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For tiotropium bromide(136310-93-5), no clinical data were available on the status of administration in pregnancy. Animal studies have shown maternal-related reproductive toxicity. There was no information on the use of tiotropium in lactating women. According to the study of lactating rodents, a small amount of tiotropium can be secreted into the milk. 

Therefore, tiotropium bromide(136310-93-5) should not be used in pregnant or lactating women unless the intended benefits outweigh the risks to the unborn child or infant.

There is no pediatric patients with tiotropium experience, so less than 18 years of age patients is not recommended to use this product.

Although no formal drug interaction studies have been conducted, no adverse effects were observed with tiotropium inhaled powders in combination with other drugs, including sympathomimetic bronchodilators, methylxanthines and oral or inhaled Steroidal drugs, etc., are commonly used for the treatment of chronic obstructive pulmonary disease (COPD) drugs. 

Tiotropium bromide(136310-93-5) has not been studied in combination with other anticholinergic drugs and is not recommended for use with other anticholinergic drugs.

High doses of tiotropium bromide can cause symptoms and signs of anticholinergic. 

However, the systemic anticholinergic effect was not seen in healthy volunteers after a single inhalation of 340 micrograms of tiotropium. In addition, healthy volunteers once a day inhalation of 170 micrograms of tiotropium bromide, medication 7 days, in addition to dry mouth, no other adverse reactions. In a multidose study of patients with chronic obstructive pulmonary disease (COPD), no significant adverse effects were observed after 4 weeks of treatment with tiotropium, the highest daily dose of 43 micrograms. Inadvertent oral administration of tiotropium capsules for acute poisoning is not possible due to the low oral bioavailability.

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