Medications

Spiriva® Respimat®   

This product is manufactured by Boehringer Ingelheim (Canada) Ltd. using the ingredient tiotropium bromide monohydrate.

This product is inhaled into the lungs using the Respimat®.


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Respimat®


Why is it prescribed?

Spiriva® Respimat® is used as a long-acting bronchodilator for the maintenance treatment of chronic obstructive pulmonary disease (COPD) and is also used as add-on maintenance bronchodilator therapy in adult patients (18 years and older) with asthma who remain symptomatic on a combination of inhaled corticosteroid and long-acting beta2-agonist and who experienced one or more severe exacerbations in the previous year.


  • Each box contains 1 Respimat® inhaler and 1 cartridge, providing 60 puffs (30 medicinal doses). Physician samples provide 28 puffs (14 medicinal doses).
  • The color of the cap of the Respimat® inhaler is color coded to match the cartridge.
  • Never spray the medication toward the eyes
  • Before the inhaler is used for the first time, the cartridge must be inserted into the inhaler and then primed.
  • Prepare For First Time Use:
    • Step 1. With the blue cap closed, press the safety catch while pulling off the clear base. Be careful not to touch the piercing element located inside thebottom of the clear base.
    • Step 2. Write the discard by date on the label of the inhaler. The discard by date is 3 months from the date the cartridge is inserted into the inhaler.
    • Step 3. Take the cartridge out of the box. Push the narrow end of the cartridge into the inhaler. The base of the cartridge will not sit flush with the inhaler. About 1/8 of an inch will remain visible when the cartridge is correctly inserted. The cartridge can be pushed against a firm surface to ensure that it is correctly inserted. Do not remove the cartridge once it has been inserted into the inhaler.
    • Step 4. Put the clear base back into place. Do not remove the clear base again. The inhaler should not be taken apart after you have inserted the cartridge and put the clear base back.
  • Prime For First Time Use:
  • The following steps are needed to fill the dosing system the first time you use it and will not affect the number of doses available. After preparation and initial priming, the inhaler will be able to deliver the labeled number of doses (30 or 14). Proper priming of the inhaler is important to make sure the correct amount of medicine is delivered.
    • Step 5. Hold the inhaler upright, with the blue cap closed, to avoid accidental release of the dose. Turn the clear base in the direction of the black arrows on the label until it clicks (half a turn).
    • Step 6. Flip the blue cap until it snaps fully open.
    • Step 7. Point the inhaler toward the ground (away from your face). Press the dose release button. Close the blue cap. Repeat Steps 5, 6, and 7 until a spray is visible. Once the spray is visible, you must repeat Steps 5, 6, and 7 three more times to make sure the inhaler is prepared for use. The inhaler is now ready to use. These steps will not affect the number of doses available. After preparation and initial priming, the inhaler will be able to deliver the labeled number of doses (30 or 14).
  • Daily Dosing:
    • Step A. Hold the inhaler upright with the blue cap closed, so you do not accidentally release a dose of medicine. Turn the clear base in the direction of the black arrows on the label until it clicks (half a turn).
    • Step B. Flip the blue cap until it snaps fully open. Breathe out slowly and fully, and then close your lips around the end of the mouthpiece without covering the air vents. Point the inhaler to the back of your throat. While taking in a slow, deep breath through your mouth, press the dose release button and continue to breathe in slowly for as long as you can. Hold your breath for 10 seconds or for as long as comfortable. Repeat Step A and Step B so that you get the full dose. Close the blue cap until you use the inhaler again.
  • Helpful Hints for Daily Dosing: If the inhaler has not been used for more than 3 days, spray 1 puff toward the ground to prepare the inhaler for use. If it has not been used for more than 21 days, repeat Steps 5, 6, and 7 until a spray is visible. Then repeat Steps 5, 6, and 7 three more times to prepare the inhaler for use.
  • The dose indicator shows approximately how much medicine is left. When the pointer enters the red area of the scale, there is enough medicine for 7 days (30 dose product) or 3 days (14 dose product). This is when you need to refill your prescription.
  • Once the dose indicator has reached the end of the scale, all puffs have been used and the inhaler locks automatically. At this point, the base cannot be turned any further.
  • Throw away the Spiriva® Respimat® inhaler 3 months after insertion of cartridge into inhaler, even if all the medicine has not been used, or when the inhaler is locked, whichever comes first.
  • Store at room temperature.

Alternatives

Other products that have the same ingredient as Spiriva® Respimat® are •Inspiolto® Respimat® •Spiriva® Handihaler® •

See other products used in the treatment of •bronchospasm associated with COPD •chronic bronchitis (COPD) •COPD •emphysema (COPD) •

Use 1 dose (2 puffs) 1 time each day, at the same time of the day.


Tiotropium is a long-acting bronchodilator. It opens up narrowed breathing passages to help relieve symptoms of asthma and COPD.


Along with its needed effects, tiotropium may cause some unwanted or undesirable effects. Often, tiotropium users who use their medication properly, never experience any unwanted effects. The severity and duration of these effects are dependant on many factors including duration of therapy, dose, route of administration and individual response. Possible unwanted effects include:

  • dry mouth
  • chest pain
  • sinusitus
  • constipation
  • stomach pain

Less common:

  • allergic reactions
  • leg pain
  • tingling sensation
  • increase blood glucose
  • increase cholesterol levels

Rare:

  • difficulty urinating
  • rapid heart beat

Many of these unwanted effects, especially the most common ones, may disappear with continued use. Check with the doctor or pharmacist if any of them continue or become bothersome.

 


  • Tiotropium is used as a once daily maintenance bronchodilator.  It should not be used for acute episodes of bronchospasm. It is not a rescue medication.
  • Immediate hypersensitivity reactions (e.g. skin rash, swelling of the lip, tongue and face) may occur after administration of tiotropium.
  • Inhaled medicines may cause inhalation-induced bronchospasm.
  • Precautions should be taken to prevent getting the drug powder in the eyes. Getting tiotropium in the eye may cause eye pain or discomfort, temporary blurring of vision, visual halos or coloured images and may cause or worsen narrow-angle glaucoma.
  • Tiotropium should not be used more frequently than once daily.
  • This medication should not be used in people with an allergy to tiotropium or to atropine and its derivatives (e.g. ipratropium), or to lactose.
  • Tiotropium should be used with caution in people with narrow angle glaucoma, enlarged prostate, bladder obstruction, kidney disease.

Use in pregnancy: No human data available. Consult your doctor or pharmacist before use.

Use while breastfeeding: No human data available. Consult your doctor or pharmacist before use.


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Page Last Updated: 05/10/2016