Spiriva capsule didn't vibrate in handihaler

Has anyone else had this? Did I still get the medication?

Used my Spiriva for the first time yesterday and all was as it should be. Came to use it this morning and did exactly the same, pierced the capsule and breathed in but it did not vibrate - forgot to hold my breath as I was concerned it hadn't worked. Breathed in a couple more times but still didn't vibrate. Checked capsule and it was empty so do you think I can assume I did get the medication but probably not as effective as I didn't hold my breath. Wouldn't try again with a second one in case I had managed to get some of the medication and didn't want to take too much.

Any idea why it wouldn't virbrate? Breathed exactly the same as yesterday, according to the instructions, when it did virbrate. Capsule was free moving in the chamber.

46 Replies

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  • Happens quite often. I've found some capsules to be empty in a batch. Giveaway is white powder round the punched holes. If none, try another capsule. take care to keep capsule dry or it won't vibrate. Anyone else had empty capsules? T

  • I didn't notice any white powder around the punched holes, but then again I did give the handihaler a bit of a shake in case the capsule had got lodged. Will leave it today just in case I did get some of the medication (I have Ventolin inhaler if necessary) but will look out for that if it happens again. Thanks Mick.

  • yes my hubby said he had empty ones, best store in a dry place and dont peel the foil back to expose the next capsule. sounds daft to tell you this i know

  • I never get white powder around the punched hole. Depends how hard you suck I suppose. In 20 years I have not knowingly had a empty one and if I have had I certainly would not know about.

  • Don't worry too much about over or under dosing with Spiriva - the occasional mishap happens to us all and it is a pretty safe medication. Believe me - one or two of us have even absentmindedly swallowed the darn capsule instead of putting it in the inhaler! One tip my respiratory nurse gave me was to firmly tap the bottom of the inhaler down just once, on a work surface or similar, after placing the cap inside and before inhaling. This was to ensure it was in the best position to pierce and vibrate correctly. Sometimes we 'over-pierce' the cap and too big a hole appears. This leads to a lack of suction and vibration. In such cases I would take a second dose. The cap may appear 'empty', but keep in mind that a 'full' cap contains only a miniscule amount of white powder. Try opening an unused capsule and carefully emptying the contents onto a dark surface or piece of dark paper - you will be amazed at the tiny amount it contains. It is 'good medicine' though!

  • Thanks Parvati. There's been a distinct lack of any advice or tips on anything from my nurse (unless I know enough to ask) or GP, so that's very useful about tapping the bottom down on a surface. Good to know that trying another capsule wouldn't be serious.

  • Good advice.

  • you made me smile as was going to say evry thing you said .yes even the bit about swalling the tablet , oops my mistake as i gave it to hubby and told him to take it .lol.

    and again you cant overdose on them.

  • Anyone know what happens to the bits that get punched out - do we inhale those as well? I have never found them when I have split a capsule :/

  • ..i think they end up in the same place as all those odd socks ......

  • I asked my GP about this. If you do ingest them, they will dissolve. I have found them attached to the capsule and also lying at the bottom of the capsule holder.

    I have also found some empty capsules, and just take another.

  • Hi

    It is highly unlikely that there are empty capsules - as Parvati says the amount of powder is quite small.

    If in doubt use the capsule again - you certainly shouldn't be using more than one capsule on a regular basis - if at all.

    If you are convinced you have a batch of empty capsules then you should go back to the pharmacist.

    Mark

  • Thanks Mark. When you say "If in doubt use the capsule again" do you mean use the same capsule again (the one already tried that hasn't vibrated)? I did do this. The instructions say to do a second suck but because it didn't vibrate either time I did do it a couple more times still without any vibration. If I get any further trouble I'll speak to the pharmacist, certainly wouldn't be using more than one capsule per day any more than a one off. Thanks again.

  • Sorry mark but i think she meant it didn,t rattle in the handyhaler not thst capsule itself.

  • Yes use the same capsule again. It is more than likely that you have had a dose - it's highly unlikely the capsule was empty.

  • OK Mark, thanks for that.

  • I always give my handihaler a shake too hear the capsule rattle, I also open the capsule after to make sure I've emptied it.

    Lib x

  • yes have had several capsules that were empty

  • That's interesting Teaky. How did you know they were empty?

  • when I got no rattle opend the capsule and there was no powder in the capsule there would normally be some residue

  • I have noticed this on a number of occasions over the last 7 years. It normally coincides with the top being completely removed from the capsule rather than just having 2 holes. I suspect that I still had the dose. But if I hadn't I wouldn't be that worried. Missing the occasional dose should not be a problem.

  • I checked and the top was still there. As it's only my second day of Spiriva, got changed over at suggestion of COPD nurse to try instead of Ventolin 3 or 4 times a day and hopefully not having to use Ventolin unless necessary, then I wasn't sure if I'd had the dose or not as the first day it vibrated perfectly.

  • I often have the same problem,but like yourself have never taken a 2nd capsule.

    Parvati, I don't believe I've ever swallowed one YET.lol.

    And I hope never to.too funny.

    X

  • Do you feel that you've actually had the medication when that happens or do you think that the capsule was empty? As I only started Spiriva yesterday I've yet to find out how I feel with it and learn to know how I feel if I haven't had it.

  • I sometimes feel that a capsule has been empty but never taken another dose. I also think I may have broken the capsule once or twice prior to putting it into the inhalor, with it being so difficult to get the capsule out if not opened properly first time, I have even had to cut them out with a sissors they are so difficult to remove from the packaging..hate them

  • I struggled at first Airhunter but got the hang of it now. Are you tearing down and separating off one strip? Then look at the back, top right hand corner is a black arrow (not the rounded edge, the squared off edge where it's been separated), if you just "stroke" the foil on that corner it folds back from the edge and then you can peel the foil backing down as far as you need. Sorry if you already know this. When I first saw the packaging I thought the capsules needed popping out like foil packed paracetamol :)

  • Hello, I've also had this happen with Spiriva and you can't be sure you've inhaled anything. I've also had them totally disintegrate whilst being punctured. And yes, like others, I did swallow one once and was really worried. And yes again, trying to get that foil to come away one capsule at a time without it tearing at an angle then you can't get the other bit to come off is a pain. Even my wife, who has longer nails, has a problem with it. George

  • I haven't noticed any empty capsules in mine but I bang mine a couple of times whilst still in the packet in case the powder has 'clumped up,. If it has sometimes it doesn't vibrate.

    Bev x

  • My experience has been that you quite often get empty or under-filled capsules.

    I always assumed that was why the pack has 30 caps instead of the 28 required by my prescription.

  • I am glad to see it's not just me, I seem to get the odd capsule that appears to be empty, and have often wondered what I should do, and yes I have swallowed one or two on days when the brain was not fully engaged. I will willingly put up with the problem of opening the foil as they seem to work so well

  • I also get the occasional empty capsule (verified by careful examination of others pre-use), 'moneal'. I also have embarrassingly swallowed the odd capsule - I have to take a Mucodine at the same time and have got them mixed up - but have noticed no after effects.

    "Keep taking the tablets" as they say !

  • My wife asked if swallowing one would produce more wind. I not sure if she was having a little go at me. As you say they seem to pass through with no ill effects

  • If only they would I would make the mistake more often as I also suffer from this 'Bloating' or 'Phantom Pregnancy' as I like to call it !

  • i found if you punch it twice it will not vibrate

  • Everything worked just fine this morning. And following on from Teaky's post about there being a powder residue in the shell, I opened the capsule up after I'd used it and there was a hint of a very fine dusting of white powder visible - with glasses on and in the right light :) . Something to remember if it happens again, I'll check to see if there's this slight residue.

  • I find if there is no vibration there is usually too large a hole in either one or both ends of the capsule. I've always thought it was a problem with the piercer - have never taken another one though. I dont notice any improvement in my breathing after I've taken it, so cannot say if there was powder in the capsule or not.

    I always used to get a new months supply with a new handihaler but now find that these are only replaced about once a year and we are supposed to wash them out and air-dry. I was not told this by my surgery or pharmacist but by an email friend who also has COPD.

    Anyone else had this happen, and were you told? I would have quite understood if I'd been told but was a bit puzzled to begin with and ordered another batch thinking they had forgotten to enclose the handi-haler!

  • Hi Vivienne. I knew about washing the handihaler as it was on the leaflet enclosed in the box, says to do it once a month, neither GP nor pharmacist told me about it. Not sure what's on my repeat prescription but don't mind having a second one as it says the handihaler takes a long time to dry.

    It's still early days for me with Spiriva (day 3 today), nurse suggested I try it as I was getting some discomfort since starting on Ventolin (Salbutamol), she said some people do better with Spiriva but I can still use Ventolin if needed. I know the Spiriva is a long acting bronchodilater so wouldn't have the same "reliever" effect as Ventolin. So far I think I'm getting on better with it, the Ventolin seemed to give me a feeling in my chest like a weight's on it, a heaviness. GP said it's indigestion/acid, well I've never suffered from that in my life and it's only happened these last few weeks since being on Ventolin so I can't agree with her. Anyway, still early days but I'm not getting the same discomfort.

  • Hi Seasidesusie, interesting one this. I had same problem and another chap on my PR group said some capsule were empty !! Which I found most disturbing as we are all totally reliant on Spiriva for our well being. I spoke to Boots my pharmacist who were unusually not too helpful. So.. I rang the manufacturers Boehringer Ingelheim who were extremely helpful. They investigated thoroughly and wrote to me with a technical report with photographs and an explanation in layman s terms.

    Essentially there are NO problems with empty capsules, it is not possible for them to be dispatched through their quality control unless 100% effective as a medication. The quantities of the active ingredient are minuscule and sometimes they do not make the rattling sound that we find comforting. One tip after inserting the capsule close the hand inhaler without breaking the capsule and give it a quick shake, I find it improves "the sound" that we are familiar with. I cannot forward their reply as it was posted to me. I hope this reassures you. By the way when you inhale, do so deeply, and count to ten slowly and then repeat. Good Luck. Adrian

  • Thanks Adrian. I'm making sure that the capsule moves freely in the chamber and I do a bit of a shake or a light tap on the table. I used it for the first time on Wednesday and the pharmacist explained how it's used and it all went as he said. Come Thursday and there was no vibration, being inexperienced with it I was wondering what I'd done wrong. Lots of info here in reply to my original question which has helped. I'm learning a bit more every day (very new to COPD) :) .

  • Seasidesusie - you will have a lot of information to take in about COPD , I was diagnosed last August and it was scary but now the more I understand the condition it gets less scary. It is very important to exercise, ask your GP to refer you to a Pulmonary Rehabilitation course. PR was the best thing I have done and you learn all the right exercises that you continue at home. It has become a way of life and I actually enjoy doing them. All the best Adrian

  • Thanks Adrian. I've got over the initial shock now and the more I read on here the more I am reassured. I realise I am nowhere near as bad as a lot of the members.

    I asked about exercise, the GP and the nurse said that walking my dog twice a day (total about one and a half to two hours, on the beach and/or pavement walking) was enough - even when I said that she is a sniffer and a plodder and that our walks were, at best, just a stroll but all they said was "well, you're outside". I'm not bad enough for the exercise class the nurse at the surgery runs at the local gym, that's reserved for people who barely move out of their chairs, and pulmonary rehab is too far according to the nurse, it's 50 miles away at the hospital. I've made enquiries locally and there's a gentle exercise class (I think mainly aimed at older people rather than younger gym bunnies) and I am going for the first time next Wednesday so it's a start :) .

  • Me too Seasidesusie, I am not as bad as many and can still do most things (apart from carrying heavy things, and struggle with steep hills). Have just hoovered stairs and next will clean bathroom, just take it steady. I travel abroad ( as me and wife took early retirement, not to do with condition, the offer was to good to refuse! It makes you grateful for what you still have.

    Happy dog walking Adrian

  • Some years ago I worked chauffeuring executives of a huge, well known, international pharmaceutical company.

    I well remember one trip when two very excited gentlemen were loudly discussing a new manufacturing plant that they had been to visit in a country with a very hot climate.

    They were apparently amazed to have found that the skylights in the roof of the plant - a reasonably sterile environment - had been opened regularly to increase the comfort level of those working within it.

    Their colourful condemnation of those responsible I will not repeat, but apparently months of produce had been distributed and used around the globe of a standard that could not be guaranteed and with no chance of a recall !

    I very much doubt that this information was put into the public domain.

    My point is that no manufacturing process, regardless how sophisticated it appears, is completely failsafe, not even Spiriva, and never will be !

  • Don't know if anyone else does this but, after use, I open the handihaler and bang it upside down on something dark and hard (like the back of a phone or remote!) to remove the capsule and check if there is any powder left.

    Very often there is a tiny amount ... it was reassuring but now I'm thinking it could be nearly half my medication! Lol

    Jude

    P.S. I push the capsule out from the back and manipulate it straight into the handihaler without touching it - fiddly but I like a daily challenge!

  • I just turn the handihaler upside down and the empty capsule just falls out.

    I've also checked what's left in the capsule after using it and the three times I've looked there is the slightest dusting of white powder on the inside walls of the shell, hard to see but in the right light with my glasses on it's detectable.

    Always up for trying things out, I used an LED torch this morning to see if I could see how much powder was actually in the capsule before I used it (mentioned by another member on a different thread about Spiriva) and you can see it and yes, it is a very small amount compared to the size of the capsule.

    I'm impressed so far, I've been using it for 5 days now and haven't needed Ventolin as well for the last 4 days.

  • Makes no difference . You still puncture the capsule and inhale the powder. Somehow though it does seem better when it fibrates . Tis easy to see if the capsule is empty when you remove it. I have never,ever had a problem with it.

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