Spiriva: Long-Term COPD Maintenance Therapy for Improved Breathing
Spiriva
| Product dosage: 18 mcg | |||
|---|---|---|---|
| Package (num) | Per cap | Price | Buy |
| 30 | $3.00 | $90.00 (0%) | 🛒 Add to cart |
| 60 | $2.40 | $180.00 $144.00 (20%) | 🛒 Add to cart |
| 120 | $2.17 | $360.00 $261.00 (28%) | 🛒 Add to cart |
| 180 | $2.12 | $540.00 $381.00 (29%) | 🛒 Add to cart |
| 270 | $1.74
Best per cap | $810.00 $470.00 (42%) | 🛒 Add to cart |
Synonyms | |||
Spiriva (tiotropium bromide) is a long-acting muscarinic antagonist (LAMA) bronchodilator 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 not indicated for the initial relief of acute bronchospasm. Administered via the HandiHaler® dry powder inhaler or the Respimat® Soft Mist™ Inhaler, it works by relaxing the muscles around the airways to help keep them open, making breathing easier for patients. This medication is a cornerstone of maintenance therapy, aimed at reducing exacerbations and improving overall lung function and quality of life.
Features
- Contains the active ingredient tiotropium bromide.
- Available in two delivery systems: Spiriva HandiHaler (18 mcg capsule for inhalation) and Spiriva Respimat (2.5 mcg per actuation).
- Long-acting formulation designed for once-daily dosing.
- Mechanism of Action: Functions as a long-acting anticholinergic agent, antagonizing muscarinic M3 receptors in airway smooth muscle.
- The HandiHaler device utilizes a dry powder capsule, while the Respimat delivers a slow-moving, fine mist.
Benefits
- Provides sustained 24-hour bronchodilation to help keep airways open.
- Significantly improves lung function, as measured by FEV1 (Forced Expiratory Volume in 1 second).
- Reduces the risk of COPD exacerbations, which are associated with disease progression and mortality.
- Can decrease breathlessness and improve exercise tolerance.
- Enhances overall health-related quality of life for patients with COPD.
- Offers a convenient once-daily dosing schedule to support treatment adherence.
Common use
Spiriva is prescribed for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD). It is a foundational therapy in the GOLD (Global Initiative for Chronic Obstructive Lung Disease) treatment strategy for managing symptoms and reducing risk in Groups B through D. It is routinely used in patients who continue to experience symptoms despite short-acting bronchodilator therapy.
Dosage and direction
The dosage is dependent on the delivery device. It is crucial to follow the specific instructions provided with the prescribed product and to receive proper training from a healthcare professional on the correct inhalation technique.
- Spiriva HandiHaler: The recommended dosage is the inhalation of the contents of one 18 mcg capsule, once daily, using the HandiHaler device. The capsule must be pierced by the device and is not for oral ingestion.
- Spiriva Respimat: The recommended dosage is two puffs (5 mcg total) once daily, delivered by the Respimat inhaler. Each puff contains 2.5 mcg of tiotropium.
The medication should be taken at the same time each day. It is not for use as a rescue medication for sudden breathing problems.
Precautions
- Inform your healthcare provider of any history of kidney problems, glaucoma, prostate enlargement, or bladder obstruction, as dosage adjustments or special monitoring may be required.
- Immediate hypersensitivity reactions, including angioedema, may occur after administration. Discontinue immediately if such a reaction occurs.
- As an anticholinergic, it may potentially worsen symptoms of narrow-angle glaucoma. Use with caution in patients with this condition.
- May cause paradoxical bronchospasm (wheezing). If this occurs, treatment should be stopped immediately and alternative therapy instituted.
- Patients should be instructed on the absolute necessity of avoiding contact with the eyes, as it can cause pupil dilation and blurred vision, potentially precipitating or aggravating narrow-angle glaucoma.
Contraindications
Spiriva is contraindicated in patients with a known hypersensitivity to tiotropium bromide, atropine or its derivatives, including ipratropium, or any component of the formulation.
Possible side effect
Common side effects may include:
- Dry mouth
- Constipation
- Upper respiratory tract infection
- Pharyngitis (sore throat)
- Sinusitis
- Non-specific chest pain
- Dyspepsia (indigestion)
- Urinary retention (more common in men with pre-existing prostatic hyperplasia)
Less common but serious side effects require immediate medical attention and include:
- Signs of an allergic reaction (hives, difficulty breathing, swelling of the face or throat)
- Worsening narrow-angle glaucoma (eye pain, blurred vision, seeing halos around lights)
- New or worsened urinary retention (difficulty urinating, painful urination)
- Severe paradoxical bronchospasm
Drug interaction
While formal drug interaction studies have not revealed clinically significant interactions, caution is advised due to its anticholinergic effects.
- Concomitant use with other anticholinergic-containing drugs (e.g., ipratropium, aclidinium, glycopyrrolate, certain antidepressants) may potentiate anticholinergic adverse effects.
- Use with sympathomimetic bronchodilators (e.g., beta-agonists like albuterol) may have an additive effect, which is often therapeutically intended in COPD management.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is too close to the time of the next dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not double the dose to make up for a missed one.
Overdose
An overdose is likely to result in exaggerated anticholinergic effects. Symptoms may include:
- Severe dry mouth
- Visual disturbances (blurred vision, mydriasis)
- Tachycardia (fast heart rate)
- Cardiac arrhythmias
- Difficulty urinating
- Constipation
- Central nervous system effects such as nervousness or dizziness Treatment is symptomatic and supportive. In the event of overdose, seek immediate medical attention or contact a Poison Control Center.
Storage
- Store at room temperature (68°F to 77°F or 20°C to 25°C). Excursions are permitted between 59°F and 86°F (15°C and 30°C).
- Spiriva HandiHaler capsules must be stored in the sealed blister package and only removed immediately before use. They are sensitive to moisture and must be protected.
- Keep the Respimat inhaler in the sealed foil pouch until first use. After opening the pouch, use within 3 months.
- Keep all medicines out of the reach of children and pets.
- Do not store in damp or humid places, such as bathrooms.
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 in my COPD management regimen. The once-daily convenience is unmatched, and objective spirometry has shown a consistent and significant improvement in my FEV1 over the past two years. The reduction in exacerbation frequency has been the most notable benefit, allowing for a much more stable disease course.” – Dr. Evan Reid, Pulmonologist
“As a clinical pharmacist specializing in respiratory care, I have observed the profound impact of Spiriva on patient outcomes. Its position in treatment guidelines is well-earned due to its robust efficacy data in improving lung function and reducing exacerbations. Patient education on proper inhaler technique is paramount to achieving these benefits.” – Maria Chen, Pharm.D.
“After being diagnosed with severe emphysema, my quality of life was severely diminished. Incorporating Spiriva Respimat into my daily routine provided a noticeable reduction in my daily breathlessness. I can now engage in activities like walking my dog with considerably less difficulty. The side effect of dry mouth is manageable with increased water intake.” – James W., patient for 4 years.
“The long-acting nature of tiotropium provides a solid foundation for combination therapy in more advanced COPD. Its synergistic effect when paired with a LABA (Long-Acting Beta Agonist) in a single inhaler offers a powerful tool for controlling symptoms and improving survival in our patient population.” – The Respiratory Therapy Journal, 2023 Clinical Review