Indications

Tropex 18 mcg is indicated for the long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It helps improve airflow and reduce breathing difficulties in patients requiring regular bronchodilator therapy.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Anticholinergic bronchodilators

Pharmacology

Tropex 18 mcg contains a long-acting antimuscarinic agent that works by blocking muscarinic receptors (M1–M5). In the respiratory tract, it primarily inhibits M3 receptors in the airway smooth muscle, resulting in sustained bronchodilation.
The antagonistic action is competitive and reversible, as demonstrated in both human and animal studies. Preclinical data show dose-dependent prevention of bronchoconstriction induced by methacholine, with bronchodilatory effects lasting for more than 24 hours. When inhaled, Tropex 18 mcg produces a localized effect in the lungs with minimal systemic exposure.

Dosage and Administration

• Adults (18 years and above):
  The recommended dose is 18 mcg (1 capsule) once daily, administered via the dry powder inhaler device.

• The capsule contents are intended for inhalation only and must not be swallowed.

• No dosage adjustment is necessary for elderly patients or those with hepatic or renal impairment.

• Patients with moderate to severe renal impairment should be monitored for potential anticholinergic effects.

Drug Interactions

Clinical interaction studies with tiotropium and histamine H2-receptor antagonists have shown:

• Concomitant use with cimetidine may increase systemic exposure and reduce renal clearance, without significant changes in peak concentration.

• Co-administration with ranitidine does not significantly affect pharmacokinetic parameters.

Contraindications

Tropex 18 mcg is contraindicated in patients with known hypersensitivity to atropine or its derivatives, including ipratropium, or to any component of the formulation.

Side Effects

The most frequently reported adverse effect is dry mouth, which is usually mild and may diminish with continued therapy. Other possible anticholinergic effects include:

• Constipation

• Increased heart rate

• Blurred vision

• Glaucoma

• Difficulty in urination or urinary retention

Pregnancy and Lactation

Tropex 18 mcg is classified as Pregnancy Category C. Adequate and well-controlled studies in pregnant women are lacking. It should be used during pregnancy only if the expected benefit outweighs potential risks to the fetus. Safety during labor, delivery, and lactation has not been established.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions and Warnings

Caution is advised when using Tropex 18 mcg in patients with conditions that may be aggravated by anticholinergic effects, such as narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction.

Overdose

Excessive doses may produce anticholinergic signs and symptoms. However, clinical studies have shown no serious systemic anticholinergic effects following high single inhaled doses. Repeated high-dose inhalation has been associated with mild effects such as dry mouth and conjunctivitis.

Storage Conditions

• Capsules are for inhalation only and must not be swallowed.

• Store below 30°C, away from direct sunlight and heat.

• Keep out of reach of children.