Additional Information
* The online pharmacies to which you may be referred from this website will only dispense a controlled substance to a person who has a valid prescription issued for a legitimate medical purpose based upon a medical relationship with the prescribing practitioner. This includes at least one prior in-person medical evaluation or medical evaluation via telemedicine in accordance with applicable requirements of section 309 of the Ryan Haight Online Pharmacy Act.
Why is this medication prescribed
Tiotropium is used to prevent wheezing, shortness of breath, and difficulty breathing in patients with chronic obstructive pulmonary disease (COPD, a group of diseases that affect the lungs and airways) such as chronic bronchitis (swelling of the air passages that lead to the lungs) and emphysema (damage to air sacs in the lungs). Tiotropium is in a class of medications called bronchodilators. It works by relaxing and opening the air passages to the lungs to make breathing easier.
Proper Use of This Medicine
Inhaled tiotropium is used with a special inhaler (HandiHaler) and usually comes with patient directions. Read the directions carefully before using this medicine. If you do not understand the directions or you are not sure how to use the inhaler, ask your health care professional to show you what to do. There are four main steps to take your medicine. Open the blister and the HandiHaler device, insert the tiotropium capsule, press the HandiHaler button and inhale your medication. Ask your health care professional to check regularly how you use the inhaler to make sure you are using it properly.
The HandiHaler is an inhalation device (inhaler) that has been specially designed for use with tiotropium capsules for inhalation. The HandiHaler must not be used to take other medicines.
Capsules should always be stored in sealed blisters and only removed immediately before use. The blister strip should be carefully opened to expose only one capsule at a time. Open the blister foil as far as the STOP line to remove only one capsule at a time. The medicine should be used immediately after the packaging over an individual capsule is opened, or else it may not be as effective as it should be. After using the first capsule, the 2 remaining capsules should be used over the next 2 consecutive days. Capsules should always be stored in the blister and only removed immediately before use. Capsules that are accidently exposed to air and that are not intended for immediate use should be discarded.
Inhaled tiotropium is a once daily maintenance medicine that opens narrowed airways and keeps them open for 24 hours. This medicine should not be used for immediate relief of breathing problems, such as a rescue medication.
Tiotropium capsules are to be used for oral inhalation only. The capsules should not be swallowed.
Dosing
Follow your doctor's orders or the directions on the label. Use this medicine exactly as prescribed by your doctor. Do not use more of it than prescribed by your doctor.
- For inhalation dosage form (capsules):
- For bronchospasm associated with Chronic Obstructive Pulmonary Disease (COPD)
- Adults 1 capsule (18 micrograms [mcg]) inhaled once daily; capsules should only be used with the HandiHaler inhalation device (inhaler)
- Children Use and dose must be determined by your doctor.
Missed dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
To store this medicine:
- Keep out of the reach of children.
- Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
- Keep the medicine from freezing. Do not refrigerate.
- Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.
- Do not store capsules in the HandiHaler.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What other information should I know
Keep all appointments with your doctor.
You will receive a new inhaler with each 30 day supply of medication. Normally, you will not need to clean your inhaler during the 30 days you use it. However, if you do need to clean your inhaler, you should open the dust cap and mouthpiece and then press the piercing button to open the base. Then rinse the entire inhaler with warm water but without any soaps or detergents. Tip out excess water and leave the inhaler to air dry for 24 hours with the dust cap, mouthpiece, and base open. Do not wash your inhaler in the dishwasher and do not use it after you wash it until it has been allowed to dry for 24 hours. You may also clean the outside of the mouthpiece with a moist (not wet) tissue.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Before Using This Medicine
In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tiotropium, the following should be considered:
Allergies Tell your doctor if you have ever had any unusual or allergic reaction to tiotropium, ipratropium, atropine, or inhaled lactose. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy This medicine has not been studied in pregnant women. Before taking this medicine, be sure your doctor knows if you are pregnant or planning to become pregnant.
Breast-feeding It is not known whether inhaled tiotropium passes into breast milk. Mothers who are taking this medicine and wish to breast feed should discuss this with their doctor.
Children Studies on this medicine have only been done in adult patients, and there is no specific information comparing the use of tiotropium in children with use in other age groups. The disease that this medicine treats does not normally occur in children.
Older adults This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.
Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using tiotropium, it is especially important that your doctor and pharmacist know if you are taking any of the following:
- Ipratropium (e.g., Atrovent) using these medicines at the same time has not been studied and is not recommended
Other medical problems The presence of other medical problems may affect the use of tiotropium. Make sure you tell your doctor if you have any other medical problems, especially:
- Difficulty urinating (bladder problems) or
- Narrow angle glaucoma (eye condition) or
- Enlarged prostate this medicine can make these conditions worse
In case of emergency overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- dry mouth
- stomach pain
- constipation
- shaking hands that you cannot control
- changes in thinking
- blurred vision
- red eyes
- fast heartbeat
- difficulty urinating
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