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High doses of Tiotropium bromide may lead to anticholinergic signs and symptoms.
However, there were no systemic anticholinergic adverse effects following a single inhaled dose of up to 282 micrograms Tiotropium in healthy volunteers.
Bilateral conjunctivitis in addition to dry mouth was seen in healthy volunteers following repeated once daily inhalation of 141 micrograms in healthy volunteers, which resolved while still under treatment. In a multiple dose study in COPD patients with a maximum daily dose of 38 micrograms Tiotropium over four weeks dry mouth was the only observed adverse event attributable to Tiotropium.
Acute intoxication by oral inhalation of Tiotropium capsules is unlikely due to low oral bioavailability.
