Spiriva® inhaler for COPD and asthma available online

Seven lifestyle tips to help COPD and asthma symptoms

• See your doctor regularly: Regular doctor visits allow your doctor to carefully manage your treatment plan to minimize flare-ups and side effects. 

• Avoid pollution: Pollutants irritate the airways of your already sensitive lungs. A high-quality HEPA filter can help keep your home's indoor air clean.  

• Quit smoking: Smoking, vaping, or marijuana use can all contribute to inflammation in your lungs. Our doctors can help you with treatment plans to quit smoking.

• Take precautions to prevent the flu: Getting the flu shot every year is imperative. Avoid crowded places during the flu season and practice good hygiene.

• Get the Pneumovax, if recommended: Adults aged 19 to 64 years with predisposing chronic medical conditions, such as chronic lung disease, chronic liver disease, or diabetes mellitus, should talk to their doctor about getting a pneumococcal vaccine.

• Eat a balanced diet: Eating a variety of fruits and vegetables helps reduce lung inflammation by providing various healthy phytochemicals and antioxidants. 

• Make gentle exercise a healthy habit: Regular exercise helps reduce stress and oxygenate your lungs.

Each Spiriva® capsule with the HandiHaler® delivers 18 cg of tiotropium bromide monohydrate, equivalent to 22.5 mcg. Inactive ingredients in the capsule include lactose monohydrate and the gelatin used in the capsule shell. The lactose monohydrate may contain milk protein.

Spiriva® Respimat® is available in two dosage strengths. Each inhalation of the Spiriva® Respimat® delivers 1.25 mcg or 2.5 mcg of tiotropium (equivalent to 1.562 mcg or 3.124 mcg, respectively, of tiotropium bromide monohydrate) from the mouthpiece. Two inhalations equal one dose (2.5 mcg or 5 mcg). Each cartridge of Spiriva® Respimat® lasts for 30 days if used as one inhalation per day.

It is important to note that only a qualified doctor can determine the most appropriate dosage for you. Your doctor will provide you with personalized instructions on how to take your medication. However, there are some general guidelines.

How should I use my Spiriva® HandiHaler®?

1. Capsule preparation: Each Spiriva® strip contains five capsules. For your dose, release one capsule from the strip. Place the Spiriva® capsule into the capsule chamber.

2. Device setup: Close the mouthpiece until you hear it click. Pierce the capsule by pressing the green button.

3. Inhalation: Sit up and breathe out. Place your mouth around the mouthpiece to form a tight seal. Breathe rapidly and deeply until your lungs are full.

4. Hold your breath: Remove the inhaler from your mouth and hold your breath for 10 seconds. Breathe out through your mouth.

5. Repeat for full dose: You must repeat the process (steps 3-5) for the second inhalation (twice for the one capsule to get your entire dose). No need to pierce the capsule again.

6. Discard and close: Open the mouthpiece and discard the used capsule. Close the mouthpiece and then close the lid of the inhaler.

7. Device maintenance: Never wash your HandiHaler® in water. If it is dirty, use a dry cloth to wipe it clean. If you need a new device, consult your doctor or pharmacist.

How to use the Spiriva® Respimat®

1. Device setup: Insert the cartridge into the Respimat® inhaler. Turn the clear base toward the arrows on the label until it clicks (half a turn). Open the cap, then press the dose-release button. Repeat this process three more times to ensure the inhaler is ready for use.

2. Click the base in place: Turn the clear base toward the white arrows on the label until it clicks (half a turn). Open the cap to expose the mouthpiece. Check that the mouthpiece is clean and dry.

3. Exhale: Breathe out slowly and fully, and then close your lips around the end of the mouthpiece without covering the air vents. Tilt your head back slightly.

4. Inhale: While taking a slow, deep breath through your mouth, press the dose-release button and continue breathing slowly. 

5. Hold your breath: Hold your breath for 10 seconds or as long as comfortable, then exhale slowly.

6. Close: Close the cap until you use your inhaler again.

7. Storage: After use, keep the inhaler clean and dry. Store the inhaler with the cap closed. Keep track of the dose indicator on the side of the inhaler to know when the cartridge is nearly empty.

What do I do if I miss a dose of Spiriva®?

It’s important to try to be consistent with Spiriva®. Taking your medication simultaneously every day helps keep a steady amount in your lungs to help manage your symptoms. Setting an alarm on your phone or alarm clock is a great way to help you stay consistent. 

However, if you miss a Spiriva® dose and remember soon after the missed dose, take it as soon as you remember. 

If it's almost time for your next dose, skip the missed dose. Don’t double up to make up for the missed dose, as this can increase your risk of side effects. Just resume your regular schedule.

Do I take Spiriva® in the morning or the night?

Spiriva® (tiotropium) can be taken at any time of day; it's up to you to choose the most convenient time. This ensures a consistent level of the medication in your body, maximizing its effectiveness. Remembering to take your dose at around the same time daily is crucial. By doing so, you optimize the benefits of Spiriva® and can maintain a consistent medication routine.

Can I just stop taking Spiriva®?

Only discontinue your medication or reduce the dosage after consulting your doctor. Abruptly stopping or lowering the dosage can make COPD symptoms worse, so it’s very important to talk to your doctor before making any changes to your medication plan.

Potential withdrawal symptoms: risks of stopping Spiriva® abruptly

While Spiriva® is not known to cause withdrawal symptoms in the traditional sense (like those associated with opioids or benzodiazepines), suddenly stopping the medication can lead to a return or worsening of respiratory symptoms. This can include increased shortness of breath, wheezing, coughing, and a general decline in lung function. For individuals with COPD or asthma, these symptoms can significantly impact their quality of life and ability to carry out daily activities: 

• Breathing problems worsened: The most immediate risk of suddenly stopping Spiriva® is that it gets harder to breathe when your airways get tighter. 

• Severe flare-ups: Your maintenance medications like Spiriva® are prescribed to minimize flare-ups. If you stop taking it, you increase the risk of severe symptoms that may even require hospitalization. 

• Decreased lung function: Ongoing use of Spiriva® is often crucial in maintaining lung function over time. Abruptly stopping the medication can lead to a decline in lung function, which may not be immediately reversible.

• Complications in overall health: Any decline in respiratory function can adversely affect the overall health of patients with COPD, particularly those with severe forms. It can increase the risk of complications, including infections and heart problems.

If you are considering stopping Spiriva®, it's strongly recommended that you consult your physician first. They can assess your current respiratory status and discuss the reasons for your decision. Sometimes, switching medications or adjusting dosage might be appropriate rather than stopping treatment altogether. Your doctor can also monitor your condition and guide you to ensure any transition is as safe and comfortable as possible.

Important drug interactions: what should I avoid while using Spiriva®?

Several medications may interact with Spiriva®, including:

• Anticholinergic medications: Combining Spiriva® with other anticholinergic medications may enhance the risk of side effects.

• Beta-blockers: Beta-blockers can counteract the bronchodilator effects of Spiriva®, potentially reducing its efficacy.

• Diuretics: Certain diuretics may lead to electrolyte imbalances when combined with Spiriva®.

While moderate alcohol consumption may not directly interact with Spiriva®, excessive alcohol intake can exacerbate side effects like dizziness or drowsiness. Always limit alcohol intake and discuss your alcohol consumption with your healthcare provider.

Medications that may be used with Spiriva®

Depending on your long-term treatment plan, your doctor may prescribe other medications that can be used together with Spiriva®, including:

• Long-acting beta-agonists (LABAs) like salmeterol or formoterol are sometimes prescribed alongside Spiriva® to help open the lung airways further. 

• Inhaled corticosteroids (ICS) like fluticasone or budesonide are commonly combined with Spiriva® to help reduce lung inflammation. 

• Combination inhalers like Advair or Symbicort have both an LABA and an ICS. 

Your doctor may also prescribe rescue inhalers like albuterol for quick relief when you suffer a COPD or asthma flare-up.

Contraindications: who should not take Spiriva®?

Your doctor will help you decide if tiotropium is right for you. While this medication is generally well-tolerated, caution is advised for specific groups:

• Pregnant and breastfeeding: The safety of Spiriva® during pregnancy and breastfeeding is not well-established. Consult with your doctor to weigh the potential risks and benefits.

• Elderly: The elderly can generally use Spiriva® safely, but caution should be exercised, especially if pre-existing health conditions exist. It’s essential to regularly monitor and discuss any potential side effects with your doctor.

• Children: Spiriva® is not typically prescribed for children as its pediatric safety and efficacy have not been established.

• Narrow-angle glaucoma: Spiriva® can worsen narrow-angle glaucoma. If you have this condition, carefully monitoring and considering alternative treatments may be necessary.

• Urinary retention issues: Spiriva® may exacerbate urinary retention; it’s important to closely monitor any worsening symptoms. 

• Hypersensitivity reactions to atropine or its derivatives: Spiriva® should be avoided altogether in this case.

Tell your doctor if you have, or have had, any of the following medical conditions:

• High pressure in the eye (glaucoma)

• Kidney/renal problems 

• Liver problems

• Problems with your prostate gland

• Problems with passing urine

• You have suffered from a heart attack during the last 6 months or from any unstable or life-threatening irregular heartbeat or severe heart failure within the past year

Moderate to severe kidney problems can affect your body’s ability to eliminate the drug, making it important to regularly monitor kidney function. It’s important to have a thorough discussion with your doctor about the pros and cons of using Spiriva® in light of any medical conditions, ongoing treatments or medications, and health history.

Overdose symptoms

The risk of overdose with Spiriva® inhaler (tiotropium) is generally low. Potential overdose symptoms include severe dry mouth, blurred vision, difficulty urinating, fast or irregular heart rate, and dizziness. If you notice any severe side effects or if you suspect an overdose, seek medical attention promptly.

In case of accidental overdose, immediately contact your local poison control center or seek emergency medical attention. Provide relevant information about the medication, dosage, and any symptoms observed. If the individual is unconscious or having difficulty breathing, call emergency services immediately.