TM Owner Boehringer Ingelheim
Spiriva Respimat 2.5mcg Inhaler
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Indications & Clinical Uses
- Spiriva Respimat (tiotropium bromide) delivers 2.5 mcg of tiotropium per actuation as a fine mist from its own reusable inhaler, and is dosed as two inhalations once daily (5 mcg total).
- It is approved for the long-term, once-daily maintenance treatment of bronchospasm associated with COPD, including chronic bronchitis and emphysema, and to reduce COPD exacerbations, in adults.
- Spiriva Respimat is also approved as a long-term, once-daily add-on maintenance treatment for asthma in patients aged 6 years and older who remain symptomatic despite inhaled corticosteroids, with or without other maintenance therapy - this asthma use does not apply to Spiriva HandiHaler.
- It is not a rescue inhaler for sudden breathlessness; a fast-acting reliever is still needed.
- Because its per-actuation dose (2.5 mcg) is much lower than the HandiHaler capsule (18 mcg), never mix up the two devices or transfer solution between them.
Side Effects
- In COPD trials, the most common effects (over 3%) were sore throat (pharyngitis), cough, dry mouth, and sinusitis; in asthma trials (over 2%), sore throat, bronchitis, headache and sinusitis were most reported.
- No boxed warning appears on the current label.
- As with other anticholinergic inhalers, immediate hypersensitivity reactions including angioedema and, rarely, anaphylaxis can occur - seek urgent care for swelling of the face, lips or throat, or sudden breathing difficulty.
- Paradoxical bronchospasm can also occur immediately after inhaling; if this happens, stop Spiriva Respimat, use your reliever inhaler, and contact your provider.
- Report eye pain, blurred vision, halos around lights, or new difficulty passing urine promptly.
Precautions & Warnings
- Spiriva Respimat is contraindicated in people with known hypersensitivity to tiotropium, atropine or its derivatives.
- Use cautiously in narrow-angle glaucoma, since anticholinergics can raise eye pressure, and in urinary retention or bladder outlet obstruction, since it can worsen difficulty passing urine.
- It is not a rescue treatment for acute symptoms.
- Patients with moderate-to-severe renal impairment have higher drug exposure and should be monitored closely.
- Data in pregnancy and breastfeeding are limited; discuss with your provider before use.
- The cartridge, once inserted into the reusable inhaler, must be discarded 3 months after first use or when the dose indicator locks, whichever comes first, even if some solution remains, to ensure dosing accuracy.
Avoid Interactions
- Avoid combining Spiriva Respimat with other anticholinergic (antimuscarinic) medicines, such as ipratropium, as their effects can add together and increase side effects like dry mouth and urinary retention.
- It is generally compatible with other standard respiratory treatments, including long-acting beta-agonists, inhaled corticosteroids and oral corticosteroids, which are often used alongside it in COPD or asthma management plans.
- Tell your healthcare provider about every medicine, herbal product and supplement you take, especially any other inhaled treatments, so they can check for unintended anticholinergic overlap.
- There are no known food interactions requiring you to avoid particular meals or drinks while using Spiriva Respimat.
References
Frequently Asked Questions
Spiriva Respimat (tiotropium) is a once-daily inhaled spray for long-term maintenance treatment of COPD and, separately, as add-on therapy for asthma in people 6 and older who still have symptoms on inhaled steroids. It's not a rescue inhaler for sudden breathlessness.
Insert the cartridge into the Spiriva Respimat inhaler, then take two inhalations once daily at the same time each day, breathing in slowly as you press the dose-release button. That delivers the full 5 mcg daily dose from 2.5 mcg per puff.
Common Spiriva Respimat side effects include sore throat, cough, dry mouth, and sinusitis. Get urgent help for facial or throat swelling, sudden breathing trouble, or wheeze that gets worse right after inhaling, since these can signal a rare but serious allergic or paradoxical reaction.
Avoid other anticholinergic medicines like ipratropium alongside Spiriva Respimat, since the effects add up. It's usually fine combined with long-acting beta-agonists and inhaled or oral steroids. Tell your provider about every inhaler and medicine you use so they can check for overlap.
Discard the Spiriva Respimat cartridge 3 months after you first use it, or when the dose indicator locks, whichever happens first, even if some solution seems left. The device itself lasts up to 1 year; check the dose counter regularly so you don't run out unexpectedly.
Yes. Unlike Spiriva HandiHaler, Spiriva Respimat is approved as add-on maintenance treatment for asthma in patients aged 6 and older who remain symptomatic on inhaled corticosteroid-based therapy. It is given once daily alongside, not instead of, your regular asthma controller medicine.
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