Generic Name: tiotropium bromide
Brand Names: spiriva 18mcg
Spiriva 18mcg: Important Information
- Spiriva inhalation is not intended for use during acute bronchospastic attacks (sudden onset of breathing difficulty). It may not be able to open your airways and allow you to breathe. Spiriva is used to prevent attacks.
- It is very important that you use the Spiriva inhaler properly so that the medicine gets into the lungs. Talk to your healthcare provider about proper inhaler use.
- In rare cases, Spiriva inhalation has been associated with the development of narrow-angle glaucoma, an eye disorder. Contact your doctor immediately if you develop symptoms suggestive of narrow-angle glaucoma such as eye pain or discomfort, blurred vision, visual halos around objects, color distortion or redness of the eyes.
- Do not allow the powder to come into contact with the eyes. This may cause blurring of vision and dilation of the pupils. If contact with the eyes occurs, flush with water and seek medical attention in case of a side effect.
What is Spiriva
- Spiriva inhalation is an anticholinergic medication. Spiriva prevents narrowing of the airways.
- Spiriva inhalation is used in the treatment of chronic obstructive pulmonary disease (COPD) such as chronic bronchitis and emphysema.
- Spiriva inhalation may also be used for purposes other than those listed in this medication guide.
What to Discuss Before Using Spiriva
- Do not use Spiriva inhalation without first talking to your doctor if you have:
- narrow-angle glaucoma
- enlargement of the prostate or
- difficulty in urinating
- You may not be able to use Spiriva inhalation or you may require a dosage adjustment or special monitoring during treatment if you have either of the conditions listed above.
- Spiriva inhalation is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not use Spiriva inhalation without first talking to your doctor if you are pregnant or could become pregnant during treatment.
- It is not known whether Spiriva passes into breast milk. Do not use Spiriva inhalation without first talking to your doctor if you are breast-feeding a baby.
Spiriva 18mcg Dosage Method
- Use Spiriva inhalation exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse or doctor to explain them to you.
- Spiriva capsules are intended for use in the inhaler provided. Do not swallow the capsules. Do not use the inhaler device to administer any medications other than Spiriva.
- The Spiriva capsules should be stored in the sealed blisters and only removed immediately before use. The drug should be used immediately after the packaging of an individual capsule is opened, else its effectiveness might be reduced. If additional capsules are accidentally exposed to air, they should be thrown away and not be used.
- Separate a blister card along the perforated line. Carefully peel back the aluminum foil using the tab until one capsule is fully visible. Peel back the foil only as far as the "STOP" line printed on the foil, in order to prevent exposure of more than one capsule. After using the first capsule, the 2 remaining capsules in the blister strip should be used over the next 2 consecutive days.
- To use the inhaler:
- Open the dust cap on the inhaler device by pulling it upwards. Next, open the mouthpiece. Insert the capsule in the center chamber. It does not matter which end of the capsule is placed in the chamber. Close the mouthpiece firmly until you hear a click, leaving the dust cap open.
- Hold the inhaler device with the mouthpiece upwards and press the piercing button completely at one go and release. This makes holes in the capsule and allows the medication to be released when you breathe in through the mouthpiece.
- Breathe out fully, away from the mouthpiece. Never breathe into the mouthpiece.
- Raise the inhaler to your mouth and close your lips tightly around the mouthpiece. Keep your head in an upright position and breathe in slowly and deeply but at a rate sufficient to hear the capsule vibrate. Breathe in until your lungs are full. Hold your breath as long as comfortable and at the same time take the inhaler out of your mouth. Resume normal breathing.
- To ensure you get the full dose, breathe out once again. Place the inhaler back in your mouth and breathe in deeply again.
- After completing a dose, open the mouthpiece and tip out the used capsule and dispose. Close the mouthpiece and dust cap for storage of the inhaler.
- Spiriva inhalation is usually used once a day. Follow your doctor's instructions. Do not use more of the medication or use it more often than is directed.
- The Spiriva capsules contain only a small amount of powder and as a result the capsule is only partially filled. After using a dose, you may notice that a tiny amount of the powder is left in the capsule. This is normal.
- It is very important that you use the Spiriva inhaler properly so that the medicine gets into the lungs. Talk to your healthcare provider about proper inhaler use.
- It is important to use Spiriva inhalation regularly to get the most benefit.
- Spiriva inhalation is not intended for use during acute bronchospastic attacks (sudden onset of breathing difficulty). It may not be able to open your airways and allow you to breathe. Spiriva is used to prevent attacks.
- Your doctor may want you to have lung function tests or other medical evaluations during treatment with ipratropium inhalation to monitor progress and side effects.
- Normally, during a one-month period of use, the inhaler device does not need to be cleaned. However, if you want to clean it, then open the dust cap and mouthpiece. Open the base by lifting the piercing button. Rinse the complete inhaler with warm water to remove any powder. Do not use cleaning agents or detergents. Tip out any water and air-dry leaving the dust cap, mouthpiece and base open. It takes about 24 hours to air dry. So if cleaning is needed, do it immediately following a dose so that it will be ready for the next dose. Do not use the inhaler when wet. The outside of the inhaler can be cleaned with damp, not wet, tissue.
- Store Spiriva inhalation at room temperature away from moisture and heat. Store the capsules, unopened, in the blister packaging. Do not store the capsules in the inhaler.
Miss a dose: Problems?
Use the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and use the next one according to your regular schedule. Do not use a double dose of this medication.
Spiriva Overdose?
- Seek emergency medical attention if an overdose is suspected.
- Symptoms of a Spiriva overdose may include altered mental status, shaking, abdominal pain and constipation.
Avoid During Treatment
- Do not allow the powder to come into contact with the eyes. This may cause blurring of vision and dilation of the pupils. If contact with the eyes occurs, flush with water and seek medical attention in case of side effects.
Spiriva Side Effects
- In rare cases, Spiriva inhalation has been associated with the development of narrow-angle glaucoma, an eye disorder. Contact your doctor immediately if you develop symptoms suggestive of narrow-angle glaucoma such as eye pain or discomfort, blurred vision, visual halos around objects, color distortion or redness of the eyes.
- Stop using Spiriva inhalation and seek emergency medical attention or contact your doctor immediately if you experience either of the following serious side effects:
- an allergic reaction (difficulty in breathing closing of the throat swelling of the lips, tongue, face or hives)
- increased breathing difficulty
- Other, less serious side effects may be more likely to occur. Continue to use Spiriva inhalation and talk to your doctor if you experience:
- dry mouth
- constipation
- difficult or painful urination
- increased heart rate.
- Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs to avoid while undergoing Spiriva treatment
- Before using Spiriva inhalation, talk to your doctor if you are taking any of the following medicines:
- ipratropium (Atrovent)
- albuterol and ipratropium (Combivent DuoNeb)
- dicyclomine (Bentyl)
- propantheline (Pro-Banthine)
- mepenzolate (Cantil)
- methscopolamine (Pamine) and
- scopolamine (Transderm-Scop).
- You may not be able to use Spiriva inhalation or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
- Drugs other than those listed here may also interact with Spiriva inhalation and adversely affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines including vitamins, minerals and herbal products.
Spiriva HandiHaler is used for the treatment of breathing problems in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. Spiriva is a maintenance bronchodilator. It helps to keep narrow airways open. Spiriva does not treat sudden episodes of breathing problems (bronchospasm).
Spiriva HandiHaler consists of a capsule dosage form containing a dry powder formulation of SPIRIVA (tiotropium bromide) intended for oral inhalation only with the HandiHaler inhalation device. Each light green, hard gelatin capsule contains 18 mcg tiotropium (equivalent to 22.5 mcg tiotropium bromide monohydrate) blended with lactose monohydrate as the carrier. The dry powder formulation within the capsule is intended for oral inhalation only.
For administration of SPIRIVA 18mcg, a capsule is placed in the center chamber of the HandiHaler device. The capsule is pierced by pressing and releasing the button on the side of the inhalation device. The tiotropium formulation is dispersed into the air stream when the patient inhales through the mouthpiece.
