SPIRIVA (Tiotropium) Inhalation Powder contains tiotropium bromide monohydrate. Tiotropium bromide monohydrate is used as a long-acting bronchodilator for the maintenance treatment of chronic obstructive pulmonary disease (COPD). SPIRIVA (Tiotropium) , a once-daily treatment, has proven more effective in clinical trials than Boehringer's Atrovent, an inhaled drug given three times a day that has been the standard of care for COPD for over a decade. Both medicines help open the airways by blocking action of the brain messenger chemical acetylcholine. Capsules comes with Handinhaler. Each SPIRIVA (Tiotropium) capsule contains 22.5 microgram tiotropium bromide monohydrate equivalent to 18 microgram tiotropium. The delivered dose of SPIRIVA (Tiotropium)(the SPIRIVA (Tiotropium) dose that leaves the mouthpiece of the HandiHaler device) is 10 microgram. SPIRIVA (Tiotropium) consists of a dry powder for inhalation. The active ingreidiant in SPIRIVA (Tiotropium) is tiotropium bromide 18mcg intended for oral inhalation using the Handihaler Device. The dry powder or capsule is not intended for oral consumption. The dry powder is delivered from the Handihaler device at a rate of 20L/min. The SPIRIVA (Tiotropium) capsules are light green hard capsules, containing a white or yellowish white powder, with product code and company logo printed on the capsule. The typical shelf life of SPIRIVA (Tiotropium) is 18 months. However, the typical shelf life of an opened SPIRIVA (Tiotropium) capsule is 9 days. Clean the HandiHaler once a month. Open the dust cap and mouthpiece. Then open the base by lifting the piercing button. Rinse the complete SPIRIVA (Tiotropium) inhaler with warm water to remove any powder. Dry the HandiHaler thoroughly by tipping excess of water out on a paper towel and air-dry afterwards, leaving the dust cap, mouthpiece and base open. It takes 24 hours to air dry, so clean SPIRIVA (Tiotropium) right after you used it and SPIRIVA (Tiotropium) will be ready for your next dose of SPIRIVA (Tiotropium). If needed, the outside of the mouthpiece may be cleaned with a moist but not wet tissue.
Candrug.com supplies only genuine Spiriva from both the Turkey and Canada shipped using either Turkish or Canadian packaging. This Spiriva is manufactured by Boehringer Ingelheim Pharmaceuticals, Inc the worldwide manufacturer of Spiriva. This offer is not endorsed nor authorized by Boehringer Ingelheim Pharmaceuticals, Inc. (the United States and Canadian distributor of Spiriva). Candrug.com has no affiliation whatsoever with Boehringer Ingelheim Pharmaceuticals, Inc.
SPIRIVA side effects like a dry mouth (more than 1/10). This is generally one of the mild SPIRIVA side effects(Tiotropium), which wears off when the treatment is continued. Another common SPIRIVA side effects is constipation (1/100 – 1/10). SPIRIVA side effects like A dry mouth and constipation are more common in elderly patients. Sometimes (1/1000 – 1/100) SPIRIVA side effects like, patients were hyper-sensitive, in particular a sudden water retention in the skin and mucous membrane (i.e. throat or tongue) wree observed. At times there were also reports of SPIRIVA side effects like (angio-oedeem), such as: breathing problems and/or itching and rashes. If you have any of these SPIRIVA side effects, tell your doctor.SPIRIVA side effects like Local irritation in the higher respiratory tract can also occur. In some cases (1/1000 – 1/100) serious SPIRIVA side effects were observed, such as: Retention of urine in the bladder, especially in older men with a higher risk of this side effect (i.e. enlarged prostate gland); this is a serious side effect; for which you need medical treatment. In isolated cases SPIRIVA side effects like fluctuating heartbeat was reported, usually in patients who were sensitive to this. Other possible SPIRIVA side effects which could occur, based on the characteristics of SPIRIVA (Tiotropium) are: dry throat, infection of the pharynx and sinuses, infection of the mucous membrane (moniliasis), rapid heartbeat, blurred vision, increased eyeball pressure (glaucoom) and difficulties in urinating. If you notice any side SPIRIVA side effects not mentioned in this leaflet, please inform your doctor or pharmacist.
SPIRIVA (Tiotropium) is a promising new medication for those with severe asthma and COPD. SPIRIVA (Tiotropium) is similar in action to Atrovent® (ipratropium bromide) and classified as an anticholinergic medication with extended action up to 36 hours.
Like Atrovent®, SPIRIVA (Tiotropium) works from an opposite direction to provide bronchodilation than do Rescue Medications such as albuterol. SPIRIVA (Tiotropium) acts on the parasympathetic nervous system as opposed to the sympathetic. Anticholinergics inhibit muscarinic or "M" receptors. Tiotropium specifically targets M3 and to a lesser extent M1 receptors. These two receptors are important in bronchoconstriction and mucus production especially the M3 receptor.
Tiotropium bromide is a long-acting, specific, muscarinic receptor antagonist, in clinical medicine often called an anticholinergic. By binding to the muscarinic receptors in the bronchial smooth musculature, tiotropium bromide inhibits the cholinergic (bronchoconstrictive) effects of acetylcholine, released from parasympathetic nerve endings. It has similar affinity to the subtypes of muscarinic receptors, M1 to M5. In the airways, tiotropium bromide competitively and reversibly antagonises the M3 receptors, resulting in relaxation. The effect was dose dependent and lasted longer than 24h. The long duration is probably due to the very slow dissociation from the M3 receptor, exhibiting a significantly longer dissociation half-life than ipratropium. As an N-quaternary anticholinergic, tiotropium bromide is topically (broncho-) selective when administered by inhalation, demonstrating an acceptable therapeutic range before systemic anticholinergic effects may occur. The bronchodilation is primarily a local effect (on the airways), not a systemic one. Dissociation from M2-receptors is faster than from M3, which in functional in vitro studies, elicited (kinetically controlled) receptor subtype selectivity of M3 over M2. The high potency and slow receptor dissociation found its clinical correlate in significant and long-acting bronchodilation in patients with COPD.
Many COPD patients, as well as severe asthmatics, have a reduced effectiveness with beta2 agonists such as albuterol. Being able to stimulate some bronchodilatation through blocking the actions of the M1 and M3 receptors allows for better symptom control. Medications such as Combivent® already take advantage for this by combining albuterol and ipratropium. A drawback to ipratropium is its shorter length of action, though longer than albuterol. Ipratropium also inhibits the M2 receptor which may increase acetylcholine release and stimulate bronchoconstriction.
A possible benefit from using SPIRIVA (Tiotropium) is an apparent reduction in side effects over ipratropium. This is probably due to it's reduced action on the M2 receptor. Some of the common side effects of ipratropium are nervousness, dizziness, headache, nausea, upset stomach, dry mouth, throat irritation, and cough.
Another important advantage of SPIRIVA (Tiotropium) over ipratropium is length of action. One study saw a three day length of action. General consensus for length of action is around 36 hours, making SPIRIVA (Tiotropium) an excellent candidate for a daily long acting medication. Daily medications are seen as an effective way of increasing compliance among patients in taking their medications.