Spiriva

What is Spiriva?

Spiriva is a medication that’s prescribed to treat COPD, a group of conditions that cause airflow blockage and breathing-related problems. There are two types of this treatment available – Spiriva Handihaler and Spiriva Respimat. They both contain the same active ingredient, tiotropium bromide. The main difference is the way that they’re both taken.

Spiriva Handihaler is used with a capsule. This capsule is inserted into your Handihaler and pierced, which then releases a powder that you inhale. Spiriva Respimat comes as a powder instead of a capsule, but it’s still inhaled using your inhaler. It’s down to you to decide which form of Spiriva you might prefer to use.

How does Spiriva work?

The active ingredient in both Spiriva treatments is tiotropium, which is a bronchodilator (a substance that relaxes and opens up your airways). The result is that breathing becomes easier, reducing the symptoms of COPD. It can also prevent your condition from worsening and causing further negative effects.

Tiotropium works by targeting the M3 muscarinic receptors in your lung’s airways and blocking a chemical in your body called acetylcholine from binding to these receptors. As a result, the muscles in your airways relax, resulting in easier breathing.

What doses of Spiriva are there?

There are two doses of Spiriva, and they depend on whether you choose the Handihaler or the Respimat. The Handihaler comes in capsules with 18 micrograms of tiotropium. This version of the treatment only needs to be taken once a day. The Respimat version comes in doses of 2.5 micrograms of tiotropium, which is to be taken in two puffs – also once a day.

How to use Spiriva

Always follow the advice of your clinician.

• Pull the cap and mouthpiece upwards on your Handihaler to open it. (You’ll need to press the pierce button in and then let go.)
• Remove the Spiriva capsule from the package. Just make sure to do this immediately before you are due to take it. Once removed, place the capsule in the now open chamber.
• Close the mouthpiece but keep the dust cap open. Once closed you should hear a click.
• Hold the HandiHaler with the mouthpiece facing up. Press the piercing button on the side. This will pierce the capsule and allow you to inhale the powder inside.
• Completely breathe out, while avoiding breathing into the mouthpiece.
• Put the device to your mouth with your lips around the mouthpiece. Keep your head up and breathe in from the HandiHaler slowly and deeply. You might hear or feel the capsule vibrate. If you do then you are taking the treatment correctly.
• Breathe in as much as you can. When your lungs are full, hold your breath for as long as you can. Make sure to remove the Handihaler from your mouth at the same time as doing this.
• Repeat steps five and six until the capsule is completely empty.
• Open the mouthpiece. Remove the used capsule.
• Close your Handihaler’s mouthpiece and dust cap and store it somewhere safe. ^[1]

For the Respimat, instructions are as follows:

• Press down on the safety catch with one hand while pulling off the clear base with the other.
• Place the Respimat cartridge into your inhaler. Once done, place your inhaler on a hard surface and push down until it clicks into place.
• Mark the check-box on the inhalers label to keep a track of the number of cartridges used. Once done, put the clear base back into place. You should hear a click if done successfully.
• Keep the cap closed and turn the clear base in the same direction as the arrows shown. You’ll know that this is done when you hear the device click. This usually takes around half a turn.
• Open the cap until it fully snaps open.
• Point the inhaler towards the ground and click the dose release button. Close the cap and repeat steps four to six until a cloud appears.
• Once you see a cloud, repeat steps four to six another three times. Once you have completed these steps, the Respimat is ready to use. It will deliver 60 puffs (30 doses) before needing another cartridge. ^[2]

How long does it take Spiriva to work?

You should feel some positive effects shortly after using your inhaler, but you’ll need to use it regularly to feel its full effects.

It’s recommended that you use Spiriva long-term. But if your symptoms haven’t improved by four to eight weeks, talk to a clinician about trying a different COPD treatment.

What should I do if I make a mistake when using Spiriva?

If you forget a dose of Spiriva Handihaler or Spiriva Respimat, it’s important that you don’t double the dose to make up for the one you missed. Instead, just take your next dose as soon as you remember. If it is almost time for your next dose, just wait until then instead.