Spiriva Respimat (tiotropium bromide inhalation spray) and Spiriva HandiHaler (tiotropium bromide inhalation powder)

Spiriva is a long-term maintenance treatment of bronchospasms associated with chronic obstructive pulmonary disease (COPD). It is not a rescue medicine and should not be used for treating sudden breathing problems. Spiriva belongs to a class of drugs known as anticholinergics that works to inhibit the effects of acetylcholine, a neurotransmitter. It transfers signals between certain cells and affects bodily functions.

Spiriva is available in two different forms:

  • Spiriva Respimat (tiotropium bromide inhalation spray)
  • Spiriva HandiHaler (tiotropium bromide inhalation powder)

What are the ingredients in Spiriva Handihaler and Spiriva Respimat?

The active ingredient in Spiriva Respimat and Spiriva HandiHaler is tiotropium, a long-acting muscarinc agent (LAMA) or anticholinergic.

How does Spiriva Handihaler and Spiriva Respimat work?

Spiriva works by relaxing the muscles that surround the airways. For people living with COPD, the muscles lining the airways can tighten causing the airways to become too narrow therefore making breathing difficult (bronchospasm).

What are the possible side effects of Spiriva Handihaler and Spiriva Respimat?

For patients in clinical trials that were treated with Spiriva Respimat, common side effects included:

  • Sore throat
  • Cough
  • Dry mouth
  • Sinusitis

For patients in clinical trials that were treated with Spiriva Handihaler, common side effects included:

  • Upper respiratory tract infection
  • Dry mouth
  • Sinusitis
  • Sore throat
  • Non-specific chest pain
  • Urinary tract infection
  • Indigestion
  • Runny nose
  • Constipation
  • Increased heart rate
  • Blurred vision

Patients with urinary retention (difficult and painful urination) and glaucoma (eye pain/redness, blurred vision, vision changes) may experience worsening of symptoms and should consult their doctors immediately if any of these signs develop. These are not all the possible side effects of Spiriva Handihaler and Spiriva Respimat. Patients should talk to their doctor about what to expect with treatment with Spiriva Handihaler and Spiriva Respimat.

Things to know about Spiriva Handihaler and Spiriva Respimat

The medicine in Spiriva HandiHaler comes in a dry powder contained in a capsule that is put into a special inhaler. The Spiriva capsules should not be swallowed and should only be used with the Handihaler device and inhaled through the mouth.

Spiriva Respimat uses a different kind of special inhaler. It delivers a slow-moving mist to help the patient inhale the medicine easier. The amount of medicine the patient takes in does not depend on how fast they are able to inhale. Patients receive one dose per day, which lasts for 24 hours.

Patients who are allergic to milk proteins or any of the ingredients of the medication should not take Spiriva Handihaler and Spiriva Respimat. Spiriva Handihaler and Spiriva Respimat should also not be used with other anticholinergic-containing drugs. Certain medications may interact with Spiriva Handihaler and Spiriva Respimat and may cause serious side effects.

Before starting Spiriva Handihaler and Spiriva Respimat, patients should tell their healthcare professionals about all medical conditions. Patients should tell their doctor if they are pregnant, plan to become pregnant, or are breast feeding since it is not known if Spiriva Handihaler and Spiriva Respimat can harm an unborn baby or pass into breast milk.

Dosing information

Spiriva Handihaler should be taken every day as 2 inhalations of the powder contents of one capsule with the handihaler device, once daily. Spiriva capsules contain 18mcg of tiotropium. Do not take more than one dose in 24 hours.

Spiriva Respimat should be taken as 2 inhalations of 2.5mcg (total dose equals 5mcg of Spiriva Respimat), once daily, at the same time of the day. Do not take more than one dose in 24 hours.

For more information, read the full prescribing information for Spiriva Respimat and Spiriva Handihaler

Written by: Amna Rizvi | Last reviewed: April 2018
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