Tiotropium interactions

Tiotropium (Spiriva), an anticholinergic has 145 documented interactions across the FDA labels and fact sheets we index: 39 major, 92 moderate, 13 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (39)

  • AclidiniumanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Albuterolbeta-adrenergic agonistMajor

    Other short-acting sympathomimetic aerosol bronchodilators should not be used concomitantly with albuterol. (Albuterol label, Drug interactions)

  • AmantadineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Amitriptylinetricyclic antidepressantMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • BenztropineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • ChlorpheniramineantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • ChlorpromazineantipsychoticMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • ClozapineantipsychoticMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Cyclobenzaprinemuscle relaxantMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • CyclopentolateanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • DarifenacinanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • DicyclomineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • DimenhydrinateantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • DiphenhydramineantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Doxepintricyclic antidepressantMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • DoxylamineantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • FesoterodineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Intervention Concomitant use of anticholinergic drugs with GVOKE VialDx is not recommended. (Glucagon label, Drug interactions)

  • GlycopyrrolateanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • HydroxyzineantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • HyoscyamineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • IpratropiumanticholinergicMajor

    SPIRIVA RESPIMAT is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, or any component of this product [see Warnings and Precautions (5.2) ] . (Tiotropium label, Contraindications)

  • MeclizineantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Metoclopramidedopamine antagonistMajor

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, malignant hyperthermia, drug fever, serotonin syndrome, and primary central nervous system pathology. (Metoclopramide label, Warnings and precautions)

  • Nortriptylinetricyclic antidepressantMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • OlanzapineantipsychoticMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • OxybutyninanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • ParoxetineSSRIMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • ProchlorperazineantipsychoticMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • PromethazineantihistamineMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Rivastigminecholinesterase inhibitorMajor

    Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended ( 7.1 , 7.2 , 7.3 ) (Rivastigmine label, Drug interactions)

  • RoflumilastPDE4 inhibitorMajor

    Treatment of Acute Bronchospasm DALIRESP is not a bronchodilator and should not be used for the relief of acute bronchospasm. (Roflumilast label, Warnings and precautions)

  • ScopolamineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • SolifenacinanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • TolterodineanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • TranylcypromineMAO inhibitorMajor

    …(HR) b or Serotonin Syndrome (SS) c ] Agents with blood pressure-reducing effects Use with caution d Hypotension e Non-selective H1 receptor antagonists Contraindicated a Increased anticholinergic effects Beta-adrenergic blockers (see also agents or procedures with blood pressure-reducing effects) Use with the caution d More pronounced bradycardia, postural hypotension… (Tranylcypromine label, Drug interactions)

  • TrihexyphenidylanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • TrospiumanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • Umeclidinium and vilanterolanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

Moderate interactions (92)

  • Allopurinolxanthine oxidase inhibitorModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • AripiprazoleantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Aripiprazole label, Warnings and precautions)

  • ArmodafinilCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • AsenapineantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use SAPHRIS with caution in patient who may experience these conditions. (Asenapine label, Warnings and precautions)

  • Atenololbeta blockerModerate

    Since beta 1 selectivity is not absolute, the lowest possible dose of TENORMIN should be used with therapy initiated at 50 mg and a beta 2 -stimulating agent (bronchodilator) should be made available. (Atenolol label, Warnings)

  • AzelastineantihistamineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • BeclomethasonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • BetamethasonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • BrexpiprazoleantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use REXULTI with caution in patients who may experience these conditions. (Brexpiprazole label, Warnings and precautions)

  • BudesonidecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Budesonide and formoterolcorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • BuprenorphineopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine label, Drug interactions)

  • Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Buprenorphine and naloxone label, Drug interactions)

  • Butalbital, acetaminophen, and caffeinebarbiturateModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • CarbamazepineanticonvulsantModerate

    Increased Intraocular Pressure Carbamazepine has mild anticholinergic activity. (Carbamazepine label, Warnings and precautions)

  • CariprazineantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use VRAYLAR with caution in patient who may experience these conditions. (Cariprazine label, Warnings and precautions)

  • CetirizineantihistamineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • ClobetasolcorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • CodeineopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Codeine label, Drug interactions)

  • DesonidecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • DeutetrabenazineVMAT2 inhibitorModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Deutetrabenazine label, Warnings and precautions)

  • DexamethasonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Dexmedetomidinealpha-adrenergic agonistModerate

    The intravenous administration of anticholinergic agents (e.g., glycopyrrolate, atropine) should be considered to modify vagal tone. (Dexmedetomidine label, Warnings and precautions)

  • DexmethylphenidateCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • DronabinolcannabinoidModerate

    Concomitant use of other drugs that cause dizziness, confusion, sedation, or somnolence such as CNS depressants may increase this effect (e.g., barbiturates, benzodiazepines, lithium, opioids, buspirone, scopolamine, antihistamines, tricyclic antidepressants, other anticholinergic agents, and muscle relaxants). (Dronabinol label, Warnings and precautions)

  • DroxidopasympathomimeticModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • EluxadolineopioidModerate

    Examples: alosetron, anticholinergics, opioids Table 3: Established and Other Potentially Clinically Relevant Interactions Affecting Drugs Co-Administered with VIBERZI OATP1B1 and BCRP Substrate Clinical Impact: VIBERZI may increase the exposure of co-administered OATP1B1 and BCRP substrates. (Eluxadoline label, Drug interactions)

  • EpinephrinesympathomimeticModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Febuxostatxanthine oxidase inhibitorModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • FentanylopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Fentanyl label, Drug interactions)

  • FexofenadineantihistamineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • FluocinonidecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • FluticasonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Fluticasone and salmeterolcorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Formoterolbeta-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • HalobetasolcorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • HaloperidolantipsychoticModerate

    Anticholinergic Drugs Clinical Impact The healthcare provider should keep in mind the possible increase in intraocular pressure when anticholinergic drugs are administered concomitantly with HALDOL DECANOATE. (Haloperidol label, Drug interactions)

  • Anticholinergic Drugs The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Hydrocodone and acetaminophen label, Drug interactions)

  • HydrocortisonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • HydromorphoneopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Hydromorphone label, Drug interactions)

  • IloperidoneantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use FANAPT with caution in patients who may experience these conditions. (Iloperidone label, Warnings and precautions)

  • Levalbuterolbeta-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • LevocetirizineantihistamineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • LevorphanolopioidModerate

    Anticholinergic Drugs The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Levorphanol label, Drug interactions)

  • LisdexamfetamineCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • LoratadineantihistamineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • MeperidineopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Meperidine label, Drug interactions)

  • MethadoneopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Methadone label, Drug interactions)

  • MethylphenidateCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • MethylprednisolonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Metoprololbeta blockerModerate

    Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)

  • Midodrinealpha-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Mirabegronbeta-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • ModafinilCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • MometasonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • MorphineopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Morphine label, Drug interactions)

  • NalbuphineopioidModerate

    Anticholinergic Drugs The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Nalbuphine label, Drug interactions)

  • Nifedipinedihydropyridine calcium channel blockerModerate

    …diverticulosis, and inflammatory bowel disease), hypomotility disorders (e.g., constipation, gastroesophageal reflux disease, ileus, obesity, hypothyroidism, and diabetes) and concomitant medications (e.g., H 2 -histamine blockers, opiates, nonsteroidal anti-inflammatory drugs, laxatives, anticholinergic agents, levothyroxine, and neuromuscular blocking agents). (Nifedipine label, Warnings)

  • OliceridineopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Oliceridine label, Drug interactions)

  • OlopatadineantihistamineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • OnabotulinumtoxinAneuromuscular blockerModerate

    Anticholinergic Drugs Use of anticholinergic drugs after administration of BOTOX may potentiate systemic anticholinergic effects. (OnabotulinumtoxinA label, Drug interactions)

  • OxycodoneopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Oxycodone label, Drug interactions)

  • Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may result in increased risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Oxycodone and acetaminophen label, Drug interactions)

  • OxymorphoneopioidModerate

    Examples: cyclobenzaprine, metaxalone Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Oxymorphone label, Drug interactions)

  • Pentazocine and naloxoneopioidModerate

    Monitor patients for signs of diminished diuresis and/or effects on blood pressure and increase the dosage of the diuretic as needed Anticholinergic Drugs The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Pentazocine and naloxone label, Drug interactions)

  • PentoxifyllinemethylxanthineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • PhentermineCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Phentermine and topiramateCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • PhenylephrinedecongestantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Pilocarpinecholinergic agonistModerate

    These effects should be considered when anticholinergic properties may be contributing to the therapeutic effect of concomitant medication (e.g., atropine, inhaled ipratropium). (Pilocarpine label, Drug interactions)

  • PrednisolonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • PrednisonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • PropofolCNS depressantModerate

    The intravenous administration of anticholinergic agents (e.g., atropine or glycopyrrolate) should be considered to modify potential increases in vagal tone due to concomitant agents (e.g., succinylcholine) or surgical stimuli. (Propofol label, Warnings and precautions)

  • PseudoephedrinedecongestantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • Pyridostigminecholinesterase inhibitorModerate

    Use with caution in persons with increased risk of anticholinergic reactions, such as persons with bronchial asthma, chronic obstructive pulmonary disease, bradycardia, cardiac arrhythmias, beta blocker treatment (increased risk of anticholinergic reactions). (Pyridostigmine label, Warnings and precautions)

  • QuetiapineantipsychoticModerate

    • Anticholinergic (antimuscarinic) Effects: Use with caution with other anticholinergic drugs and in patients with urinary retention, prostatic hypertrophy, or constipation (5.20) (Quetiapine label, Warnings and precautions)

  • RitonavirantiretroviralModerate

    Bronchodilator: theophylline ↓ theophylline Increased dosage of theophylline may be required; therapeutic monitoring should be considered. (Ritonavir label, Drug interactions)

  • Salmeterolbeta-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • SolriamfetolCNS stimulantModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • TapentadolopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Tapentadol label, Drug interactions)

  • Terbutalinebeta-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • TetrabenazineVMAT2 inhibitorModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Tetrabenazine label, Warnings and precautions)

  • TheophyllinemethylxanthineModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • TopiramateanticonvulsantModerate

    Caution should be used when TROKENDI XR is given with other drugs that predispose patients to heat-related disorders; these drugs include, but are not limited to, other carbonic anhydrase inhibitors and drugs with anticholinergic activity . (Topiramate label, Warnings and precautions)

  • TramadolopioidModerate

    Anticholinergic Drugs Clinical Impact: The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. (Tramadol label, Drug interactions)

  • TriamcinolonecorticosteroidModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • ValbenazineVMAT2 inhibitorModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Valbenazine label, Warnings and precautions)

  • Vibegronbeta-adrenergic agonistModerate

    Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)

  • ZiprasidoneantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system (CNS) pathology. (Ziprasidone label, Warnings and precautions)

  • ZonisamideanticonvulsantModerate

    Caution should be used when ZONISADE is prescribed with other drugs that predispose patients to heat-related disorders; these drugs include, but are not limited to, carbonic anhydrase inhibitors and drugs with anticholinergic activity. (Zonisamide label, Warnings and precautions)

Minor mentions (13)

  • Bisoprololbeta blockerMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol label, Warnings)

  • Bisoprolol and hydrochlorothiazidebeta blockerMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Cevimelinecholinergic agonistMinor

    Cevimeline might interfere with desirable antimuscarinic effects of drugs used concomitantly. (Cevimeline label, Drug interactions)

  • ClonazepambenzodiazepineMinor

    In a study in which the 2 mg clonazepam orally disintegrating tablet was administered with and without propantheline (an anticholinergic agent with multiple effects on the GI tract) to healthy volunteers, the AUC of clonazepam was 10% lower and the C max of clonazepam was 20% lower when the orally disintegrating tablet was given with propantheline compared to… (Clonazepam label, Drug interactions)

  • Donepezilcholinesterase inhibitorMinor

    Cholinesterase inhibitors have the potential to interfere with the activity of anticholinergic medications ( 7.1 ) (Donepezil label, Drug interactions)

  • Galantaminecholinesterase inhibitorMinor

    Potential to interfere with the activity of anticholinergic medications ( 7.1 ) (Galantamine label, Drug interactions)

  • Insulin regular (human)insulinMinor

    In a study of patients with asthma whose bronchodilators were temporarily withheld for assessment, bronchoconstriction and wheezing following AFREZZA dosing was reported in 29% (5/17) and 0% (0/13) of patients with and without a diagnosis of asthma, respectively. (Insulin regular (human) label, Warnings and precautions)

  • Labetalolbeta blockerMinor

    Beta blockers antagonize the bronchodilator effect of beta-receptor agonists. (Labetalol label, Drug interactions)

  • LumateperoneantipsychoticMinor

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic drugs may contribute to an elevation in core body temperature. (Lumateperone label, Warnings and precautions)

  • LurasidoneantipsychoticMinor

    Appropriate care is advised when prescribing LATUDA for patients who will be experiencing conditions that may contribute to an elevation in core body temperature, e.g., exercising strenuously, exposure to extreme heat, receiving concomitant medication with anticholinergic activity, or being subject to dehydration. (Lurasidone label, Warnings and precautions)

  • PaliperidoneantipsychoticMinor

    Appropriate care is advised when prescribing ERZOFRI to patients who will be experiencing conditions which may contribute to an elevation in core body temperature, e.g., exercising strenuously, exposure to extreme heat, receiving concomitant medication with anticholinergic activity, or being subject to dehydration. (Paliperidone label, Warnings and precautions)

  • RituximabimmunosuppressantMinor

    Institute medical management (e.g., glucocorticoids, epinephrine, bronchodilators, or oxygen) for infusion-related reactions as needed. (Rituximab label, Warnings and precautions)

  • TobramycinaminoglycosideMinor

    In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)

No significant interaction reported (1)

  • Ropiniroledopamine agonistNo interaction

    Commonly Administered Drugs: Population analysis showed that commonly administered drugs (e.g., selegiline, amantadine, tricyclic antidepressants, benzodiazepines, ibuprofen, thiazides, antihistamines, anticholinergics) did not affect the clearance of ropinirole. (Ropinirole label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.