Spiriva Respimat is it still powder inside the device?

Hi

Im looking to do a switch in my spiriva inhaler from the handihaler to the respimat (im switching all my inhalers from powder to MDI or aerosol type!) I just wondered if the device was changed or if the respimat was an aerosol device?

tc

c

[Hidden]

WOW, never seen that before. but this is what I dug up.

If you would like further information on SPIRIVA or SPIRIVA RESPIMAT, please contact Medical Information on 0845 602 3809

Prescribing Information (UK) SPIRIVA® RESPIMAT®▼, SPIRIVA® (tiotropium) Long acting, specific antimuscarinic agent, available as: Spiriva Respimat - solution for inhalation containing tiotropium bromide monohydrate equivalent to 2.5 microgram tiotropium for inhalation with the Respimat device or, Spiriva - hard capsules of powder for inhalation containing tiotropium bromide monohydrate equivalent to 18 microgram tiotropium for inhalation with the HandiHaler¨ device. Indication Tiotropium is indicated as a maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease (COPD). Dose Adults only age 18 years or over: For Spiriva Respimat, 5 microgram tiotropium given as two puffs once daily, at the same time of the day. For Spiriva, inhalation of the contents of one capsule once daily from the HandiHaler. Contra-indications Hypersensitivity to tiotropium bromide, atropine or its derivatives, e.g. ipratropium or oxitropium or to any of the excipients: lactose monohydrate which contains milk protein (capsules only); benzalkonium chloride, disodium edetate, purified water, hydrochloric acid 3.6% (for pH adjustment)(solution only). Precautions Not for the initial treatment of acute episodes of bronchospasm, i.e. rescue therapy. Immediate hypersensitivity reactions may occur after administration. Caution in patients with narrow-angle glaucoma, prostatic hyperplasia or bladder-neck obstruction. Inhaled medicines may cause inhalation-induced bronchospasm. In patients with moderate to severe renal impairment tiotropium bromide should be used only if the expected benefit outweighs the potential risk. Patients should be cautioned to avoid getting the powder or spray into their eyes. They should be advised that this may result in precipitation or worsening of narrow-angle glaucoma, eye pain or discomfort, temporary blurring of vision, visual halos or coloured images in association with red eyes from conjunctival congestion and corneal oedema. Should any combination of these eye symptoms develop, patients should stop using tiotropium bromide and consult a specialist immediately. Tiotropium bromide should not be used more frequently than once a day. Spiriva capsules contain 5.5mg lactose monohydrate. Interactions Although no formal drug interaction studies have been performed, tiotropium bromide has been used concomitantly with other drugs commonly used in the treatment of COPD, including sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids without clinical evidence of drug interactions. The co-administration of tiotropium bromide with other anticholinergic-containing drugs has not been studied and is therefore not recommended. Pregnancy and Lactation No documented clinical data on exposed pregnancies are available. The potential risk for humans is unknown. Tiotropium bromide should therefore only be used during pregnancy when clearly indicated. It is unknown whether tiotropium bromide is excreted in human breast milk. Use of tiotropium bromide during breast feeding is not recommended. A decision on whether to continue/discontinue breast feeding or therapy with tiotropium bromide should be made taking into account the benefit of breast feeding to the child and the benefit of tiotropium bromide therapy to the woman. Effects on ability to drive and use machines No studies have been performed. The occurrence of dizziness, blurred vision or headache may influence the ability to drive and use machinery. Side-effects In clinical trials, dry mouth was the most commonly reported adverse event. Dry mouth occurred in approximately 3% of patients for Spiriva (5437 patients from 19 pooled placebo-controlled clinical trials) and 6% of patients for Spiriva Respimat (849 patients pooled from four placebo-controlled clinical trials). Dry mouth was usually mild and often resolved with continued treatment. Serious undesirable effects consistent with anticholinergic effects include constipation, intestinal obstruction including ileus paralytic, and urinary retention, although none was attributed to tiotropium by clinical trial investigators for Spiriva and none were reported in the tiotropium Respimat development programme. Urinary retention was usually observed in elderly men with predisposing factors, (e.g. prostatic hyperplasia). Uncommon undesirable effects reported for Spiriva Respimat were: dizziness, headache, blurred vision, palpitations, supraventricular tachycardia, atrial fibrillation, cough, pharyngitis and other application site irritation, dysphonia, oral candidiasis, gastrooesophageal reflux disease, dysphagia, pruritus, dysuria and urinary retention. Uncommon undesirable effects reported for Spiriva were: oral candidiasis, nausea, dizziness, headache, taste disorders, bronchospasm, cough, pharyngitis and dysphonia. In addition, local upper airway irritant phenomena have been observed in patients receiving tiotropium bromide. In common with all inhaled medicines, tiotropium may cause inhalation-induced bronchospasm. An increased incidence of dry mouth and constipation may occur with increasing age. Prescribers should consult the individual product SPC in relation to other undesirable effects. Pack size and basic NHS prices ComboPack: HandiHaler device and 30 capsules (3 blister strips) £37.62 Refill Pack: 30 capsules (3 blister strips) £34.40 PL 14598/0062. Single Pack: 1 Respimat inhaler and 1 cartridge, providing 60 puffs (30 medicinal doses) £37.62 PL 14598/0084. Legal category POM Product Licence holder Boehringer Ingelheim International GmbH, D-55216 Ingelheim am Rhein, Germany. For full prescribing information please see individual product SPC. Updated September 2007.

Adverse events should be reported to Boehringer Ingelheim Drug Safety on 0800 328 1627 (freephone). Information about adverse event reporting can be found at yellowcard.gov.uk Spiriva has been developed by Boehringer Ingelheim and is being copromoted by Pfizer Limited and Boehringer Ingelheim Limited.

References: 1. Hochrainer D, Hoelz H, Kreher C, Scaffidi L, Spallek M, Wachtel H. Comparison of the aerosol velocity and spray duration of Respimat¨ Soft Mist Inhaler and pressurised metered dose inhalers. J Aerosol Med 2005; 18(3):273-282.

2. van Noord JA, Cornelissen G, Aumann J-L, Platz J, Mueller A, Fogarty C. Efficacy in COPD patients of tiotropium administered via the Respimat¨ Soft Mistª Inhaler (SMI) compared to HandiHaler® (HH). Eur Respir J 2006; 28(Suppl 50): 431s.

3. SPIRIVA Respimat Summary of Product Characteristics R1e/UK/SPC/1.

[KateMoss]

In a nutshell......

Spiriva Respimat is a sort of aerosol spray with liquid. It isn't a powder inhaler.

Do a google search and yuu will find some pictures etc on how it works too!

Kate

[Hidden]

It may be hard to get the respimat though as it is more expensive overall and really designed for people who have such a poor lung function that they cant breathe in properly for either a dry powder or a MDI.

I used to ahve the respimat and if i am honest i preferred the dry powder as the respimat made me cough as it really forces the dose down your throat.

Why are you changing you inhalers to MDI's?

[Hidden]

Hi olive, this recent flare up has been pretty bad and i was left unable to suck the powder out of my accuhaler during one really bad attack. lucky my i had someone nearby nearby with a Ventolin evohaler and had to use theirs as it was an emergency (literally pre-ambulance turning up was taken to A&E and put on a nebuliser later on). this was a wake up call and i switched to the evohaler inhaler the next day.

woody, i saw that list too but this really really works you know i don't even have a problem with this medication but hopefully its a temporary addition.

[Hidden]

confused do you use a spacer when you use the ventolin MDI in attacks? 10 puffs of spacer is thought to be as effective as 1 neb in most case, using a spacer with any MDI is a good idea as it means its gets further into your lungs and reduce oral/throat side effects.

I have not had the Respimat but from what I gather it is relatively new? therefore will be expensive and you might have issues getting it prescribed, the only people I know on it were prescribed it by a hospital consultant.

[Hidden]

yup your right simi,

I was on it from my cons at the specliast hosp not my local con and had to go each month to the hospital to get it. I had to get it from the con and he had to arrange for me to get it and the hosp pharmacy really struggled getting it in sometimes. I think it may ahve changed since then but I was one of the first to ahve it. But i still reckon it will be hard to get.

Confused...when you having an attack you should have some sort of inhaler you can take. an accuhaler is not the best for in an attack but it is pretty good for every day sort of use. But also when you are having an attack you not goijg to be taking all your other inhalers so do you need to change all your inhalers.

[Hidden]

Hi olive,

i think some sort arrangement must have been made between the hospital doctor and the gp at the emergency clinic as i just walked in and he had the prescription ready..not sure what the usual process was to get that.

i don't think that Ventolin can cope when i'm mid an asthma flare up! i'm due to see my asthma doctor today to have yet another review.