Tiotropium: a potential replacement for ipratropium in patients with COPD.

Inhaled tiotropium provides a sustained bronchodilator effect over a 24-hour period in patients with chronic obstructive pulmonary disease (COPD). There is some evidence that tiotropium 18 micro g once daily is more efficacious than ipratropium bromide 40 micro g four times daily, for patients with COPD, as measured by improvements in lung function, dyspnea disease-specific quality of life and reductions in hospitalization due to COPD. Dry mouth is a more frequent problem with tiotropium than with ipratropium bromide.