Spiriva Respimat

[John198834]

has anyone tried Spiriva respimat spray inhaler? If so, what was it like for you?

[Homely2 Administrator]

I get on well with Spiriva. It took a while to work for me.

For me it seems to stop the nastier attacks going too far and makes my breathing less variable. I need my fostair and alvesco for my front line asthma control, but the spiriva works away in the background.

[John198834 in reply to Homely2]

nice. Have you ever tried Symbicort 200/6? Or have you always been on fostair. My inhaled LABa/ics doesn’t really affect me that well

[Maltesemama in reply to Homely2]

hi! Spiriva Respimat is fabulous. I use my inhaler or albuterol respirator 15 minutes later I use 2 puffs of Spiriva Res. I get longer time between wheezing. It can only b used once a day, 2 puffs, so I use it in the morning to make my day healthy

[redstar9]

It definitely helps. Can't say it's a magic fix but helps to keep my asthma more stable. It seems to open up my small airways allowing my other medication to work a bit better. Still need frequent oral steroids but does improve overall control.

[John198834 in reply to redstar9]

Okay thanks the reply

[Mons]

I started Spiriva to go alongside Fostair 200/6. It took about 6 weeks for me to notice a big difference but now it is working has made a huge difference to the breathlessness and my asthma is controlled well and I feel so much better without the breathlessness.

[John198834]

thanks Mon appreciate the reply

[My_fairy]

yes my daughter has and it’s very good with little to no side effects like other inhalers with corticosteroids I believe. I am not 100% though please check but I think it doesn’t have steroids.

My daughter said nothing has opened her chest like this inhaler before. Hope it helps.

[John198834 in reply to My_fairy]

yes I’m pretty sure it isn’t a steroid as well. Thank you for your replay

[Lysistrata Administrator Community Ambassador in reply to My_fairy]

Yep - totally different drug class, no steroids. It's a longer-acting version of Atrovent, for anyone familiar with that.

[Headoverheels]

I was dubious when I first started Spiriva...but it's proved to be fine. No probs whatsoever!

[John198834 in reply to Headoverheels]

Did you find it works better then steroid inhalers?

[Headoverheels]

I take 2 puffs of Spiriva straight after one puff of Relvar every morning. I never take Spirivia on it's own. I feel in my own mind that the answer to your question would be no as Spiriva helps open the airways. Unfortunately we have to rely on steroids and it was because of this reason I am now on Biologics ....truly amazing.

[John198834 in reply to Headoverheels]

Thanks for sharing

[Poobah]

Spiriva was amazing when I first started taking it and the results continued that way for around 6 weeks. After that, I had side effects that made me feel increasingly unwell, to the point where I had to stop taking it. It also gave me hypertension. My asthma nurse had taken my blood pressure before I started on Spiriva and after a couple of months, my BP was sky high. If you're going to try Spiriva, get your BP checked first and monitor it thereafter. Not everyone gets side effects, but it's difficult to know if your BP is affected without monitoring. I was fortunate that my asthma nurse understood potential side effects.

[John198834 in reply to Poobah]

Appreciate the reply. I will keep this in mind

[Anjidav]

hi, I have taken it for a few years and it’s better by far than other inhalers I’ve had of the old style. I just had a review of my asthma and it was explained (for some reason I didn’t know or had forgotten) that it’s important to open the airways with fostair or something similar twice daily for me and meanwhile the spiriva helps fight/reduce the build up of mucus in the airways.

I would recommend trying it for sure.

I also take a montelukast tablet at nighttime too.

Good luck

[John198834 in reply to Anjidav]

Thank you

[Lysistrata Administrator Community Ambassador]

Yes it works for me - in an understated way that I didn't really notice until there was a mix-up with my prescription. 2 days without and I was apologising to my inhaler that I ever doubted it! I don't have full control still but I'm definitely better with it.

It targets the processes that make the muscles round your airways contract and squeeze the airways. Ventolin (salbutamol) and longer-acting versions of it also do this but in a different way. These two types of drugs work together well.

As mentioned above, Spiriva (tiotropium) is the longer-acting version of Atrovent (ipratropium) - if you've ever had a hospital admission, you probably had Atrovent nebulisers. Spiriva lasts longer than Atrovent and is also more specific to the lungs.

As someone else mentioned, it does also reduce mucus production in the lungs, and it possibly has an anti-inflammatory effect which is not well understood.

It seems like it may work better in some people with asthma than others - perhaps more likely to help people with asthma that is not allergic or eosinophilic. Eosinophilic asthma is a specific subtype related to an increase in specific white blood cells called eosinophils, which are linked to certain kinds of inflammation in asthma. Many of the biologic drugs specifically treat this kind of asthma, but not everyone with asthma has this kind.

It's possible that Spiriva might be especially helpful for people who don't have eosinophilic asthma, like me - but my impression is it's not just limited to one type of asthma.

Worth a try, but bear in mind the effect might be subtle - you probably aren't going to see a dramatic difference or an immediate one.

[John198834 in reply to Lysistrata]

Appreciate the reply. I actually don’t have eos either so this could work good

[Bagpiper0304]

I'm using it just now and it definitely seems to help. 2 puffs in the morning.

[John198834 in reply to Bagpiper0304]

Thank you for the reply

[Sudhirdhir7]

it has been a game changer. Been it for many years . The original works ,the generic ones do not work for me ! I hope this helps.

[dsddsd]

Was on fostair 200 for 4 years but told the yearly phone asthma review person that it( & salbutamol ) weren't cutting it and was there anything else.

Asthma lady ( should be copd review but it's always labelled Asthma review) suggested spiriva as an additional medicine with fostair. Was slightly dubious because the first review was switched to anora (?). Awful inhaler, which made my brown face red after a week!

Answer your question, spiriva definitely helps. Although I use with a spacer which may or may not lessen intake. But not risking mouth thrush again, especially with this additional inhaler.

Not sure if it's a steroid medicine, I

[dsddsd]

Does anyone else use it with a spacer? I do. Only by reading the replies have I learnt it's not steroid based. Catch mouth thrush so quickly from the inhalers but if spiriva doesn't have thrush risk I'll use it without a spacer.

Anyone know if thrush is a possible side effect?

[Lysistrata Administrator Community Ambassador in reply to dsddsd]

I just checked on the official leaflet which has to list effects from the trials and from after it's released (they keep monitoring). It is a risk but less than 1%. I always rinse out my mouth with water after taking it and Fostair anyway - never had an issue with thrush. It isn't designed to be used with a spacer so I would give it a go without and rinse out your mouth after taking it (I do this because I used to be on Atrovent inhaler which is related to Spiriva, and found it affected my teeth. I haven't had any issues with thrush or teeth on Spiriva in 9 years.)

[Thunderdome]

hi,

I was first prescribed spiriva in the inhaler that you put a tablet inside and click it then inhale. This was a game changer for me. I took it as and when when I was feeling breathless. However nhs gp has prescribed the spiriva without tablet and it’s not nearly as affective. I’m going to ask to go back on the first inhaler. But interesting comments about blood pressure. I will monitor it.

I take with symbicort 200/6 2 puffs twice a day.

I used to take montelukast but had a ‘waking dream’ experience obe night after taking it and freaked me out a little. But also found it very effective so may take again in emergencies.

Thanks for everyone’s helpful comments

[John198834 in reply to Thunderdome]

thanks for your feedback. Yes apparently it’s only the spray they have approved for asthma treatment.

[Lilly_the_unicorn]

Spiriva was a game changer for me, I had 4 courses of oral pred in 5 months before the asthma nurse added in the Spiriva inhaler and I have only had 2 courses in 5 months since starting it.

The first time I took it, within an hour I noticeably felt my airways open up and felt like I could breath more easily. If I forget to take the Spiriva I notice within about 12 hours of not taking it as my chest feels tighter and by the next morning I am coughing up mucus.

I do not have eosinophilia asthma, but adult onset asthma.

I take it with Fostair 100/6 (I went up to 200/6 but had asthma attack on that so dropped back to 100/6 but increased frequency as the bronchodilators have more of an effect than the inhaled steroids)

[John198834 in reply to Lilly_the_unicorn]

That’s great that is has helped you. Appreciate the feedback

[Dogsbody2all]

I started Spiriva in November 2023 as an extra inhaler on top of my DuoResp. I stuck it for 7 weeks before the side effects became too much. The dry mouth was unrelenting, as was the dry skin. A week after starting it I started with a slight tickly cough that slowly got worse. Mid December I had full blown sinusitis, which can be another side effect of Spiriva. I was on an antibiotic over Christmas, then steroid tablets over New Year. My sinuses are still being temperamental, but that could be down to the pollen.

Would I take it again? Absolutely not! BUT, we're all individuals and our personal experiences with this inhaler are different.

[Twinklydiamond]

I started spiriva two months ago on top of symbicort 200/6, montelukast and antihistamines, It has been very helpful for my chest but my blood pressure has shot up so the nurse (not asthma nurse, she has retired!) is now talking about blood pressure tablets. I hope I can get her to listen about the spiriva and maybe suggest another brand? Considering going to the GP about this one!!

[Poobah in reply to Twinklydiamond]

Same happened to me and I had to change from Spiriva to Eklira Genuair and that was an excellent LAMA inhaler, much better than Spiriva. However, I developed low angle glaucoma and had to stop taking it. I stress that I was unlucky with the side effects and they don't happen to everyone. NB that my Consultant had my BP meds changed to Losartan as Amalodapline and Ramipril exacerbate asthma symptoms.

[Twinklydiamond]

So are you still taking a LAMA inhaler or doing without, under consultant supervision? Very bad luck about the glaucoma. I have been prescribed amlopadine, not started yet but I have an asthma review next week and will check about it!!