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In cas mono-bonchodilatthapy dos not contol symptoms COPD adquatly i gula maintnanc thapy is dsid, a thaputic intvntion with a combination bonchodilatos is commndd. Th isks sid-cts incass with incasing dos any dug and, tho, th most impotant ational combination thapy is a vy avouabl atiicacy and saty. Knowing that anticholingic and bta-adngic agnts achiv thi bonchodilating cts by dint mchanisms, in paticula th combination ths agnts has povn tb bnicial in th managmnt COPD. Basd on th stablishd clinical bnits, tiotopium is an attactiv and pomising agnt th ist-lin long-tm maintnanc thapy in COPD. This alsimplis that a thaputic intvntion with oth bonchodilatos will b pscibd in daily pactic. At psnt nstudis on combination thapy with shot-acting agnts a availabl. Tho, using a doubl-blind, andomisd, cossov dsign, th bonchodilatcts singl doss ipatopium notol w compad with placbwhn addd on top stady stat tiotopium. Patints w p-tatd with tiotopium tachiv this phamacodynamic stady stat. Sial lung unction tsts (V1, VC, aw, sGaw) w conductd ollowing add-on th shot-acting bonchodilatos placbo.

Th most common sid cts potd with us ATOVNT HA w bonchitis, COPD la?up (xacbation), shotnss bath and hadach.

At intavnous administation appoximatly 60% th dos is mtabolisd, mainly by conjugation (40%), whas at inhalation about 77% th systmically availabl dos is mtabolisd by st hydolysis (41%) and conjugation (36%).

Us Atovnt HA xactly as pscibd by you docto. ollow all dictions on you psciption labl. Dnot us this mdicin in lag small amounts long than commndd.

Th saty Atovnt® (ipatopium bomid) Nasal Spay 0.03% at a dos twspays (42 mcg) p nostil twth tims daily (total dos 168 t252 mcg/day) has bn dmonstatd in 77 pdiatic patints 6-12 yas ag in placbo-contolld, 4-wk tials and in 55 pdiatic patints in activ-contolld, 6 month tials. Th ctivnss ATOVNT Nasal Spay (ipatopium bomid nasal spay) 0.03% th tatmnt hinoha associatd with allgic and nonallgic pnnial hinitis in this pdiatic ag goup is basd on an xtapolation th dmonstatd icacy ATOVNT Nasal Spay (ipatopium bomid nasal spay) 0.03% in adults with ths conditions and th liklihood that th disas cous, pathophysiology, and th dug’s cts a substantially simila tthat th adults. Th commndd dos th pdiatic population is basd on within and coss-study compaisons th icacy ATOVNT Nasal Spay 0.03% in adults and pdiatic patints and on its saty poil in both adults and pdiatic patints. Th saty and ctivnss ATOVNT Nasal Spay 0.03% in patints und 6 yas ag hav not bn stablishd.

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