Stiolto Respimat (tiotropium bromide/olodaterol) is a prescription drug that’s used to treat chronic obstructive pulmonary disease (COPD). It comes with an inhaler for breathing the drug into your lungs. You take it once per day.

Stiolto Respimat is used in adults to treat COPD.

The active ingredients in Stiolto Respimat are tiotropium bromide and olodaterol. (An active ingredient is what makes a drug work.)

Tiotropium bromide belongs to a group of drugs called long-acting anticholinergics. Olodaterol belongs to a group of drugs called long-acting beta2 adrenergic agonists.

This article describes the dosage of Stiolto Respimat, as well as its strength and how to take it. To learn more about Stiolto Respimat, see this in-depth article.

This section describes the usual dosages of Stiolto Respimat. A puff is one inhalation of the drug through the inhaler device. Keep reading to learn more.

What is Stiolto Respimat’s form?

Stiolto Respimat consists of a cartridge (cylinder) that you use with an inhaler device. Respimat is the name of the device. One spray of the device delivers one puff of the drug in an aerosol mist that you breathe in.

What strength does Stiolto Respimat come in?

Stiolto Respimat comes in one strength of 2.5 micrograms (mcg) tiotropium bromide and 2.5 mcg olodaterol per puff.

What is the usual dosage of Stiolto Respimat?

The information below describes the dosage that is commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for chronic obstructive pulmonary disease

The typical Stiolto Respimat dosage for adults with COPD is 2 puffs once per day. You’ll take this dosage at the same time every day. This is also the maximum recommended dosage.

Stiolto Respimat is not taken for treating sudden breathing problems. For this purpose, your doctor will likely prescribe a rescue inhaler such as albuterol.

Is Stiolto Respimat taken long term?

Yes, Stiolto Respimat is usually a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.

The dosage of Stiolto Respimat your doctor prescribes may depend on several factors. These include:

  • the type and severity of the condition the drug is treating
  • your age
  • other conditions you may have

If you have a COPD flare-up, your doctor will likely wait until you’ve recovered before starting Stiolto Respimat.

If you have moderate to severe kidney problems, you may be at higher risk of side effects.

Conditions that could worsen

Stiolto Respimat may worsen certain other conditions. This includes:

Conditions that could develop

You may develop the following conditions while taking Stiolto Respimat, or these conditions could worsen with the use of Stiolto Respimat:

Side effects

If you develop the following side effects while taking Stiolto Respimat, your doctor likely will stop the drug:

  • an allergic reaction, including a rash or tongue swelling
  • sudden tightening of your airways after taking a dose, possibly making it hard to breathe

Other medications

If you take certain medications, your doctor may prescribe Stiolto Respimat more cautiously or have you avoid taking the drug.

For example, if you take an oral beta-blocker, your doctor may prescribe Stiolto Respimat only if absolutely necessary. Examples of oral beta-blockers are metoprolol and propranolol.

If you take another anticholinergic medication, your doctor may choose another drug to manage COPD. (Stiolto Respimat is an anticholinergic drug.) Examples of other anticholinergic medications are benztropine and oxybutynin.

Stiolto Respimat consists of a cartridge (or cylinder) that you use with an inhaler device. When you spray the device (one puff), it delivers the drug in a mist. You breathe the mist into your lungs.

You’ll take 2 puffs once per day, at the same time every day.

Each time you refill your prescription, you’ll need to place the cartridge into the device before using it. You’ll also need to prime the inhaler device before you first use each one.

Your healthcare professional will teach you how to take Stiolto Respimat. You can also see the drugmaker’s website for a detailed instructional video and a quick-start guide.

Using Stiolto Respimat

The drug’s prescribing information has the following step-by-step instructions:

  1. Keeping the cap closed, turn the clear base in the direction of the arrows. Stop when you hear a click at half a turn.
  2. Open the cap completely.
  3. Breathe out fully and then close your lips around the mouthpiece. (Do not cover the air vents. Keep the inhaler level, and point it to the back of your throat.)
  4. Take a slow, deep breath as you press the dose-release button.
  5. Hold your breath for 10 seconds or as long as it’s comfortable.
  6. For your second puff, repeat steps 1–5.
  7. Close the cap.

If you still have questions about taking Stiolto Respimat, talk with your doctor or pharmacist.

Stiolto Respimat is for maintenance treatment of COPD but not for sudden breathing problems. It’s likely that your doctor also will prescribe a rescue inhaler for sudden breathing problems.

Seek medical attention if you feel your breathing problems are severe or need immediate attention. Call 911 or go to your nearest emergency room.

For information on the expiration, storage, and disposal of Stiolto Respimat, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • 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 doesn’t.

If you miss a dose of Stiolto Respimat, take it as soon as you remember. But do not take more than one dose (2 puffs or sprays) in 24 hours. If you’re not sure whether you should take a missed dose, talk with your doctor or pharmacist.

If you need help remembering to take your dose of Stiolto Respimat on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not take more Stiolto Respimat than your doctor prescribes, as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

In extreme cases or if untreated, overdose can lead to death.

What to do in case you take too much Stiolto Respimat

Call your doctor right away if you think you’ve taken too much Stiolto Respimat. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Stiolto Respimat’s dosage.

Can Stiolto Respimat be taken for asthma? If so, what’s the dosage?

No, Stiolto Respimat is not taken for asthma. Stiolto Respimat contains two active ingredients: tiotropium bromide and olodaterol. Olodaterol has been linked to an increased risk of serious health problems when taken by itself for asthma. This can even be fatal.

Because Stiolto Respimat isn’t taken for asthma, the drugmaker doesn’t provide recommended dosages for this use.

Still, numerous treatments are available for asthma. A drug called Spiriva Respimat is used for COPD and asthma in adults. It contains tiotropium bromide, which is an active ingredient in Stiolto Respimat. But Spiriva Respimat contains only that one active ingredient, while Stiolto Respimat contains two.

To learn more about treatment options for asthma, talk with your doctor. They can tell you more about how they’re taken and their dosages.

Is Stiolto Respimat’s dosage similar to the dosages of similar drugs, such as Symbicort or Anoro?

The forms and how often you take each of these drugs may be similar.

Stiolto Respimat (tiotropium bromide/olodaterol) delivers medication to your lungs with its inhaler device. Similarly, Symbicort (budesonide/formoterol) and Anoro Ellipta (umeclidinium/vilanterol) are inhaler devices that deliver medication to your lungs.

Symbicort contains budesonide, which is a steroid. Stiolto Respimat and Anoro Ellipta do not contain a steroid.

Stiolto Respimat and Anoro Ellipta are not approved to treat asthma, but Symbicort is. The dose in micrograms for each of the three drugs differs.

You usually take Stiolto Respimat and Anoro Ellipta once per day. But the usual dose of Stiolto Respimat is 2 puffs, while the usual dose of Anoro Ellipta is 1 puff. The usual dosage of Symbicort is 2 puffs two times per day.

Your doctor will prescribe the drug and the dosage that’s right for you. They can also tell you more about how these drugs compare.

The sections above describe the usual dosage provided by the drugmaker. If your doctor recommends Stiolto Respimat for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Stiolto Respimat without your doctor’s recommendation. Only take Stiolto Respimat exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Can you reduce my dosage of Stiolto Respimat to 1 puff once per day if that manages my symptoms?
  • Can I use a spacer with Stiolto Respimat if I have difficulty taking inhaled medications?
  • Do I need to rinse my mouth after I take a dose of Stiolto Respimat?

To learn more about Stiolto Respimat, see the “Stiolto Respimat (tiotropium bromide/olodaterol)” article.

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.