zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.tiotropium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.Minor (3)dimenhydrinatedimenhydrinate increases toxicity of tiotropium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.donepezildonepezil decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.galantaminegalantamine decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.abobotulinumtoxinAMonitor Closely (1)abobotulinumtoxinA increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .amantadineMonitor Closely (1)tiotropium, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.amitriptylineMonitor Closely (1)tiotropium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.amoxapineMonitor Closely (1)tiotropium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.anticholinergic/sedative combosMonitor Closely (1)anticholinergic/sedative combos and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.aripiprazoleMonitor Closely (3)tiotropium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atracuriumMonitor Closely (1)atracurium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineMonitor Closely (1)atropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.atropine IV/IMMonitor Closely (1)atropine IV/IM and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna alkaloidsMonitor Closely (1)belladonna alkaloids and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumMonitor Closely (1)belladonna and opium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.benperidolMonitor Closely (3)tiotropium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor. benperidol increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.benztropineMonitor Closely (1)benztropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. bethanecholMonitor Closely (1)bethanechol increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbacholMonitor Closely (1)carbachol increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.cevimelineMonitor Closely (1)cevimeline increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpromazineMonitor Closely (3)tiotropium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor. chlorpromazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cisatracuriumMonitor Closely (1)cisatracurium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.clomipramineMonitor Closely (1)tiotropium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.clozapineMonitor Closely (3)tiotropium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyclizineMonitor Closely (1)cyclizine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.cyclobenzaprineMonitor Closely (1)cyclobenzaprine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.darifenacinMonitor Closely (1)darifenacin and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.desipramineMonitor Closely (1)tiotropium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.dicyclomineMonitor Closely (1)dicyclomine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.dimenhydrinateMinor (1)dimenhydrinate increases toxicity of tiotropium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.diphenhydramineMonitor Closely (1)diphenhydramine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.donepezilMonitor Closely (1)donepezil increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)donepezil decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.donepezil transdermalMonitor Closely (1)donepezil transdermal, tiotropium. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.dosulepinMonitor Closely (1)tiotropium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.doxepinMonitor Closely (1)tiotropium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.droperidolMonitor Closely (3)tiotropium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor. droperidol increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.echothiophate iodideMonitor Closely (1)echothiophate iodide increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.fesoterodineMonitor Closely (1)fesoterodine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.flavoxateMonitor Closely (1)flavoxate and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.fluphenazineMonitor Closely (3)tiotropium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.galantamineMonitor Closely (1)galantamine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)galantamine decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.glucagonSerious - Use Alternative (1)glucagon increases toxicity of tiotropium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .glucagon intranasalSerious - Use Alternative (1)glucagon intranasal increases toxicity of tiotropium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .glycopyrrolateMonitor Closely (1)glycopyrrolate and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.glycopyrrolate inhaledMonitor Closely (1)glycopyrrolate inhaled and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.glycopyrronium tosylate topicalMonitor Closely (1)glycopyrronium tosylate topical, tiotropium. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.haloperidolMonitor Closely (3)tiotropium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor. haloperidol increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.henbaneMonitor Closely (1)henbane and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.homatropineMonitor Closely (1)homatropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.huperzine AMonitor Closely (1)huperzine A increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.hyoscyamineMonitor Closely (1)hyoscyamine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.hyoscyamine sprayMonitor Closely (1)hyoscyamine spray and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.iloperidoneMonitor Closely (3)tiotropium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor. iloperidone increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.imipramineMonitor Closely (1)tiotropium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.ipratropiumMonitor Closely (1)ipratropium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.levodopaMonitor Closely (1)tiotropium, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .lofepramineMonitor Closely (1)tiotropium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.loxapineMonitor Closely (3)tiotropium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.loxapine inhaledMonitor Closely (2)loxapine inhaled increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. tiotropium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.maprotilineMonitor Closely (1)tiotropium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.meclizineMonitor Closely (1)meclizine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.methscopolamineMonitor Closely (1)methscopolamine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.neostigmineMonitor Closely (1)neostigmine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineMonitor Closely (1)tiotropium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.olanzapineMonitor Closely (3)tiotropium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.onabotulinumtoxinAMonitor Closely (1)onabotulinumtoxinA and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.orphenadrineMonitor Closely (1)tiotropium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutyninMonitor Closely (1)oxybutynin and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicalMonitor Closely (1)oxybutynin topical and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermalMonitor Closely (1)oxybutynin transdermal and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.paliperidoneMonitor Closely (3)tiotropium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor. paliperidone increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pancuroniumMonitor Closely (1)pancuronium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazineMonitor Closely (3)tiotropium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor. perphenazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.physostigmineMonitor Closely (1)physostigmine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpineMonitor Closely (1)pilocarpine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (3)tiotropium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pralidoximeMonitor Closely (1)pralidoxime and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.pramlintideSerious - Use Alternative (1)pramlintide, tiotropium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.prochlorperazineMonitor Closely (3)tiotropium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor. prochlorperazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.promethazineMonitor Closely (3)tiotropium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor. promethazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.propanthelineMonitor Closely (1)propantheline and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptylineMonitor Closely (1)tiotropium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.pyridostigmineMonitor Closely (1)pyridostigmine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (3)tiotropium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor. quetiapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rapacuroniumMonitor Closely (1)rapacuronium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.revefenacinSerious - Use Alternative (1)revefenacin and tiotropium both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.risperidoneMonitor Closely (3)tiotropium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. risperidone increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rocuroniumMonitor Closely (1)rocuronium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.scopolamineMonitor Closely (1)scopolamine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.solifenacinMonitor Closely (1)solifenacin and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.succinylcholineMonitor Closely (1)succinylcholine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.thioridazineMonitor Closely (3)tiotropium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor. thioridazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.thiothixeneMonitor Closely (3)tiotropium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor. thiothixene increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tolterodineMonitor Closely (1)tiotropium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.trazodoneMonitor Closely (1)tiotropium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.trifluoperazineMonitor Closely (3)tiotropium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.trihexyphenidylMonitor