Spiriva

Spiriva (Tiotropium bromide)

What is Spiriva?

Spiriva (Tiotropium bromide) is a medication prescribed to prevent and control wheezing, and shortness of breath caused by breathing problems, such as chronic obstructive pulmonary disorder (COPD), bronchitis, and emphysema. It is also used to prevent asthma attacks in adults and children 6 years and older.

It belongs to the drug class, anticholinergics. These medications work by relaxing the muscles around the airways to breathe more easily.

Spiriva is not recommended:

• If you are allergic to or have had an allergic reaction to it or any of its ingredients
• To treat sudden breathing problems
• If you are pregnant or breastfeeding
• For patients younger than 6 years of age

What are the Indications for Spiriva?

Spiriva is approved for the long-term, daily maintenance treatment of bronchospasms associated with COPD, chronic bronchitis, and emphysema.

How is Spiriva used?

Storage

Spiriva should be stored in its original packaging at 77°F (25°C) with excursions permitted between 59-86°F (15-30°C). Do not expose it to extreme temperatures or moisture. Do not freeze the medicine.

Do not store Spiriva capsules in the inhaler device. Replace the inhaler device at least every 3 months.

Keep out of reach of children.

Instructions

Spiriva should be used as directed by your doctor, even if you feel well.

This medication should be used regularly to be effective. It does not work right away and should not be used to relieve sudden breathing problems.

Do not spray into the eyes. If it gets into your eyes, rinse it with a lot of water.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, only take one dose. Do not catch up by taking two doses at once.

Do not change your dosage, take more than what is prescribed, or stop using it without consulting with your doctor. If you took more than prescribed, contact your doctor immediately or seek emergency medical care.

If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication.

Rinse your mouth after each use to prevent dry mouth and throat irritation.

Clean the inhaler at least once a month with water and let it air dry fully before using it again.

Spiriva is for oral inhalation only. Do not breathe out into the mouthpiece at any time.

Dosage

Spiriva is available in two forms:

• Spiriva HandiHaler, which is a capsule filled with 18 mcg powder in packages of 5, 30, or 90 capsules.
• Spiriva Respimat, which is a liquid solution in these strengths: 1.25 mcg and 2.5 mcg actuation.

The Spiriva capsule is only for use in the HandiHaler device. Do not take the capsule by mouth. Use only one capsule at a time.

Spiriva is meant to be used as a long-term treatment and your doctor will determine the best dosage and frequency of use for your condition.

The typical dosage for asthma is 2 puffs of the 1.25 mcg strength once daily.

Spiriva HandiHaler and Spiriva Respimat can be used for COPD by taking two puffs once a day.

The children’s dosage for Spiriva Respimat is the same as in adults to treat asthma. Children should always be supervised by an adult while using this medicine.

Side Effects

It’s important to understand that although Spiriva is FDA-approved, it comes with side effects that may or may not affect you.

Before starting, you should discuss possible side effects with your doctor or pharmacist.

Common Side Effects

Not all side effects require medical attention. As your body adjusts to the medication, side effects may go away. Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own.

• Dry mouth
• Constipation
• Upset stomach
• Vomiting
• Nosebleed
• Muscle pain
• Cold symptoms, e.g., stuffy/runny nose, sinus pain, sore throat

Serious Side Effects

Severe adverse reactions may occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:

• Difficult/painful urination
• Rapid heartbeat
• Breathing problems: new/worsening cough, shortness of breath, wheezing, increased sputum, trouble breathing
• Vision changes: eye pain/swelling/redness, seeing rainbows around lights at night, blurred vision
• Allergic reaction: rash, itching, swelling, severe dizziness, trouble breathing

The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.

Warnings & Precautions

Before using Spiriva, tell your doctor or pharmacist:

• If you are allergic to it or any ingredients in it.
• If you have, ever had any narrow-angle glaucoma or a family history of it, kidney disease, milk allergy/lactose intolerant, enlarged prostate, or urination problems.
• If you are pregnant or plan to become pregnant.
• If you are breastfeeding or plan to breastfeed.

Avoid getting Spiriva into your eyes as it may cause eye pain/irritation, temporary blurred vision, and other vision changes.

Not for acute use

Spiriva is used to prevent bronchospasm attacks. Do not use this medication to treat a bronchospasm attack that has already begun. It will not work fast enough to reverse your symptoms. Use only a fast-acting inhalation medication to treat an attack.

Pregnant or Planning to Become Pregnant

It is not known if Spiriva will harm an unborn baby. Only use Spiriva if clearly needed. If you become pregnant, speak to your doctor who will determine if the benefit of using Spiriva, outweighs the risk.

Breastfeeding or Planning to Breastfeed

It is not known if Spiriva passes into breast milk. Speak to your doctor if you are breastfeeding or planning to start breastfeeding.

Interactions & Contraindications

Before using Spiriva, tell your doctor or pharmacist if you take any medications (prescription and over-the-counter), herbal supplements, or vitamins.

Spiriva may interact with other medicines that treat:

• Depression, anxiety, mood disorders, or mental illness
• Colds or allergies, like Benadryl
• Parkinson’s disease
• Stomach problems, motion sickness, or irritable bowel syndrome (IBS)
• Overactive bladder
• Bronchodilator asthma medication