Generic Name: tiotropium inhalation (tye oh TROE pee um)
Brand Names: Spiriva

Update: FDA Approves Spiriva Respimat - September 24, 2014. Read more...

What is Spiriva?

Spiriva (tiotropium) is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs.

Spiriva is used to prevent bronchospasm (narrowing of the airways in the lungs) in people with COPD (chronic obstructive pulmonary disease), including bronchitis and emphysema.

Spiriva may also be used for purposes not listed in this medication guide.

Important information

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

Before using Spiriva, tell your doctor if you have narrow-angle glaucoma, or an enlarged prostate or bladder obstruction.

Slideshow: COPD - Could You Be At Risk?

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.

Before taking this medicine

You should not use this medicine if you are allergic to tiotropium or ipratropium (Atrovent, Combivent, DuoNeb).

To make sure Spiriva is safe for you, tell your doctor if you have:

  • narrow-angle glaucoma;

  • kidney disease;

  • enlarged prostate or urination problems;

  • if you are allergic to milk; or

  • if you also take medicine to treat Parkinson's disease, overactive bladder, irritable bowel syndrome, depression, high blood pressure, or muscle spasms.

FDA pregnancy category C. It is not known whether Spiriva is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether tiotropium passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to a child without medical advice.

How should I use Spiriva?

Use Spiriva exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Spiriva is a powder that comes with a special inhaler device and blister packs containing capsules of the medicine. You will load one capsule into the inhaler device each time you use the medicine. Pushing the button on the side of the HandiHaler device will pierce the capsule and release the medicine into the inhaler chamber.

Do not take the capsule by mouth. Spiriva capsules are for use only in the HandiHaler device. Use only one capsule at a time. Do not use the HandiHaler device to take any other medicine.

Spiriva comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Spiriva is not a rescue medicine. It will not work fast enough to treat a COPD flare-up. Your doctor may prescribe a fast-acting inhalation medicine to treat a bronchospasm attack. Tell your doctor if it seems like your medications don't work as well.

Use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your lung function will need to be tested on a regular basis.

Store at room temperature away from moisture and heat. Do not freeze.

Keep each capsule in its blister pack until you are ready to place the capsule into the HandiHaler and use the device. Throw away any capsule that is not used right after you have taken it out of the blister pack. Exposure to air can ruin the capsule.

Spiriva dosing information

Usual Adult Dose for Chronic Obstructive Pulmonary Disease - Maintenance:

18 mcg by oral inhalation once a day

Comments:
-One capsule contains 18 mcg of tiotropium (dry powder formulation).
-The full dose is delivered via 2 inhalations from 1 capsule using the HandiHaler(R) device.

Approved indications: For the long-term maintenance therapy of bronchospasm associated with COPD, including chronic bronchitis and emphysema; to reduce exacerbations in COPD patients

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Do not use the Spiriva HandiHaler more than 1 time in a 24-hour period.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include dry mouth, eye redness, constipation, stomach pain, and confusion or drowsiness.

What should I avoid while using Spiriva?

Avoid getting the powder from a Spiriva capsule in your eyes. If this does happen, call your doctor.

This medicine may cause dizziness or blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Using Spiriva with other drugs that cause blurred vision, constipation, or difficult urination can worsen these effects. Avoid using cold or allergy medicine, over-the-counter sleep medicine, a muscle relaxer, or medicine to prevent nausea or motion sickness.

Spiriva side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Spiriva: hives, itching; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • wheezing, choking, or other breathing problems after using this medicine;

  • blurred vision, eye pain or redness, seeing halos around lights;

  • sores or white patches on your mouth, lips, or tongue;

  • pain or burning when you urinate; or

  • little or no urinating.

Common Spiriva side effects may include:

  • dry mouth;

  • blurred vision;

  • constipation, painful or difficult urination;

  • fast heart rate;

  • upset stomach;

  • chest pain; or

  • cold symptoms such as stuffy or runny nose, sinus pain, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Spiriva?

Other drugs may interact with tiotropium, including prescription and over-the-counter medicines, eye drops, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about Spiriva.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Spiriva only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 8.01. Revision Date: 2014-10-09, 11:18:20 AM.

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