What is Spiriva (tiotropium bromide), and what is it used for?

  • Spiriva HandiHaler is a prescription medicine used each day (a maintenance medicine) to control symptoms of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.
  • Spiriva HandiHaler helps make your lungs work better for 24 hours. Spiriva HandiHaler relaxes your airways and helps keep them open. You may start to feel like it is easier to breathe on the first day, but it may take longer for you to feel the full effects of the medicine. Spiriva HandiHaler works best and may help make it easier to breathe when you use it every day.
  • Spiriva HandiHaler reduces the likelihood of flare-ups and worsening of COPD symptoms (COPD exacerbations). A COPD exacerbation is defined as an increase or new onset of more than one COPD symptom such as cough, mucus, shortness of breath, and wheezing that requires medicine beyond your rescue medicine.

Spiriva HandiHaler is not a rescue medicine and should not be used for treating sudden breathing problems. Your doctor may give you other medicine to use for sudden breathing problems.

It is not known if Spiriva HandiHaler is safe and effective in children.

Do not use Spiriva HandiHaler if you:

  • are allergic to tiotropium, ipratropium(Atrovent®), or any of the ingredients in Spiriva HandiHaler. 

Symptoms of a serious allergic reaction to Spiriva HandiHaler may include:

  • raised red patches on your skin (hives)
  • itching
  • rash
  • swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing

If you have these symptoms of an allergic reaction, stop taking Spiriva HandiHaler and call your doctor right away or go to the nearest hospital emergency room.

Before taking Spiriva HandiHaler, tell your doctor about all your medical conditions, including if you:

  • have kidney problems.
  • have glaucoma. Spiriva HandiHaler may make your glaucoma worse.
  • have an enlarged prostate, problems passing urine, or a blockage in your bladder. Spiriva HandiHaler may make these problems worse.
  • are pregnant or plan to become pregnant. It is not known if Spiriva HandiHaler could harm your unborn baby.

What are the side effects of Spiriva (tiotropium bromide)?

Spiriva HandiHaler can cause serious side effects, including: Allergic reaction. Symptoms may include:

  • raised red patches on your skin (hives)
  • itching
  • rash
  • swelling of the lips, tongue, or throat that may cause difficulty in breathing or swallowing

If you have these symptoms of an allergic reaction, stop taking Spiriva HandiHaler and call your doctor right away or go to the nearest hospital emergency room.

  • Sudden narrowing and blockage of the airways into the lungs (bronchospasm). Your breathing suddenly gets worse.

If you have these symptoms of bronchospasm, stop taking Spiriva HandiHaler and call your doctor right away or go to the nearest hospital emergency room.

  • New or worsened increased pressure in the eyes (acute narrow-angle glaucoma). Symptoms of acute narrow-angle glaucoma may include:

Using only eye drops to treat these symptoms may not work. If you have these symptoms, stop taking Spiriva HandiHaler and call your doctor right away.

If you have these symptoms of urinary retention, stop taking Spiriva HandiHaler and call your doctor right away.

Other side effects with Spiriva HandiHaler include:

These are not all the possible side effects with Spiriva HandiHaler. Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

SLIDESHOW

COPD Foods to Boost Your Health - COPD Diet Tips See Slideshow

What is the dosage of Spiriva (tiotropium bromide)?

For oral inhalation only. Do not swallow Spiriva capsules, as the intended effects on the lungs will not be obtained. The contents of the Spiriva capsules should only be used with the HandiHaler device.

The recommended dose of Spiriva HandiHaler is two inhalations of the powder contents of one Spiriva capsule, once-daily, with the HandiHaler device. Do not take more than one dose in 24 hours.

For administration of Spiriva HandiHaler, a Spiriva capsule is placed into the center chamber of the HandiHaler device. The Spiriva capsule is pierced by pressing and releasing the green piercing button on the side of the HandiHaler device. The tiotropium formulation is dispersed into the air stream when the patient inhales through the mouthpiece.

No dosage adjustment is required for geriatric, hepatically-impaired, or renally-impaired patients. However, patients with moderate to severe renal impairment given Spiriva HandiHaler should be monitored closely for anticholinergic effects.

What drugs interact with Spiriva (tiotropium bromide)?

Sympathomimetics, Methylxanthines, Steroids

Spiriva HandiHaler has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, and oral and inhaled steroids without increases in adverse reactions.

Anticholinergics

There is potential for an additive interaction with concomitantly used anticholinergic medications. Therefore, avoid coadministration of Spiriva HandiHaler with other anticholinergic-containing drugs as this may lead to an increase in anticholinergic adverse effects.

Is Spiriva (tiotropium bromide) safe to use while pregnant or breastfeeding?

Before taking Spiriva HandiHaler, tell your doctor about all your medical conditions, including if you:

  • are pregnant or plan to become pregnant. It is not known if Spiriva HandiHaler could harm your unborn baby.
  • are breast-feeding or plan to breast-feed. It is not known if Spiriva HandiHaler passes into breast milk. You and your doctor will decide if Spiriva HandiHaler is right for you while you breast-feed.
  • have a severe allergy to milk proteins. Ask your doctor if you are not sure.

QUESTION

COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma. See Answer

Summary

Spiriva (tiotropium bromide) is an oral inhalation powder for long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. Spiriva HandiHaler reduces exacerbations in COPD patients and improves lung function for 24 hours. Spiriva HandiHaler is not a rescue medicine and should not be used for treating sudden breathing problems. It is not known if Spiriva HandiHaler is safe and effective in children. Signs of a serious allergic reaction to Spiriva include hives, itching, rash, swelling of the lips, tongue, or throat that may cause difficulty in breathing or swallowing.

Treatment & Diagnosis

Medications & Supplements

Subscribe to MedicineNet's Allergy and Asthma Newsletter

By clicking "Submit," I agree to the MedicineNet Terms and Conditions and Privacy Policy. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time.

Health Solutions From Our Sponsors

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Medically Reviewed on 3/3/2020
References
Article courtesy of the U.S. Food and Drug Administration
CONTINUE SCROLLING FOR RELATED SLIDESHOW