Classes
DEA Class; Rx
Common Brand Names; Spiriva HandiHaler, Spiriva Respimat
- Anticholinergics, Respiratory
Description
Inhaled long-acting muscarinic antagonist (LAMA); administered once daily; minimal side effects except for xerostomia
Used for maintenance treatment of COPD in adults
Also approved for maintenance treatment of asthma in adult and pediatric patients 6 years and older
Indications
For asthma maintenance treatment.
For the maintenance treatment of chronic obstructive pulmonary disease (COPD), (e.g., chronic bronchitis or emphysema) and to reduce exacerbations of COPD.
Oral Inhalation dosage (powder capsule for inhalation; e.g., Spiriva HandiHaler)
Contraindications
History of hypersensitivity to ipratropium or tiotropium
History of severe hypersensitivity to milk proteins (excipient in powder contained in capsule)
Lactose allergy
Adverse Effects
- Upper respiratory tract infection (41%)
- Dry mouth (16%)
- Sinusitis (11%)
- Abdominal pain
- Allergic reaction
- Angina pectoris (including aggravated angina pectoris)
- Cataract
- Chest pain (nonspecific)
- Constipation
- Depression
- Dyspepsia
- Dysphonia
- Edema
- Epistaxis
- Gastroesophageal reflux
Warnings
Not for acute use; not a rescue medication
Immediate hypersensitivity reactions (eg, angioedema, itching, rash); stop treatment immediately
Capsule not to be swallowed; to be administered only by PO inhalation via HandiHaler device
Worsening of narrow-angle glaucoma
Worsening of urinary retention
Potential for paradoxical bronchospasm
Prostatic hyperplasia
Bladder-neck obstruction
Wash hands after handling capsules
Pregnancy and Lactation
The limited human data with therapy during pregnancy are insufficient to inform a drug-associated risk of adverse pregnancy-related outcomes
There are no data on presence of tiotropium in human milk, effects on breastfed infant, or effects on milk production
Maximum Dosage
2.5 mcg/day for asthma or 5 mcg/day for COPD for inhalation spray; 18 mcg/day for dry powder inhaler.
2.5 mcg/day for asthma or 5 mcg/day for COPD for inhalation spray; 18 mcg/day for dry powder inhaler.
2.5 mcg/day for inhalation spray.
6 to 12 years: 2.5 mcg/day for inhalation spray.
6 years and younger: Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Tiotropium hydrobromide
capsule (Spiriva Handihaler; powder for oral inhalation)
- 18mcg
solution for inhalation (Spiriva Respimat)
- 1.25mcg/actuation
- 2.5mcg/actuation
