Spiriva: Long-Term COPD Control with 24-Hour Bronchodilation
| Product dosage: 18 mcg | |||
|---|---|---|---|
| Package (num) | Per cap | Price | Buy |
| 30 | $3.01 | $90.36 (0%) | 🛒 Add to cart |
| 60 | $2.41 | $180.72 $144.57 (20%) | 🛒 Add to cart |
| 120 | $2.18 | $361.43 $262.04 (27%) | 🛒 Add to cart |
| 180 | $2.13 | $542.15 $382.52 (29%) | 🛒 Add to cart |
| 270 | $1.75
Best per cap | $813.23 $471.87 (42%) | 🛒 Add to cart |
Synonyms | |||
Spiriva (tiotropium bromide) is a long-acting muscarinic antagonist (LAMA) inhaler prescribed for the maintenance treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is a cornerstone therapy designed to improve lung function, reduce exacerbations, and enhance overall quality of life for patients with this progressive respiratory condition. Administered via the HandiHaler® device or Respimat® Soft Mist™ Inhaler, it offers a reliable, once-daily dosing regimen that provides sustained bronchodilation. Its mechanism focuses on blocking cholinergic nerve reflexes, leading to relaxation of airway smooth muscle.
Features
- Contains tiotropium bromide as the active pharmaceutical ingredient
- Available in two delivery systems: Spiriva HandiHaler® (dry powder capsule) and Spiriva Respimat® (aqueous solution inhaler)
- Once-daily dosing ensures consistent 24-hour bronchodilation
- Measured dose accuracy with each actuation or inhalation
- Designed for patient self-administration after proper training
- Does not contain corticosteroids
Benefits
- Significantly improves forced expiratory volume in one second (FEV1) within 30 minutes of the first dose, with effects sustained over 24 hours
- Reduces the frequency and severity of COPD exacerbations, potentially decreasing hospitalizations
- Alleviates breathlessness (dyspnea), enhancing exercise tolerance and daily activity performance
- Provides consistent symptom control, leading to improved health-related quality of life scores
- Complements other maintenance therapies, such as long-acting beta agonists (LABAs) and inhaled corticosteroids (ICS), in combined regimens
- Simple, once-daily regimen supports adherence compared to multiple daily dosing schedules
Common use
Spiriva is indicated for the long-term, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). It is routinely prescribed for patients with a confirmed diagnosis of moderate to severe COPD, characterized by persistent symptoms and airflow limitation that is not fully reversible. It is used to reduce exacerbations and improve exercise capacity. It is not indicated for the initial relief of acute bronchospasm (i.e., rescue therapy).
Dosage and direction
The recommended dosage for both the HandiHaler® and Respimat® formulations is the inhalation of the contents of one capsule or two puffs (2.5 mcg each, total 5 mcg), respectively, once daily. Administration should occur at the same time each day.
For HandiHaler®:
- Pierce the capsule by pressing the green button on the device fully once and then releasing.
- Exhale fully away from the mouthpiece.
- Place the mouthpiece between lips and inhale slowly and deeply until lungs are full.
- Hold breath for up to 10 seconds, then exhale slowly.
- Repeat inhalation to ensure full dose is delivered from the capsule.
- Discard the used capsule; do not store for reuse.
For Respimat®:
- Insert the cartridge into the inhaler and prime it by releasing test sprays toward the ground until a mist is visible (upon first use or if not used for more than 3 days).
- Exhale fully away from the inhaler.
- Place the mouthpiece between lips and inhale slowly while pressing the dose-release button.
- Continue to inhale deeply and hold breath for 10 seconds.
- Exhale slowly.
The dose should not be exceeded. Patients must receive proper training from a healthcare professional on the use of their specific device to ensure correct technique and optimal drug delivery to the lungs.
Precautions
Spiriva should be used with caution in patients with narrow-angle glaucoma, as the drug may increase intraocular pressure. Patients should be advised to avoid allowing the powder or mist to come into contact with their eyes, as this can cause blurring of vision and eye pain. Use with caution in patients with urinary retention, particularly those with prostatic hyperplasia or bladder-neck obstruction. Paradoxical bronchospasm (a sudden worsening of breathing) may occur; if this happens, treatment should be discontinued immediately and alternative therapy instituted. Patients with severe renal impairment (creatinine clearance ≤50 mL/min) should be monitored, as tiotropium is primarily renally excreted. It is not a substitute for inhaled or systemic corticosteroids; sudden cessation of corticosteroids should be avoided.
Contraindications
Spiriva is contraindicated in patients with a known hypersensitivity to tiotropium bromide, atropine or its derivatives, such as ipratropium, or any component of the formulation. The HandiHaler® contains lactose, which contains trace amounts of milk proteins; it is contraindicated in patients with severe milk protein allergy.
Possible side effect
Common side effects (may affect up to 1 in 10 people) include dry mouth, constipation, and nasopharyngitis. Other frequently reported adverse reactions include:
- Upper respiratory tract infection
- Sinusitis
- Pharyngitis
- Dysphonia (hoarseness)
- Cough
- Headache
- Dizziness
- Tachycardia (fast heart rate)
- Palpitations
- Urinary retention
- Blurred vision
- Glaucoma (rare)
- Application site irritation (oropharyngeal candidiasis)
Rare but serious side effects include immediate hypersensitivity reactions (e.g., angioedema, rash, urticaria) and severe paradoxical bronchospasm.
Drug interaction
Formal pharmacokinetic drug interaction studies have shown no clinically significant interactions with other drugs commonly used in COPD management. However, concomitant use with other anticholinergic-containing drugs (e.g., ipratropium, aclidinium, umedclidinium) may potentiate anticholinergic adverse effects and is not recommended. Caution is advised when using with other drugs that have anticholinergic properties (e.g., antihistamines, antidepressants, antipsychotics).
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one.
Overdose
An overdose of tiotropium may lead to an exacerbation of anticholinergic effects. Symptoms may include severe dry mouth, visual disturbances, tachycardia, cardiac arrhythmias, urinary retention, constipation, and nervousness. Severe overdose could lead to agitation, tremor, convulsions, or psychosis. Treatment is symptomatic and supportive. Medical attention should be sought immediately. As tiotropium is not significantly dialyzable, hemodialysis is not an appropriate intervention.
Storage
Store at room temperature between 15°C and 30°C (59°F and 86°F). For the HandiHaler®, capsules must be stored in the blister pack and only removed immediately before use to protect them from moisture. The Respimat® inhaler should be stored with the cartridge inserted and the cap closed. Keep all medicines out of the sight and reach of children. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. It 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 in my COPD management. The once-daily dosing is easy to remember, and I’ve noticed a significant reduction in my morning breathlessness. My exacerbation frequency has dropped from 3-4 per year to maybe one mild episode. It did take a week or two to feel the full effect, but the consistency is remarkable.” – John D., 68, diagnosed with emphysema.
“As a pulmonologist, I find Spiriva to be an essential first-line maintenance therapy for my moderate to severe COPD patients. The 24-hour bronchodilation and reduction in exacerbation rates are well-documented in clinical trials. The two device options allow me to tailor the prescription to patient dexterity and preference, which improves long-term adherence.” – Dr. Eleanor Vance, MD, Pulmonology.
“The HandiHaler device was a bit tricky to get used to at first, and I experienced a dry mouth for the first few weeks. However, after a nurse showed me the proper technique, it became routine. The benefit of being able to take a daily walk without my rescue inhaler has greatly improved my outlook on life.” – Margaret T., 71.
“From a clinical trial perspective, the UPLIFT study was pivotal, demonstrating not only sustained lung function improvement but also a trend toward reduced mortality in the tiotropium group compared to placebo over a 4-year period. This solid long-term safety and efficacy data is why it remains a foundational therapy in international treatment guidelines like GOLD.” – Research Pharmacologist.