Spiriva (Tiotropium Bromide) Drug Information: Description, User Reviews, Drug Side Effects, Interactions

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February 9, 2012

Spiriva

Acute Bronchitis »

What is acute bronchitis?

Air is pulled into the lungs when we breathe, initially passing through the mouth, nose, and larynx (voicebox) into the trachea and continues en route to each lung via either the right or left bronchi (the bronchial tree - bronchi, bronchioles, and alveoli). Bronchi are formed as the lower part of the trachea divides into two tubes that lead to the lungs. As the bronchi get farther away from the trachea, each bronchial tube divides and gets smaller (resembling an inverted tree) to provide the air to lung tissue so that it can transfer oxygen to the blood stream and remove carbon dioxide (the waste product of metabolism).

Bronchitis describes inflammation of the bronchial tubes (inflammation = itis). The inflammation causes swelling of the lining of these breathing tubes, narrowing the tubes and promoting secretion of inflammatory fluid.

Acute bronchitis describes the inflammation of the bronchi u...

Read the Acute Bronchitis article »

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SPIRIVA®
HandiHaler® (tiotropium bromide) Inhalation Powder

DRUG DESCRIPTION

SPIRIVA HandiHaler consists of a capsule dosage form containing a dry powder formulation of tiotropium intended for oral inhalation only with the HandiHaler device.

Each light green, hard gelatin SPIRIVA capsule contains 18 mcg tiotropium (equivalent to 22.5 mcg tiotropium bromide monohydrate) blended with lactose monohydrate (which may contain milk proteins) as the carrier.

The dry powder formulation within the SPIRIVA capsule is intended for oral inhalation only.

The active component of SPIRIVA HandiHaler is tiotropium. The drug substance, tiotropium bromide monohydrate, is an anticholinergic with specificity for muscarinic receptors. It is chemically described as (1α, 2β, 4 β, 5α, 7β)-7-[(Hydroxydi-2-thienylacetyl)oxy]-9,9-dimethyl-3-oxa-9-azoniatricyclo[3.3.1.02,4]nonane bromide monohydrate. It is a synthetic, non-chiral, quaternary ammonium compound. Tiotropium bromide is a white or yellowish white powder. It is sparingly soluble in water and soluble in methanol.

The structural formula is:

SPIRIVA® HandiHaler® (tiotropium bromide) Structural Formula Illustration

Tiotropium bromide (monohydrate) has a molecular mass of 490.4 and a molecular formula of C₁₉H₂₂NO₄S₂Br •H₂O.

The HandiHaler device is an inhalation device used to inhale the dry powder contained in the SPIRIVA capsule. The dry powder is delivered from the HandiHaler device at flow rates as low as 20 L/min. Under standardized in vitro testing, the HandiHaler device delivers a mean of 10.4 mcg tiotropium when tested at a flow rate of 39 L/min for 3.1 seconds (2 L total). In a study of 26 adult patients with COPD and severely compromised lung function [mean FEV₁ 1.02 L (range 0.45 to 2.24 L); 37.6% of predicted (range 16% to 65%)], the median peak inspiratory flow (PIF) through the HandiHaler device was 30.0 L/min (range 20.4 to 45.6 L/min). The amount of drug delivered to the lungs will vary depending on patient factors such as inspiratory flow and peak inspiratory flow through the HandiHaler device, which may vary from patient to patient, and may vary with the exposure time of the SPIRIVA capsule outside the blister pack.

What are the possible side effects of tiotropium inhalation (Spiriva)?

Stop using tiotropium inhalation and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

tongue swelling or redness;
sores or white patches of your mouth, lips, or tongue; or
urinating less than usual or not at all.

Less serious side effects may include:

dry mouth, cough,...

Read All Potential Side Effects and See Pictures of Spiriva »

What are the precautions when taking tiotropium bromide (Spiriva)?

Before using tiotropium, tell your doctor or pharmacist if you are allergic to it or to ipratropium; or to atropine or other belladonna-type drugs; or if you have any other allergies. This product may contain inactive ingredients (such as milk proteins), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, glaucoma (narrow-angle), difficulty urinating (for example, due to enlarged prostate).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this...

Read All Potential Precautions of Spiriva »

Last reviewed on RxList: 9/7/2011
This monograph has been modified to include the generic and brand name in many instances.