Tiotropium inhalation

Tiotropium is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs.

Tiotropium inhalation is used to prevent bronchospasm (narrowing of the airways in the lungs) in adults with COPD (chronic obstructive pulmonary disease), including bronchitis and emphysema.

Tiotropium inhalation is also used to prevent asthma attacks in adults and children who are at least 6 years old.

Tiotropium inhalation may also be used for purposes not listed in this medication guide.

You should not use this medicine if you are allergic to tiotropium or ipratropium (Atrovent, Combivent, DuoNeb).

To make sure this medicine is safe for you, tell your doctor if you have:

• narrow-angle glaucoma;

• kidney disease;

• enlarged prostate or urination problems;

• if you are allergic to milk; or

• if you also take medicine to treat Parkinson's disease, overactive bladder, irritable bowel syndrome, depression, high blood pressure, or muscle spasms.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether tiotropium inhalation passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Tiotropium inhalation is not approved for use by anyone younger than 6 years old.

The usual dose of this medicine is 2 inhalations (puffs) through the mouth once daily. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Tiotropium inhalation is not a rescue medicine. It will not work fast enough to treat a COPD flare-up. Your doctor may prescribe a fast-acting inhalation medicine to treat a bronchospasm attack. Tell your doctor if it seems like your medications don't work as well.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Any child using tiotropium inhalation should be supervised by an adult while using this medicine.

Tiotropium inhalation powder (Spiriva HandiHaler) is packaged in capsules that come with a special inhaler device. Each time you use the medicine, load a capsule into the device and click the mouthpiece closed. Push the button on the side of the device to pierce the capsule and release the medicine into the inhalation chamber. You will need 2 inhalations to get the full dose from 1 capsule.

Do not take the capsule by mouth. Tiotropium capsules are for use only in the HandiHaler device. Use only 1 capsule at a time. Do not use the HandiHaler device to take any other medicine.

Keep each tiotropium capsule in its blister pack until you are ready to place the capsule into the HandiHaler and use the device. Throw away any capsule that is not used right after you have taken it out of the blister pack. Exposure to air can ruin the capsule.

Tiotropium inhalation aerosol (Spiriva Respimat) comes in a cartridge that is inserted into a special inhaler device provided with this medicine. Turning the base of the Respimat device until it clicks will release the medicine into the inhaler chamber. You will need 2 puffs to get a full dose.

The Spiriva Respimat inhaler will lock and cannot be turned after 30 doses (or 60 puffs) have been used. An indicator on the side of the inhaler will show when there are 14 puffs (or 7 days) of medicine left in the cartridge.

To be sure this medicine is helping your condition, your lung function will need to be tested on a regular basis.

Use tiotropium inhalation regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture and heat. Do not freeze.

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Do not use more than 2 inhalations in a 24-hour period.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Maintenance:

Tiotropium inhalation powder, hard capsule:
-18 mcg (2 inhalations) orally once a day using the HandiHaler device

Tiotropium, solution for inhalation:
-5 mcg (2 inhalations) orally once a day

Uses: Long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema; to reduce exacerbations in COPD patients

Usual Adult Dose for Asthma -- Maintenance:

-2.5 mcg (2 inhalations of 1.25 mcg) orally once a day

Comments:
-The maximum benefits in lung function may take up to 4 to 8 weeks of dosing.

Use: Long-term maintenance treatment of asthma

Usual Pediatric Dose for Asthma -- Maintenance:

Less than 12 years: The safety and efficacy have not been established.

12 years or older:
-2.5 mcg (2 inhalations of 1.25 mcg) orally once a day

Comments:
-The maximum benefits in lung function may take up to 4 to 8 weeks of dosing.

Use: Long-term maintenance treatment of asthma