SPIRIVA® Respimat® mechanism of action (MoA)

This video illustrates the mechanism of action (mode of action or MoA) of SPIRIVA® Respimat® (tiotropium bromide), an inhaled long-acting anticholinergic medication for the treatment of asthma.

Read about Dosage and Administration of SPIRIVA® Respimat® in asthma.

You can also read about efficacy or safety of SPIRIVA® Respimat® in asthma.


Asthma – the role of acetylcholine

Released from parasympathetic nerves, acetylcholine is thought to play a significant role in the pathophysiology of asthma.2Acetylcholine binds to muscarinic receptors and modulates inflammation  increases airway tone, contracts bronchial smooth muscle, and leads to mucus secretion and vasodilation.1 The muscarinic M3 receptor is the primary subtype responsible for bronchial and tracheal smooth muscle contraction.2


How does SPIRIVA® Respimat® work in asthma?

SPIRIVA® Respimat® (tiotropium bromide) is a once daily maintenance bronchodilator. Tiotropium competitively and reversibly binds to M3 muscarinic receptors in bronchial smooth muscle, antagonising the cholinergic (bronchoconstrictive) effects of acetylcholine, resulting in bronchial smooth muscle relaxation.3

Cross section of bronchiole

SPIRIVA® Respimat® should not be used for the initial treatment of acute episodes of bronchospasm, or for the relief of acute symptoms.3​ 


Drug class

Tiotropium bromide is a long-acting muscarinic antagonist (LAMA).3 It antagonises the effect of acetylcholine, which is the main neurotransmitter in the parasympathetic nervous system of the airways.

Acetylcholine regulates bronchoconstriction and mucus secretion and is thought to play a significant role in the pathophysiology of asthma.

Tiotropium bromide binds competitively and reversibly to M3 receptors, which results in relaxation of the bronchial smooth musculature3 and bronchodilation. 

On the Guidelines page you can access recommendations for tiotropium in asthma from the Global Initiative for Asthma (GINA).