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Spiriva Respimat Dosing For Asthma

If You Forget To Use It

How to use the Respimat Inhaler

If you forget to use your Spiriva Respimat, use it as soon as you remember.

If it is almost time for your next dose, skip the dose you missed and inhale just one dose at your usual time the next day.

Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

When You Must Not Use It

Do not use Spiriva Respimat if you have an allergy to:

  • any medicine containing tiotropium bromide
  • any of the ingredients listed at the end of this leaflet
  • any medicine containing atropine or its derivatives, e.g. ipratropium or oxitropium
  • any other anticholinergic medicines.

Symptoms of an allergic reaction may include:

  • shortness of breath
  • swelling of the face, lips, tongue or other parts of the body
  • rash, itching or hives on the skin

Do not use Spiriva Respimat to treat an acute asthma attack or sudden attack of breathlessness, wheezing or coughing. You will need a different type of medicine for this.

Do not give Spiriva Respimat to children below the age of 6 years.

Do not use this medicine after the expiry date printed on the inhaler label or carton, or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start using this medicine, talk to your doctor.

What Spiriva Respimat Is Used For

Spiriva Respimat is used to make breathing easier for patients with:

  • chronic obstructive pulmonary disease

When used to treat asthma you should use Spiriva Respimat in addition to other medicines called inhaled corticosteroids.

COPD is a serious lung condition that can cause difficulty in breathing and constant coughing. The term COPD is associated with the conditions chronic bronchitis and emphysema. Spiriva Respimat helps to improve your COPD condition and to prevent exacerbations from occurring.

Asthma is a serious lung condition where the lining of the lungs becomes inflamed , making it difficult to breathe. This may be due to an allergy to house dust mites, smoke or other irritants.

Spiriva Respimat improves breathing by relaxing the breathing tubes or air passages that carry air to and from the lungs.

Spiriva Respimat contains the active ingredient tiotropium bromide monohydrate. It belongs to a group of medicines called anticholinergics.

Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.

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Interactions Between Spiriva And Other Medications

Spiriva may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements that you are currently taking. The list below does not include all possible drug interactions with Spiriva . Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Night and day difference – forgot what it was like to be able to breathe well. Doctor diagnosed COPD, put me on Spiriva, was breathing well in a few days. Was able to do things that would have left me panting for breath just a few days earlier. A fan of Spiriva – hate the cost, but it does what it says it will.

My Spiriva Respimat Doesnt Spray

Spiriva Reviews, Price, Coupons, Where to Buy Spiriva Generic ...

Did you insert a cartridge? If not, insert a cartridge.

Did you repeat Turn, Open, Press less than three times after inserting the cartridge? Repeat Turn, Open, Press three times after inserting the cartridge as shown in the steps 4 to 6 under âPrepare for first useâ.

Is the dose indicator on the Spiriva Respimat pointing to 0? If the dose indicator points to 0, you have used up all your medication and the inhaler is locked.

Once your Spiriva Respimat is assembled, do not remove the clear base or the cartridge. Always insert a new cartridge into a NEW Spiriva Respimat inhaler.

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The Dose Indicator On The Spiriva Respimat Reaches Zero Too Soon

Did you use Spiriva Respimat as indicated ? Spiriva Respimat will last 30 days if used at two puffs once daily.

Did you turn the clear base before you inserted the cartridge? The dose indicator counts each turn of the clear base regardless whether a cartridge has been inserted or not.

Did you spray in the air often to check whether the Spiriva Respimat is working? Once you have prepared Spiriva Respimat, no test-spraying is required if used daily.

Did you insert the cartridge into a used Spiriva Respimat inhaler? Always insert a new cartridge into a NEW Spiriva Respimat inhaler.

Carcinogenesis Mutagenesis Impairment Of Fertility

No evidence of tumorigenicity was observed in a 104-week inhalation study in rats at tiotropium doses up to 59 mcg/kg/day, in an 83-week inhalation study in female mice at doses up to 145 mcg/kg/day, and in a 101-week inhalation study in male mice at doses up to 2 mcg/kg/day. These doses correspond to approximately 30, 40, and 0.5, times the maximum recommended human daily inhalation dose on a mcg/m2 basis, respectively.

Tiotropium bromide demonstrated no evidence of mutagenicity or clastogenicity in the following assays: the bacterial gene mutation assay, the V79 Chinese hamster cell mutagenesis assay, the chromosomal aberration assays in human lymphocytes in vitro and mouse micronucleus formation in vivo, and the unscheduled DNA synthesis in primary rat hepatocytes in vitro assay.

In rats, decreases in the number of corpora lutea and the percentage of implants were noted at inhalation tiotropium doses of 78 mcg/kg/day or greater . No such effects were observed at 9 mcg/kg/day . The fertility index, however, was not affected at inhalation doses up to 1689 mcg/kg/day .

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How To Use Spiriva Respimat Mist Inhaler

Read the Patient Instruction Sheet for directions on the proper use of this medication. If you have any questions, consult your doctor or pharmacist.

Follow the instructions for test sprays in the air if you are using the inhaler for the first time or if you have not used it for more than 3 days or for more than 21 days. Make sure to spray away from the face so that you do not get the medication into your eyes. A slow-moving mist is a sign that the inhaler is working properly.

Inhale this medication by mouth as directed by your doctor, usually 2 sprays once daily. Do not inhale more than 2 sprays in 24 hours.

Avoid getting this medication into your eyes. It may cause eye pain/irritation, temporary blurred vision, and other vision changes. When using the inhaler, put your lips tightly around the mouthpiece.

Rinse your mouth after using the inhaler to prevent dry mouth and throat irritation.

If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Clean the mouthpiece of the inhaler at least once a week as directed.

When this medication is used to treat asthma, it may take 4 to 8 weeks before you get the full benefit of this drug.

My Spiriva Respimat Sprays Automatically

Inhaler device technique: Respimat®

Was the cap open when you turned the clear base? Close the cap, then turn the clear base.

Did you press the dose-release button when turning the clear base? Close the cap, so the dose-release button is covered, then turn the clear base.

Did you stop when turning the clear base before it clicked? Turn the clear base in a continuous movement until it clicks .

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Before You Start To Use It

Tell your doctor or pharmacist if you have allergies to any other medicines, foods, preservatives or dyes.

Tell your doctor if you have, or have had, any of the following medical conditions:

  • high pressure in the eye
  • kidney or liver problems
  • problems with your prostate gland
  • problems with passing urine
  • you have suffered from a heart attack during the last 6 months or from any unstable or life threatening irregular heart beat or severe heart failure within the past year

Tell your doctor if you are pregnant or plan to become pregnant or are breast-feeding. Your doctor can discuss with you the risks and benefits involved. Spiriva is not generally recommended for use in pregnant women.

Do not allow the mist to enter your eyes. Should this occur, immediately flush your eyes with cold tap water for several minutes and immediately consult your doctor for further advice. If the mist enters the eye, it may result in eye pain or discomfort, blurred vision, seeing halos around lights or coloured images in association with red eyes . Eye symptoms may be accompanied by headache, nausea or vomiting.

Use this medicine only with the Respimat device.

Are Spiriva Handihaler Or Spiriva Respimat Used Twice Daily

No, Spiriva HandiHaler and Spiriva Respimat are not used twice daily. Both forms of the drug should be used once per day. But both the Spiriva HandiHaler and Spiriva Respimat will both require two inhalations taken once daily.

Certain other drugs used to treat asthma or chronic obstructive pulmonary disease may be used twice daily, such as Advair Diskus . To learn more about how Spiriva and Advair Diskus are alike and different, check out this article.

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Accessible Drug Containers And Labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:

  • have large print or use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesnt.

How To Use Spiriva Respimat

Spiriva Respimat for Asthma

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.

If you have been prescribed Spiriva Respimat for your asthma it should be added on to your treatments that include an inhaled corticosteroid.

If you do not understand the instructions on the box, ask your doctor or pharmacist for help.

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How Does This Medication Work What Will It Do For Me

Tiotropium belongs to the class of medications called bronchodilators. This medication is used once daily for the long-term relief of symptoms such as shortness of breath and wheezing associated with the lung disease known as chronic obstructive pulmonary disease , which includes chronic bronchitis and emphysema. Tiotropium works by opening the airways to make breathing easier.

Tiotropium is also used to treat asthma in combination with other medications, when your asthma is not well controlled with those medications alone. The other medications include an inhaled corticosteroid and a long-acting beta-agonist .

Tiotropium should not be used as a rescue medication to relieve sudden attacks of COPD or asthma symptoms such as wheezing or shortness of breath. Consult your doctor or pharmacist for advice about rescue medications that are appropriate for you.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Spiriva Respimat Dosage And Administration

To receive the full dose of medication, Spiriva Respimat must be administered as two inhalations once-daily. Do not take more than one dose in 24 hours.

Prior to first use, the Spiriva Respimat cartridge is inserted into the Spiriva Respimat inhaler and the unit is primed. When using the unit for the first time, patients are to actuate the inhaler toward the ground until an aerosol cloud is visible and then repeat the process three more times. The unit is then considered primed and ready for use. If not used for more than 3 days, patients are to actuate the inhaler once to prepare the inhaler for use. If not used for more than 21 days, patients are to actuate the inhaler until an aerosol cloud is visible and then repeat the process three more times to prepare the inhaler for use .

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What Other Drugs Could Interact With This Medication

There may be an interaction between tiotropium and any of the following:

  • narcotic pain relievers
  • thiazide diuretics
  • tricyclic antidepressants

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter , and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source:

Maintenance Treatment Of Chronic Obstructive Pulmonary Disease

How to: Load a new Respimat cartridge

Spiriva Respimat is indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease , including chronic bronchitis and emphysema. Spiriva Respimat is indicated to reduce exacerbations in COPD patients.

Important Limitation of Use:

Spiriva Respimat is NOT indicated for the relief of acute bronchospasm.

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Things To Be Careful Of

Be careful when driving or operating machinery until you know how Spiriva Respimat affects you. This medicine may cause dizziness or blurred vision in some people. If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous.

Pay attention to oral hygiene. Dry mouth which has been observed with anticholinergic treatment may in the long term be associated with tooth decay.

How To Use It

Spiriva Respimat is for inhalation use only.

Make sure that you know how to use your Spiriva Respimat inhaler properly. The instructions for use are provided at the end of this leaflet.

Carefully read the instructions for use and follow the diagrams that show you how to use the Spiriva Respimat inhaler.

If you do not understand the instructions on how to use the Spiriva Respimat inhaler, ask your doctor or pharmacist for help.

Use the Spiriva Respimat inhaler supplied in the pack to breathe in the solution containing the medicine from the Spiriva Respimat cartridge.

Insert the Spiriva Respimat cartridge into the Spiriva Respimat inhaler to prepare the inhaler for first use.

The Spiriva Respimat inhaler releases a mist of solution slowly and gently, making it easy to inhale it into your lungs where it is needed. The mist containing the medication is released by pressing the dose release button.

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What Are The Side Effects Of Spiriva

With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

If You Take More Than The Recommended Amount Of Spiriva

Spiriva respimat cartridges with inhalation solution 2.5 mg/dose 4 ml

Call your doctor right away if you believe youve taken too much of Spiriva. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

The Spiriva dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition youre using Spiriva to treat
  • the form of Spiriva you take

Other medical conditions you have can also affect your Spiriva dosage.

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Spiriva Respimat 25 Microgram Inhalation Solution

This information is intended for use by health professionals

Spiriva Respimat 2.5 microgram, inhalation solution

The delivered dose is 2.5 microgram tiotropium per puff and is equivalent to 3.124 microgram tiotropium bromide monohydrate.

The delivered dose is the dose which is available for the patient after passing the mouthpiece.

Excipient with known effect: This medicine contains 0.0011 mg benzalkonium chloride in each actuation.

For the full list of excipients, see section 6.1.


Tiotropium is indicated as a maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease .


Spiriva Respimat is indicated as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year .


The medicinal product is intended for inhalation use only. The cartridge can only be inserted and used in the Respimat inhaler .

Two puffs from the Respimat inhaler comprise one medicinal dose.

The recommended dose for adults is 5 microgram tiotropium given as two puffs from the Respimat inhaler once daily, at the same time of the day.

The recommended dose should not be exceeded.

In the treatment of asthma the full benefit will be apparent after several doses of the medicinal product. In adult patients with severe asthma, tiotropium should be used in addition to inhaled corticosteroids and at least one controller.




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