Tiotropium, Inhalation Powder

Medically reviewed by University of Illinois-Chicago, Drug Information Group on May 3, 2017Written by University of Illinois-Chicago, Drug Information Group

Highlights for tiotropium

  1. Tiotropium inhalation powder is available as a brand-name drug. It’s not available as a generic drug. Brand name: Spiriva.
  2. Tiotropium comes in two forms: inhalation powder and inhalation spray.
  3. Tiotropium inhalation powder is used to treat chronic obstructive pulmonary disease (COPD).

Important warnings

  • Worsened shortness of breath warning: Inhaled medications like this drug can unexpectedly worsen shortness of breath. It can also lead to new breathing problems. If this occurs, call your doctor and stop using this drug.
  • Eye damage warning: This drug can damage your eyes. Call your doctor if you have any of the following eye problems while taking this drug:
    • eye pain or discomfort
    • blurred vision
    • seeing halos or colored images
  • Urinary retention warning: This drug can cause you to retain urine. Call your doctor if you have trouble passing urine, or if you have pain when you urinate.
  • Dizziness warning: This drug can cause dizziness. Use extreme caution when driving a vehicle or using machinery if you take this drug.

What is tiotropium?

Tiotropium is a prescription drug. It comes as an inhalation powder or inhalation spray.

Tiotropium inhalation powder is available as the brand-name drug Spiriva. It’s not available as a generic drug. The powder comes in a capsule that you inhale using a special device called a HandiHaler.

Tiotropium inhalation powder may be used as part of combination therapy. This means you may need to take it with other drugs.

Why it's used

Tiotropium inhalation powder is used for long-term treatment of chronic obstructive pulmonary disease (COPD). It’s used to reduce disease flare-ups.

Tiotropium inhalation powder should not be used for immediate treatment of shortness of breath or other breathing problems.

How it works

Tiotropium inhalation powder belongs to a class of drugs called inhaled anticholinergic medications. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Tiotropium inhalation powder relaxes the muscles of your lungs. This helps to decrease and prevent shortness of breath.

Tiotropium side effects

Tiotropium inhalation powder does not make you tired. However, it can make you dizzy. It can also cause other side effects.

More common side effects

Some of the more common side effects that can occur with use of tiotropium include:

  • dry mouth
  • sore throat
  • cough
  • sinus problems
  • constipation
  • fast heart rate
  • blurred vision or vision changes
  • pain with urination

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Sudden shortness of breath that may be life-threatening
  • Eye damage. Symptoms can include:
    • eye pain or discomfort
    • blurred vision
    • halos
    • red eyes
    • seeing colored images
  • Urine problems. Symptoms can include:
    • pain while urinating
    • trouble urinating

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Tiotropium may interact with other medications

Tiotropium inhalation powder can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with tiotropium are listed below.

Other anticholinergic drugs

The risk of side effects may be increased when tiotropium is used with other anticholinergic medications. Do not use tiotropium with other anticholinergic drugs. Examples of these drugs include:

  • diphenhydramine
  • benztropine
  • clomipramine
  • olanzapine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Tiotropium warnings

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

  • itching
  • swelling of the lips, tongue, or throat
  • rash
  • trouble breathing

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death). Also, do not take this drug if you have had an allergic reaction to ipratropium. And use extreme caution if you have had an allergic reaction to atropine or milk proteins. The powder for inhalation contains lactose, which may contain milk proteins.

Warnings for people with certain health conditions

For people with kidney disease: If you have kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects.

For people with narrow-angle glaucoma: This drug may worsen your condition. Talk to your doctor about whether this drug is safe for you.

For people with enlarged prostate or bladder obstruction: This drug can cause urinary retention. If you have increased problems urinating while taking this drug, call your doctor right away.

Warnings for other groups

For pregnant women: This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: This drug may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

How to take tiotropium

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Dosage for chronic obstructive pulmonary disease

Brand: Spiriva

  • Form: Capsules with powder for oral inhalation, to be used with the HandiHaler device
  • Strength: Each capsule contains 18 micrograms of medication.

Adult dosage (ages 18 years and older)

  • Take two inhalations of the powder contents of a single capsule once per day.
  • Do not take more than 2 inhalations in 24 hours.

Child dosage (ages 0–17 years)

It has not been confirmed that tiotropium is safe and effective for use in children with COPD who are younger than 17 years old.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

Take as directed

Tiotropium inhalation powder is used for long-term treatment. It should not be used as immediate treatment for shortness of breath or other breathing problems. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: You may have worsened shortness of breath or other breathing problems.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You should have less shortness of breath or other breathing problems.

Important considerations for taking tiotropium

Keep these considerations in mind if your doctor prescribes tiotropium for you.

General

  • Do not cut, crush, or open the capsule. It can only be used with the HandiHaler device.

Storage

  • Store the capsules at 77°F (25°C). They can be kept in temperatures of 59°F and 86°F (15°C and 30°C) for very short periods.
  • Do not store this medication in moist or damp areas, such as bathrooms.
  • The capsules should be stored in the blister package they come in and removed just before you use them. Do not store the capsules inside the HandiHaler device.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Tiotropium inhalation powder comes in a capsule. Do not swallow the capsule. You place the capsule in a special inhaling device called a HandiHaler. This device allows you to inhale the powder through your mouth.

Your doctor will show you how to use your inhaler. You should also read the instructions that come with your prescription so that you know how to use your device.

Clinical monitoring

While you take this drug, your doctor will periodically ask you questions. They’ll check in with you about your shortness of breath and your ability to tolerate exercise and other physical activities of your daily life.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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 other healthcare professional before taking any medication. The drug information contained here in 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.

CMS Id: 139184