<unk> , sold under the brand name Spiriva among others, is a long-acting bronchodilator used in the management of chronic obstructive pulmonary disease (COPD) and asthma. Specifically it is used during periods of breathing difficulty to prevent them from getting worse, rather than to prevent them from happening. It is used by inhalation through the mouth. Onset typically begins within half an hour and lasts for 24 hours. Common side effects include a dry mouth, runny nose, upper respiratory tract infection, shortness of breath and headache. Severe side effects may include angioedema, worsening bronchospasm, and QT prolongation. Tentative evidence has not found harm during pregnancy, however, such use has not been well studied. It is an anticholinergic medication and works by blocking acetylcholine action on smooth muscle.<unk>  was patented in 1989, and approved for medical use in 2002. It is on the World Health Organization's List of Essential Medicines. In 2019, it was the 132nd most commonly prescribed medication in the United States, with more than 5million prescriptions.
Tiotropium bromide
Fluticasone/salmeterol
Mometasone/formoterol
Beclometasone/formoterol
Fluticasone furoate
Fluticasone propionate
Theophylline
Roflumilast