Spiriva: Long-Term COPD Control and Bronchodilation Therapy
| Product dosage: 18 mcg | |||
|---|---|---|---|
| Package (num) | Per cap | Price | Buy |
| 30 | $2.58 | $77.40 (0%) | 🛒 Add to cart |
| 60 | $2.06 | $154.80 $123.84 (20%) | 🛒 Add to cart |
| 120 | $1.87 | $309.60 $224.46 (28%) | 🛒 Add to cart |
| 180 | $1.82 | $464.40 $327.66 (29%) | 🛒 Add to cart |
| 270 | $1.50
Best per cap | $696.60 $404.20 (42%) | 🛒 Add to cart |
Synonyms | |||
Spiriva (tiotropium bromide) is a long-acting muscarinic antagonist (LAMA) inhaler prescribed for the 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. By targeting airway smooth muscle M3 receptors, it induces sustained bronchodilation, reduces dynamic hyperinflation, and improves lung function over 24 hours with once-daily dosing. Clinical evidence supports its role in decreasing exacerbation frequency and improving health-related quality of life in appropriate patient populations.
Features
- Contains tiotropium bromide as the active pharmaceutical ingredient
- Delivered via the HandiHaler® dry powder inhaler device or Respimat® Soft Mist™ Inhaler
- Provides 24-hour bronchodilation with a single daily dose
- Available in 18 mcg per capsule (HandiHaler) or 2.5 mcg per puff (Respimat) formulations
- Anticholinergic mechanism selectively inhibits muscarinic receptors M1 and M3
Benefits
- Sustained improvement in forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC)
- Reduction in COPD exacerbation rates and related hospitalizations
- Decreased dyspnea and improved exercise tolerance
- Enhanced quality of life through better symptom control
- Convenient once-daily dosing supports adherence
- Long-term lung function preservation in maintenance therapy
Common use
Spiriva is indicated for the long-term, once-daily maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). It is used in patients with a confirmed diagnosis of COPD, including those with chronic bronchitis and/or emphysema, to improve lung function, reduce symptoms, and decrease the frequency of exacerbations. It is not a rescue medication and should not be used for the immediate relief of acute breathing problems.
Dosage and direction
The recommended dose for Spiriva HandiHaler is the inhalation of the contents of one 18 mcg capsule once daily, using the HandiHaler device. For Spiriva Respimat, the dose is two puffs (5 mcg total) once daily. Administration should occur at the same time each day. Capsules must not be swallowed and are for oral inhalation only. Patients should be trained on proper inhaler technique to ensure optimal drug delivery to the lungs. Rinsing the mouth after inhalation is advised to reduce the risk of anticholinergic side effects.
Precautions
Spiriva should be used with caution in patients with narrow-angle glaucoma, urinary retention, or renal impairment (creatinine clearance ≤50 mL/min). Immediate medical attention should be sought if signs of acute narrow-angle glaucoma (eye pain, blurred vision, visual halos) or urinary retention develop. Paradoxical bronchospasm may occur; if it does, treatment should be discontinued immediately. Patients with severe hypersensitivity to milk proteins should avoid the HandiHaler formulation. Avoid contact with the eyes.
Contraindications
Spiriva is contraindicated in patients with a history of hypersensitivity to tiotropium, ipratropium, or any component of the formulation. The HandiHaler formulation is contraindicated in patients with severe milk protein allergy. It should not be used for the initial treatment of acute episodes of bronchospasm.
Possible side effect
Common adverse reactions (≥3% incidence) include dry mouth, sinusitis, pharyngitis, non-specific chest pain, and urinary tract infection. Less frequently, patients may experience constipation, dyspepsia, vomiting, stomatitis, tachycardia, palpitations, blurred vision, glaucoma, urinary retention, and allergic reactions. Paradoxical bronchospasm, angioedema, and immediate hypersensitivity reactions have been reported rarely.
Drug interaction
No clinically significant pharmacokinetic drug interactions have been observed. However, concomitant use with other anticholinergic-containing drugs (e.g., ipratropium, aclidinium) may potentiate adverse effects and is not recommended. Caution is advised when using with other medications that have 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 nearly time for the next dose, the missed dose should be skipped. Patients should not double the dose to make up for a missed one. Consistency in daily dosing is important for maintaining therapeutic effect.
Overdose
Overdose may lead to anticholinergic symptoms such as dry mouth, visual disturbances, tachycardia, urinary retention, and constipation. Severe overdose could potentially result in cardiac effects. Treatment is symptomatic and supportive. There is no specific antidote. Dialysis is not appropriate due to high protein binding and extensive tissue distribution of tiotropium.
Storage
Store at room temperature (15–30°C or 59–86°F) in a dry place. Keep capsules in the blister pack and only remove immediately before use. Protect from moisture and light. The HandiHaler device should be kept clean and dry. Keep out of reach of children and pets. Do not store in bathrooms or damp areas. Do not puncture or incinerate the canister (Respimat) or capsules.
Disclaimer
This information is for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations. Do not initiate or discontinue medication without medical supervision. Individual responses to therapy may vary.
Reviews
Clinical trials and real-world evidence consistently demonstrate Spiriva’s efficacy in improving lung function, reducing exacerbations, and enhancing quality of life in COPD patients. In the 4-year UPLIFT trial, Spiriva showed sustained bronchodilation and a reduction in exacerbation frequency compared to placebo. Many pulmonologists regard it as a cornerstone maintenance therapy in moderate to severe COPD. Some patients report dry mouth as a tolerable side effect given the clinical benefits. Adherence is generally high due to once-daily dosing.