Hi all. I found this recently. It's from 2011 in the British medical journal with regards Spiriva respimat. As someone with COPD and a heart condition I shall be aiming to come off it. Especially as I've been having palpitations since I've been using it.
You may want to check it out for yourselves.
Published June 14 by the British Medical Journal, the findings suggest that long-term use of Tiotropium Respimat (also known as Spiriva Respimat) increases the risk of death by more than half.
Chronic Obstructive Pulmonary Disease (COPD), as chronic bronchitis and emphysema are collectively known, affects three million people in the UK and caused 24,000 deaths in 2005 -- the latest year for which figures are available. Most COPD sufferers use inhalers to help them breathe and more than half a million prescriptions for Tiotropium inhalers were issued in the UK last year.
Tiotropium inhalers have been available internationally for some years but a new device known as Tiotropium Respimat was launched more recently and licensed for use in the UK and Europe. However, the US Food and Drug Administration (FDA) has not granted approval for Tiotropium Respimat in the United States because of the need for further testing.
"We analysed five clinical trials involving 6500 people and the risk of death in patients using this particular inhaler appeared to be 52 per cent higher," said Dr Yoon Loke of Norwich Medical School at the University of East Anglia.
"We estimate that there will be one additional death for every 124 patients treated for a year with Tiotropium Respimat. Some of this risk appears to stem from patients dying of heart trouble, especially for those with existing heart problems that may be worsened because of a potential adverse effect of tiotropium on the heart rhythm."
Dr Loke and his US colleagues first became aware of a potential problem after reading the minutes of an FDA meeting which discussed an increased number of deaths in clinical trials of Tiotropium Respimat. After analysing the data presented in the FDA documents, along with additional information from a number of published trials, they concluded that there were clear indications of increased risk of death, particularly related to heart disease.
"We have since discovered that, due to safety concerns, Tiotropium Respimat was not granted FDA approval for use in the United States, where it must now undergo further safety testing in a large trial involving 17,000 patients," said Dr Loke.
The Tiotropium Respimat inhaler continues to be available in the UK, despite a recent UK Medicines and Healthcare Regulatory Agency warning of a significant risk of death in users who suffer from irregular heart rhythms. And last month Canadian researchers found that COPD patients started on Tiotropium inhalers had higher rates of hospitalization, emergency department visits, and death -- as compared to those starting treatment with other inhalers.
Dr Loke said: "There are alternative inhalers that can help patients with COPD. Patients currently using Tiotropium Respimat should not suddenly stop taking their medication, but I would advise them to make an appointment with their doctor to discuss the possibility of switching to a different drug. As Tiotropium Respimat can have an adverse effect on the heart rhythm, patients with a history of palpitations or irregular heartbeat (fast or slow) should mention such problems to their doctor."
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Gazza01
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Medicines and Healthcare products Regulatory Agency
Published 12 February 2015
Last updated 16 February 2015
This is basically saying that patients with certain (listed) heart conditions should be taken into consideration before prescribing Tiotropium. This is a little more up to date.
I get heart palpitations at night come to think of it it about an hour after thinking this compound. Hmmm iv been on it for 2 years now and since using it I have had increased health anxiety now I can't say for certain this is causing it but it could be a factor. To be honest I don't see any difference in using it to not using it?
There are two kinds of Spiriva. The capsule kind then the Respimat which is what I have. It's more similar to an inhaler than I think the capsule version of Spiriva is. But instead of being an inhaler like ventolin you twist the inhaler and a mist for inhalation comes out. Also instead of an inhaler like ventolin, the Respimat comes with a little canister that you have to insert before the first use.
I must say I've stopped taking Spiriva, which I haven't yet told my doctor, because it was causing weird heart feelings (sorry, vocabulary failure) and headaches, and difficulty in passing urine. I didn't know it mentions heart conditions in the leaflet 🤔
I'm not sure if you mean feel different breathing-wise, or heart wise. Breathing-wise it's hard to say because it's deteriorated anyway. I don't know that it's any worse now that I've stopped taking the Spiriva.
The strange heart feelings are better though I still get some, but it had felt like I could feel my heart beat in my back when I was in bed (propped up on pillows, I don't lay down), sometimes my heart beat so loudly it would wake me up, and I'd get what I guess is palpitations that made me stop in my tracks. All that is much improved since I stopped taking the Spiriva. Also I became aware that I was needing to really focus to be able to pass urine. That's better now too. Actually when I first started Spiriva last year, and when I restarted it having already tried stopping Spiriva a while ago, I noticed my urine was bright orange for a day or so.
Sorry, this has turned into a really long answer! I'm not sure if it answers your question 🤔
No it's answers its perfectly. I have been on spiriva for about 2 years now. And to be honest I haven't really felt any side effects probably because I'm on symbicort as well at a high dose. Now they have put me on a extra high dose of budesonide my heart feels all over the place. I didn't take the spiriva last night for the first time in 2 years and don't feel anything yet I guess it too early to tell. But my asthma isn't great at the moment. I have asked to see a asthma nurse months ago but they never called back. So I have made an appointment to see the gp today. I was on seretide 250 before all this I'm tempted to ask to go back to it. I keep getting told about xolair but the respiratory specialist says we'll save that untill you really need it haha sometimes I think he's joking🤔🤔🤔🤔
Thanks hungry,the reason I ask I am going to ask my consultant who I see in two weeks, to take me of trimbow ,and put me back on fostair and spiriva ,the spiriva I was on is the capsul type
All I can tell you is the capsule type has been a long time and wasn't part of the study. Maybe one of our American friends can tell us if the capsule form is being used in the states.
Tiotropium delivered via Respimat compared with Handihaler: no significant difference in mortality in TIOSPIR trial
Take the risk of cardiovascular side effects into account when prescribing tiotropium delivered via Respimat or Handihaler to patients with certain cardiac conditions, who were excluded from clinical trials of tiotropium (including TIOSPIR).
I think Trimbow has the same type of drug as spiriva, and then mixed with a combination inhaler so might be worth searching Trimbow to see if it's the same in the anticholinergic part. Either way they'll tell you it's fine. The drug companies are all powerful with very long tentacles.
Saw the gp yesterday and asked if Trimbow was the same drug as spiriva ( tiotropium) and it's not. Can't remember what the word was but it definitely was not the same.
I could not use the spiriva with a capsule as it caused serious overheating problems at night. I have tried Spiriva respimat, but am now on Spiolta respimat. What concerns me is Spiolta respimat is also tiotropium + olodaterol. After seeing what happened to my mother and her heart rhythms, I am wondering whether I should ask for anything else.
Recently on a pulmonary rehab. course, I did ask the pharmacist about the side affects of the inhalers and he just said that the positive effects outweighed the risks (not a very satisfactory answer) .
What a meaningless and inaccurate (avoiding saying ‘silly’) answer. In some cases the positive effects outweigh the risks. In other cases, the risks, or the actual experienced effects, are far worse than any benefit that the medicine may offer. 🤨
Yes I think that's where I'm going inhaler wise. I'm already on fostair and asked for an add on as my breathing was taking all morning to pick up. The first couple of days on spiriva were great, this was only six weeks ago, I thought all my problems were solved. By day 3 everything seemed to go back to how it was before, as if it was no longer making a difference, But I stuck with it. Having read this, and given the palpitations lately I'm going to drop it. I am due to see my GP tomorrow so will tell him I'll stick with fostair and ventolin as needed. As far as the professionals are concerned I don't think any of the GPS or asthma nurses have much depth of knowledge, and if I quote anything from NICE they seem lost. If I was an asthma nurse I would definitely know everything inside out. Maybe that's just how I am.
I’m on spiriva Respimat now. Was on the other type a couple years ago. I’m also on symbacort. Ive not had any side effects. If I don’t use the spiriva Respimat when I first get up I can barely breath!
I have the spiriva respimat. I am asthmatic and copd sufferer. Since i bn on respimat i have terrible gastric pains which im sure is being caused by this. Has anybody else suffered the same?
I've been on ,spiriva resprimat for about 4 years and never had a problem with it , I prefer it actually ,the mist is easy in inhail has no taste and doesnt need a mouth rinse afterwards
A couple of years ago some clinical research had data that showed a link to increased heart disease whilst using ,spiriva, this was double checked and found the data was tainted by bad analytical interpretation, it's a good drug I know when I've not used it
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