Spiriva (tiotropium) is a brand-name, prescription inhaler used to help manage symptoms of chronic obstructive pulmonary disease (COPD) and asthma in adults and some children. A generic version of tiotropium bromide is also available. Spiriva comes in two forms: Spiriva Handihaler and Spiriva Respimat. The prescribed form depends on factors such as age and the specific condition being treated.
Spiriva is a once-daily maintenance inhaler designed to prevent COPD flare-ups and asthma attacks. It is crucial to note that neither form of Spiriva is approved for use as a rescue inhaler to stop an active episode. The active ingredient in Spiriva is tiotropium, which belongs to a class of drugs called anticholinergics.
Spiriva Respimat includes a cartridge containing a liquid form of Spiriva and an inhaler device called the Respimat. The Respimat delivers the liquid as a fine mist for inhalation. Spiriva Handihaler comes with capsules containing Spiriva powder and an inhaler device called the Handihaler. The Handihaler pierces the capsule, allowing the powder to be inhaled.
What is Spiriva used for?
Spiriva is prescribed to treat asthma and chronic obstructive pulmonary disease (COPD). The specific form recommended by a doctor depends on the condition being addressed.
Both Spiriva Respimat and Spiriva Handihaler are used to treat COPD in adults. COPD is a chronic lung condition that progressively worsens over time, typically involving a combination of emphysema and chronic bronchitis. For COPD, Spiriva is taken daily to relax and keep the airways open, facilitating easier breathing and symptom relief.
Spiriva Respimat is prescribed to treat asthma in adults and children aged 6 years and older. The Spiriva Handihaler is not used for asthma treatment, being reserved solely for COPD. Asthma involves inflammation and narrowing of the airways, leading to symptoms such as wheezing, coughing, chest tightness, and shortness of breath. Certain triggers can exacerbate these symptoms, leading to an asthma attack. For asthma, daily Spiriva use helps relax airways, keep them open, ease breathing, relieve symptoms, and prevent asthma attacks.
What are Spiriva’s side effects?
Like most medications, Spiriva can cause mild or serious side effects. It is advisable to consult a doctor or pharmacist for a comprehensive list of potential side effects.
Commonly reported mild side effects include sore throat, dry mouth, headache, upper respiratory infection (such as the common cold), blurry vision, and indigestion. Many mild side effects may resolve within a few days or weeks. If they become bothersome, medical advice should be sought for management strategies.
Serious side effects from Spiriva are rare but can occur. If serious side effects are experienced, immediate medical attention is necessary. Reported serious side effects include new or worsened urinary retention (difficulty emptying the bladder), paradoxical bronchospasm (sudden tightening of airways after a dose), and severe allergic reactions, including anaphylaxis and angioedema.
What is Spiriva’s dosage?
A doctor will determine the appropriate dosage of Spiriva. The following are commonly used dosages, but patients should always adhere to their prescribed regimen.
Spiriva Respimat consists of an inhaler device and a cartridge containing liquid Spiriva, delivered as a fine mist. It is available in strengths of 1.25 micrograms (mcg) per puff and 2.5 mcg per puff. Spiriva Handihaler includes an inhaler device and capsules containing Spiriva powder. Each capsule contains 18 mcg of Spiriva, which is inhaled after the device pierces the capsule.
The specific form and strength prescribed depend on the treated condition. However, the recommended dosage of Spiriva for both asthma and COPD is generally 2 puffs per day.
If a dose of Spiriva is missed, it should be taken as soon as possible. However, if it is almost time for the next scheduled dose, the missed dose should be skipped to avoid taking two doses at once, which can increase the risk of side effects. Spiriva is intended for long-term treatment. If deemed safe and effective, its use will likely continue long-term. Spiriva typically begins to open airways approximately 1 hour after the first dose, but noticeable symptom improvement may take a few weeks.
In the event of using too much Spiriva, medical advice should be sought immediately. For severe symptoms, emergency medical services should be contacted.
Frequently Asked Questions about Spiriva
Here are answers to some common questions regarding Spiriva.
No, Spiriva capsules should never be swallowed. These capsules, used with the Handihaler device, are strictly for oral inhalation. Swallowing them renders the medication ineffective for COPD as it would be processed through the digestive tract rather than the lungs. Capsules should be stored in their sealed blister packaging and only inserted into the Handihaler immediately before inhalation. Accidental ingestion requires immediate consultation with a doctor or a poison control center.
Regular cleaning of the Spiriva device is essential to prevent drug buildup, blockages, and contamination. Cleaning should be done without cleaning agents, detergents, or hair dryers.
For Spiriva Respimat, the mouthpiece, including its metal element, should be cleaned at least once per week using only a clean, damp cloth or tissue. The Respimat device or cartridge should not be rinsed or submerged in water.
For Spiriva Handihaler, the entire open device can be rinsed under warm running water as needed. While rinsing, the green piercing button should be pressed several times to clear the needle and center chamber of any residual gelatin or powder. After rinsing, excess water should be tapped out on a paper towel, and the device air-dried with the dust cap, mouthpiece, and base fully open. The Handihaler should not be used while wet.
A Spiriva Respimat inhaler should be discarded exactly 3 months after its first use or when the dose indicator reaches the end of the red scale, whichever comes first. The device automatically locks after approximately 60 full doses.
What should be considered before taking Spiriva?
Before starting Spiriva, it is important to discuss overall health, existing medical conditions, and other medications with a doctor, as these factors can influence its suitability.
Spiriva, an anticholinergic drug, can interact with other anticholinergics, such as ipratropium (Atrovent HFA), oxybutynin (Ditropan XL), and revefenacin (Yupelri). A doctor or pharmacist can provide more information on potential drug interactions.
Spiriva may cause adverse effects in individuals with certain conditions. Factors to discuss with a doctor include a history of closed-angle glaucoma, urinary retention, moderate or severe kidney problems, or a previous allergic reaction to Spiriva, its ingredients, or related drugs like ipratropium (Atrovent). Pregnancy and breastfeeding status should also be discussed.
What does Spiriva cost?
The cost of prescription drugs varies based on factors such as insurance coverage, pharmacy choice, and whether the brand-name Spiriva or generic tiotropium bromide is prescribed. Savings cards, such as the Spiriva Respimat Savings Card, may be available to help reduce out-of-pocket costs, even for those without insurance.
What to ask your doctor
Patients with questions about Spiriva should consult their doctor or pharmacist. Potential questions include inquiries about ease of use with arthritis, effects on eye conditions other than closed-angle glaucoma, overall effectiveness, suitability of combination inhalers, and potential long-term side effects.
Spiriva (tiotropium) is an effective, once-daily maintenance treatment for preventing flare-ups in individuals with COPD or asthma. Available as the dry powder Handihaler or the Respimat aerosol mist inhaler, both forms serve as long-term medications to help relax airways and facilitate easier breathing. It is recommended to discuss with a doctor which form of Spiriva is best for managing daily asthma or COPD symptoms.
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