Spiriva: Long-Term COPD Maintenance Therapy for Improved Breathing
| Product dosage: 18 mcg | |||
|---|---|---|---|
| Package (num) | Per cap | Price | Buy |
| 30 | $3.00 | $90.07 (0%) | 🛒 Add to cart |
| 60 | $2.40 | $180.14 $144.12 (20%) | 🛒 Add to cart |
| 120 | $2.18 | $360.29 $261.21 (27%) | 🛒 Add to cart |
| 180 | $2.12 | $540.43 $381.31 (29%) | 🛒 Add to cart |
| 270 | $1.74
Best per cap | $810.65 $470.38 (42%) | 🛒 Add to cart |
Synonyms | |||
Spiriva (tiotropium bromide) is a long-acting muscarinic antagonist (LAMA) inhalation powder indicated for the long-term, once-daily maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is a cornerstone maintenance therapy designed to improve lung function, reduce exacerbations, and enhance overall quality of life for patients managing this progressive respiratory condition. By targeting the underlying bronchoconstriction, it provides sustained 24-hour bronchodilation, helping patients breathe easier and engage more fully in daily activities.
Features
- Contains tiotropium bromide as the active pharmaceutical ingredient.
- Delivered via the HandiHaler® dry powder inhaler device.
- Provides 24-hour bronchodilation with a single daily dose.
- Available in 18 mcg capsules for inhalation.
- Works as a long-acting muscarinic antagonist (LAMA), blocking acetylcholine receptors in airway smooth muscle.
Benefits
- Sustained Bronchodilation: Provides 24-hour improvement in lung function (FEV1), helping to keep airways open.
- Reduced Exacerbations: Lowers the risk of COPD flare-ups, which can lead to hospitalizations and accelerate disease progression.
- Improved Exercise Tolerance: Enhanced breathing capacity allows for greater physical activity and reduced breathlessness.
- Better Symptom Control: Effectively reduces wheezing, shortness of breath, and chronic coughing.
- Convenient Dosing: A simple, once-daily regimen supports long-term adherence to therapy.
Common use
Spiriva is prescribed for the long-term, maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD). It is not indicated for the initial relief of acute bronchospasm (i.e., a rescue inhaler). It is routinely used to manage symptoms and improve lung function in patients with a confirmed diagnosis of COPD, including those with chronic bronchitis and/or emphysema.
Dosage and direction
The recommended dosage of Spiriva HandiHaler is the inhalation of the contents of one 18 mcg capsule, once daily, at the same time each day. The capsules are for oral inhalation only and must NOT be swallowed.
Directions for Use with the HandiHaler® device:
- Immediately before use, peel back the foil of a single blister to remove one capsule. Do not store removed capsules; use immediately.
- Open the HandiHaler® device by lifting the mouthpiece cover and then pulling the mouthpiece open.
- Place the capsule squarely into the center chamber. Do not place it in the mouthpiece.
- Close the mouthpiece firmly until it clicks, piercing the capsule.
- Exhale fully. Do not exhale into the mouthpiece.
- Tilt head slightly back, place mouthpiece between lips, and close lips to form a firm seal.
- Inhale slowly and deeply at a rate sufficient to hear the capsule vibrate. Hold breath for as long as comfortable (5-10 seconds).
- Exhale away from the device. Repeat Step 7 to ensure full dose is inhaled.
- Open the mouthpiece to remove and discard the empty capsule. Close the mouthpiece and cover.
Precautions
- Not for Acute Use: Spiriva is not a rescue medication and should not be used for the relief of acute bronchospasm. Patients must have a short-acting beta2-agonist available for acute symptoms.
- Paradoxical Bronchospasm: As with any inhaled medicine, Spiriva can cause immediate bronchospasm after administration. If this occurs, it should be discontinued immediately and alternative therapy instituted.
- Cardiovascular Effects: Use with caution in patients with known cardiac arrhythmias, especially tachycardia. Some patients may experience an increase in heart rate.
- Narrow-Angle Glaucoma: Use with extreme caution in patients with narrow-angle glaucoma. Advise patients to consult an ophthalmologist immediately if any visual changes occur.
- Urinary Retention: Use with caution in patients with symptomatic prostatic hyperplasia or bladder-neck obstruction, as anticholinergics may worsen these conditions.
- Renal Impairment: Patients with moderate to severe renal impairment (creatinine clearance ≤ 50 mL/min) should be monitored closely, as tiotropium is primarily renally excreted.
Contraindications
Spiriva is contraindicated in patients with a history of hypersensitivity to tiotropium bromide, atropine or its derivatives, including ipratropium, or to any component of the product formulation.
Possible side effect
The most common adverse reactions (≥3% incidence and greater than placebo) from clinical trials were:
- Dry mouth
- Upper respiratory tract infection
- Pharyngitis
- Sinusitis
- Non-specific chest pain
Other important side effects can include:
- Constipation
- Increased heart rate (tachycardia)
- Urinary retention
- Blurred vision
- Glaucoma (usually associated with powder getting into the eyes)
- Allergic reactions (rash, pruritus, angioedema)
- Paradoxical bronchospasm
Drug interaction
While formal drug interaction studies have not been performed with Spiriva, concomitant use with other anticholinergic-containing drugs (e.g., ipratropium, aclidinium, glycopyrrolate, oxybutynin) is not recommended as it may potentiate anticholinergic adverse effects. As an anticholinergic agent, Spiriva should be used with caution with other drugs that also possess anticholinergic properties, such as antihistamines, tricyclic antidepressants, and antipsychotics.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is not remembered until the next day, the missed dose should be skipped and the regular dosing schedule resumed. Do not double the next dose to make up for a missed one.
Overdose
An overdose of tiotropium bromide by inhalation is unlikely due to its topical administration. However, excessive administration may lead to severe anticholinergic signs and symptoms. These may include:
- Severe dry mouth
- Severe constipation
- Blurred vision and pupillary dilation (mydriasis)
- Tachycardia
- Cardiac arrhythmias
- Difficulty voiding (urinary retention)
Treatment should be symptomatic and supportive. In the case of accidental ingestion (swallowing capsules), other systemic effects may occur.
Storage
- Store Spiriva capsules in the sealed blister package at room temperature (25°C/77°F); excursions permitted between 15°C and 30°C (59°F and 86°F).
- Protect from light and moisture.
- Keep capsules in the blister package until immediately before use.
- Keep out of reach of children.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.
Reviews
“Spiriva has been a game-changer for my moderate COPD. The once-daily routine is simple, and I’ve noticed a significant reduction in my morning shortness of breath. It has given me back the ability to take walks with my dog without constantly worrying about my next breath.” – John D., 68
“As a pulmonologist, I have prescribed Spiriva for over a decade. Its efficacy in improving FEV1 and reducing exacerbation frequency is well-documented in robust clinical trials. It remains a first-line foundational therapy in the GOLD strategy for COPD management. The HandiHaler device is reliable, though proper technique is paramount for drug delivery.” – Dr. Eleanor R., Pulmonologist
“I’ve been on Spiriva for three years. The dry mouth was noticeable at first but has lessened over time. The most important thing for me is that I haven’t had a major flare-up requiring steroids since I started. That alone makes it worth it.” – Maria L., 71