Spiriva HandiHaler

Generic name: Tiotropium bromide

What is Spiriva HandiHaler?

Spiriva is a medicine used for the long-term, once-a-day treatment of bronchial spasms (wheezing) associated with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. It comes as a capsule containing dry powder, which is inhaled through the mouth using the HandiHaler device. When inhaled, Spiriva opens up narrow air passages, allowing more oxygen to reach the lungs.

What is the most important information I should know about Spiriva HandiHaler?

Spiriva is not for initial use in sudden attacks of wheezing when fast action is needed. (Spiriva is not for "rescue therapy.")

An immediate allergic reaction (hives, swelling, or rash) is possible when you first use Spiriva HandiHaler. Inhaled medications such as Spiriva can also cause wheezing in some people. If you have an allergic reaction or you start wheezing, stop using Spiriva and contact your doctor.

Who should not take Spiriva HandiHaler?

You should not take Spiriva if you have an allergic reaction to it, or if you are allergic to atropine or any of its derivatives, including ipratropium.

What should I tell my doctor before I take the first dose of Spiriva HandiHaler?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Spiriva. Also, talk to your doctor about your complete medical history, especially if you have narrow angle glaucoma (high pressure inside the eye), an enlarged prostate, obstruction in the neck of the bladder, or kidney problems.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The recommended dose is the inhalation of the contents of one capsule, taken once a day, with the HandiHaler device.

Children: Spiriva has not been studied in children.

How should I take Spiriva HandiHaler?

Spiriva capsules are designed to be used only with the HandiHaler inhalation device. The capsules should not be swallowed. You should try to use the inhaler about the same time each day.

When removing a capsule from the blister card, peel back only the foil that is covering the capsule you are about to use. The capsule's effectiveness may be reduced if it is not used immediately after the foil is opened. If you accidentally remove the foil covering any of the other capsules, you must throw them away.

When you're ready to take the medication, use the HandiHaler device as follows:

1. Open the dust cap, and then open the mouthpiece.

2. Place the capsule in the center chamber. Close the mouthpiece until you hear a click. Leave the dust cap open.

3. Hold the HandiHaler device with the mouthpiece upward and press the piercing button that will make holes in the capsule to allow the powder to come out.

4. Before inhaling the powder, breathe out completely, but not into the mouthpiece.

5. Place the inhaler's mouthpiece in your mouth, make a seal with your lips, keep your head upright, and breathe in slowly and deeply with your mouth. Breathe in quickly enough that you hear the capsule vibrate.

6. Hold your breath for as long as is comfortable; at the same time, remove the HandiHaler from your mouth. Resume normal breathing.

7. When you're done, breathe out completely. Seal your lips around the mouthpiece again, and inhale a second time as before.

8. Remove the capsule from the inhaler and discard. A tiny amount of powder may still be left in the capsule; this is normal.

What should I avoid while taking Spiriva HandiHaler?

Avoid getting the Spiriva powder into your eyes. It may cause blurred vision.

Spiriva is for oral inhalation only. Do not swallow Spiriva capsules.

What are possible food and drug interactions associated with Spiriva HandiHaler?

The use of Spiriva together with other anticholinergic drugs has not been studied and is not recommended.

What are the possible side effects of Spiriva HandiHaler?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: Abdominal pain, constipation, dry mouth, chest pain, common cold, indigestion, infection, muscle pain, nose bleeds, rash, runny nose or nasal inflammation, sinus infection, sore throat, swelling, urinary tract infection, vomiting, yeast infection

Can I receive Spiriva HandiHaler if I am pregnant or breastfeeding?

The effects of Spiriva during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Spiriva HandiHaler?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at once.

How should I store Spiriva HandiHaler?

Store at room temperature. Do not store capsules in the HandiHaler. Keep capsules away from moisture and extreme temperatures, such as in the refrigerator or in direct sunlight.