Make sure you know how to use the inhaler device properly. Ask your nurse, doctor or pharmacist to show you, if you are unsure.
Use the inhaler once each day.
The most common side-effect is a dry mouth.
|Type of medicine||An antimuscarinic bronchodilator|
|Used for||Chronic obstructive pulmonary disease (COPD), severe asthma|
|Also called||Braltus®; Spiriva®; Spiolto® (a combination inhaler of tiotropium with olodaterol)|
|Available as||An inhaler device for dry powder capsules; and a metered dose inhaler (called a Respimat®)|
Tiotropium belongs to the group of medicines known as antimuscarinic bronchodilators. It is given to improve the airflow to your lungs. It works by opening up the air passages in your lungs so that air can flow into your lungs more freely.
Tiotropium can be helpful in relieving symptoms of chronic obstructive pulmonary disease (COPD). In this condition, the airflow to the lungs is restricted and this causes symptoms such as cough, wheeze, and breathlessness. You will have been prescribed tiotropium to help reduce these symptoms. It is long-acting, which means that its effects last for 24 hours, so you only need to use it once each day. It is not a rescue treatment for sudden breathlessness.
Tiotropium is also available in a combination with another medicine used to ease the symptoms of COPD, called olodaterol. The brand name of this combination inhaler is Spiolto®.
Some tiotropium inhaler devices can be used for the management of severe asthma in adults and children aged 6 years or older. Your doctor will advise you if tiotropium is being used in this way.
Tiotropium inhaler devices are usually green-coloured.
Before using tiotropium
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using tiotropium it is important that your doctor knows:
- If you have problems with your kidneys or prostate gland, or if you have any difficulty passing urine.
- If you have increased pressure in your eyes (glaucoma).
- If you are pregnant or breastfeeding.
- If you are taking or using any other medicines or inhalers. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to use tiotropium
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about tiotropium, diagrams to remind you how to use the inhaler device, and a full list of side-effects which you may experience.
- Follow your doctor's instructions carefully and make sure you know how to use the inhaler device properly. There are two types of tiotropium inhaler device - one which uses a cartridge containing a liquid and one which uses capsules containing powder. If you are not sure how to use the device you have been given, please ask your nurse, doctor or pharmacist to show you what to do.
- Use your inhaler device once each day. (If you are using the Spiriva® Respimat inhaler, you will need to take two puffs.) Try to use the inhaler at the same time each day, as this will help you to remember to use it regularly. If you do forget at your usual time, use it as soon as you remember. If you do not remember until the following day, leave out the missed dose - do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Treatment with tiotropium is usually long-term so you should continue to use it unless you are advised otherwise by your doctor. If you are currently using any other inhalers or nebulisers to help your breathing, please discuss with your doctor if there are any of these that you should no longer use. This is because you should not use any other antimuscarinic bronchodilator as well as tiotropium.
- Try to keep your regular appointments with your doctor. This is so your doctor can review your condition on a regular basis.
- If you find that your symptoms are getting worse or that you need to use a reliever inhaler more regularly, contact your doctor or nurse for advice straightaway.
- COPD is usually caused by smoking, so the most important treatment is to stop smoking. Smoking causes irritation and damage to the lungs and will make your condition worse. Speak with your doctor or practice nurse for further advice if you are having difficulty in stopping smoking.
- People with COPD who exercise regularly, tend to have improved breathing and a better quality of life. If you are not used to exercise, a daily walk is a good start if you are able to do this. Speak with your doctor about what level of activity will help your breathing and keep you as fit as possible.
- If you are overweight, it may help your breathing if you try to lose weight. This is because being overweight means that you have to work much harder to breathe in to inflate your lungs. A dietician will be able to give you advice on how to eat a healthy diet and lose weight.
- Remember to arrange to have your yearly 'flu jabs' each autumn. This will help protect you against influenza and any chest infections that develop due to it.
Can tiotropium cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with tiotropium. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common tiotropium side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Less common side-effects: headache, changes to the way things taste, blurred vision, throat irritation, acid reflux, oral thrush, rash, difficulties passing urine||If any become troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to the inhaler, please speak with your doctor or pharmacist for further advice.
How to store tiotropium
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never use more than the prescribed dose. If you suspect that you or someone else might have had an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Spiriva® 18 microgram inhalation powder, hard capsule; Boehringer Ingelheim Limited, The electronic Medicines Compendium. Dated December 2016.
Manufacturer's PIL, Spiriva® Respimat 2.5 microgram, solution for inhalation; Boehringer Ingelheim Limited, The electronic Medicines Compendium. Dated March 2018.
British National Formulary, 75th Edition (Mar 2018); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.