
  1. Ipratropium vs Tiotropium
  2. 1st Generation Antihistamines
  3. 2nd-Generation Antihistamines
  4. Albuterol vs Salmeterol
  5. Fluticasone & Budesonide
  6. Montelukast & Zafirlukast
  7. Zileuton
  8. Omalizumab
  9. Cromolyn & Nedocromil
  10. Guaifenesin
  11. Endothelin Receptor Antagonists (Bosentan)
  12. Prostaglandin Analogs (Epoprostenol, Iloprost)
  13. Theophylline


Ipratropium and tiotropium are inhaled drugs that act as muscarinic antagonists. By blocking muscarinic or parasympathetic signalling at the bronchioles, these drugs induce bronchodilation, which may be useful in the treatment of asthma or COPD. Ipratropium and Tiotropium differ mainly by their duration of action. Ipratropium is short-acting, which means it is best suited for acute resolution of asthma attacks or COPD exacerbations. In contrast, tiotropium is long-acting, making it preferred for chronic maintenance of these diseases.

Key Points

  • Tiotropium, Ipratropium
    • Mechanism
      • (M3) Muscarinic antagonist
        • Bronchodilation results from antagonism of M3 Receptors at the bronchioles
      • Tiotropium is long-acting (slow)
        • Used for chronic maintenance
      • Ipratropium is short-acting (fast)
        • Used for acute exacerbations
    • Clinical Use
      • Bronchodilation
        • COPD
        • Asthma
    • Adverse Effects
      • Few side effects
        • Inhaled route of administration leads to few off-target effects