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General FAQs

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  • SPIRIVA RESPIMAT is a bronchodilator indicated for the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older.4
  • The recommended dosage for patients with asthma is 2 inhalations of SPIRIVA RESPIMAT 1.25mcg per actuation once-daily (so that the total dose equals 2.5mcg of SPIRIVA RESPIMAT).4
  • It is recommended that your patients carefully read the Instructions for Use before using SPIRIVA RESPIMAT for the first time, and each time they refill their prescription.4
  • Check how to use SPIRIVA RESPIMAT for more details on its usage.

It is important for your patients to familiarize themselves with the RESPIMAT inhaler components prior to use. SPIRIVA RESPIMAT consists of two main components:4

  • The inhaler, which includes the cap, mouthpiece, air vent, dose-release button, safety catch button, and clear base with piercing element
  • The cartridge, which holds the medication

It is important for patients to understand how to correctly administer SPIRIVA inhalation spray using the SPIRIVA RESPIMAT inhaler. Instruct patients that SPIRIVA inhalation spray should only be administered via the SPIRIVA RESPIMAT inhaler and the SPIRIVA RESPIMAT inhaler should not be used for administering other medications.

Instruct patients that priming SPIRIVA RESPIMAT is essential to ensure appropriate content of the medication in each actuation.4

To receive the full dosage of medication, SPIRIVA RESPIMAT must be administered as two inhalations once-daily. Do not take more than one dose (2 inhalations) in 24 hours.

When using the unit for the first time, the SPIRIVA RESPIMAT cartridge is inserted into the SPIRIVA RESPIMAT inhaler and the unit is primed. SPIRIVA RESPIMAT patients are to actuate the inhaler toward the ground until an aerosol cloud is visible and then to repeat the process three more times. The unit is then considered primed and ready for use. If not used for more than 3 days, patients are to actuate the inhaler once to prepare the inhaler for use. If not used for more than 21 days, patients are to actuate the inhaler until an aerosol cloud is visible and then repeat the process three more times to prepare the inhaler for use.4

SPIRIVA RESPIMAT should be taken once daily for the long-term maintenance treatment of asthma. Your patients can take SPIRIVA RESPIMAT can be taken any time of day, at the same time each day exactly as prescribed.4

SPIRIVA RESPIMAT is NOT indicated for the relief of acute bronchospasm.4

  • The recommended dosage for your patients with asthma is 1 dose of 2 puffs (so that the total dose equals 2.5mcg) of SPIRIVA RESPIMAT.4
  • It may take up to 4 to 8 weeks of treatment with SPIRIVA RESPIMAT for maximum benefits in lung function.4

By opting for the “Savings Card Program” your patients can pay as little as $35 for a 30-day prescription fill of their SPIRIVA RESPIMAT covered inhaler.5 Further, your patient can use this card for up to a maximum of 12 prescription fills per year for each eligible inhaler. However, this Saving Card is valid for patients with below criteria5:

  • Uninsured patients who pay cash or
  • Commercially insured patients

To find out their eligibility, your patients can check at https://patient.boehringer-ingelheim.com/us/products/spiriva/asthma/savings-and-support/sign-up-for-savings

SPIRIVA RESPIMAT 2.5mcg has been compared to placebo in four placebo-controlled parallel-group trials ranging from 12 to 52 weeks of treatment duration in adult patients (aged 18 to 75 years) with asthma. The safety data described below are based on one 1-year, two 6-month and one 12-week randomized, double-blind, placebo controlled trials in a total of 2849 asthma patients on background treatment of at least ICS or ICS and long-acting beta agonist (ICS/LABA). Of these patients, 787 were treated with SPIRIVA RESPIMAT at the recommended dose of 2.5mcg once-daily; 59.7% were female and 47.5% were Caucasian with a mean age of 43.7 years and a mean post-bronchodilator percent predicted forced expiratory volume in 1 second (FEV1) of 90.0% at baseline.4

Table 1: Number (Percentage) of Asthma Patients Exposed to SPIRIVA RESPIMAT 2.5mcg with Adverse Reactions >2% (and Higher than Placebo): Pooled Data from 4 Adult Clinical Trials with Treatment Periods Ranging between 12 and 52 Weeks in Asthma Patients.4

BODY SYSTEM
(REACTION)*

SPIRIVA RESPIMAT 2.5mcg

(n=787)

PLACEBO

(n=735)

Respiratory, Thoracic, and Mediastinal Disorders

Pharyngitis

Sinusitis

Bronchitis

125 (15.9)

21 (2.7)

26 (3.3)

91 (12.4)

10 (1.4)

10 (1.4)

Nervous System Disorders

Headache

30 (3.8)

20 (2.7)

*Adverse reactions include a grouping of similar terms.

Other reactions that occurred in the SPIRIVA RESPIMAT 2.5mcg group at an incidence of 1% to 2% and at a higher incidence rate on SPIRIVA RESPIMAT 2.5mcg than on placebo included: Nervous system disorders: dizziness; Gastrointestinal disorders: oropharyngeal candidiasis, diarrhea; Respiratory, thoracic, and mediastinal disorders: cough, rhinitis allergic; Renal and urinary disorders: urinary tract infection; General disorders and administration site conditions: pyrexia; and Vascular disorders: hypertension.4

SPIRIVA RESPIMAT has been used concomitantly with other respiratory medications including short-acting and long-acting sympathomimetic (beta2-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions.4

But there is potential for an additive interaction with concomitantly used anticholinergic medications. Therefore, avoid coadministration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs as this may lead to an increase in anticholinergic adverse effects.4

INDICATIONS

SPIRIVA RESPIMAT, 2.5mcg, is indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, and for reducing COPD exacerbations.

SPIRIVA RESPIMAT, 1.25mcg, is a bronchodilator indicated for the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older.

SPIRIVA RESPIMAT is not indicated for relief of acute bronchospasm.

IMPORTANT SAFETY INFORMATION

SPIRIVA® RESPIMAT® (tiotropium bromide) Inhalation Spray is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, or any component of this product. Immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported.

SPIRIVA RESPIMAT is intended as a once-daily maintenance treatment for COPD and asthma, and should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. In the event of an attack, a rapid-acting beta2-agonist should be used.

Immediate hypersensitivity reactions, including urticaria, angioedema (including swelling of the lips, tongue, or throat), rash, bronchospasm, anaphylaxis, or itching may occur after administration of SPIRIVA RESPIMAT. If such a reaction occurs, discontinue SPIRIVA RESPIMAT at once and consider alternative treatments. Given the similar structural formula of atropine to tiotropium, patients with a history of hypersensitivity reactions to atropine or its derivatives should be closely monitored for similar hypersensitivity reactions to SPIRIVA RESPIMAT.

Inhaled medicines, including SPIRIVA RESPIMAT, may cause paradoxical bronchospasm. If this occurs, it should be treated with an inhaled short-acting beta2-agonist, such as albuterol. Treatment with SPIRIVA RESPIMAT should be stopped and other treatments considered.

SPIRIVA RESPIMAT should be used with caution in patients with narrow-angle glaucoma. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema). Instruct patients to consult a physician immediately should any of these signs or symptoms develop.

Since dizziness and blurred vision may occur with the use of SPIRIVA RESPIMAT, caution patients about engaging in activities such as driving a vehicle, or operating appliances or machinery.

SPIRIVA RESPIMAT should be used with caution in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Instruct patients to consult a physician immediately should any of these signs or symptoms develop.

Patients with moderate to severe renal impairment (creatinine clearance of <60 mL/min) treated with SPIRIVA RESPIMAT should be monitored closely for anticholinergic side effects.

The most common adverse reactions >3% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in COPD trials were pharyngitis 11.5% (10.1%), cough 5.8% (5.5%), dry mouth 4.1% (1.6%), and sinusitis 3.1% (2.7%).

The most common adverse reactions >2% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in asthma trials in adults were pharyngitis 15.9% (12.4%), headache 3.8% (2.7%), bronchitis 3.3% (1.4%), and sinusitis 2.7% (1.4%). The adverse reaction profile for adolescent and pediatric patients was comparable to that observed in adult patients with asthma.

SPIRIVA RESPIMAT may interact additively with concomitantly used anticholinergic medications. Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs.

Inform patients not to spray SPIRIVA RESPIMAT into the eyes as this may cause blurring of vision and pupil dilation.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

CL-SVR-100065 2.15.2017

Please see full Prescribing Information, including Instructions for Use, for SPIRIVA RESPIMAT.

References:

  1. Fuhlbrigge A, Reed ML, Stempel DA, et al. The status of asthma control in the U.S. adult population. Allergy Asthma Proc. 2009;30:529-533.

  2. Narasimhan K. Difficult-to-treat and severe asthma: management strategies. Am Fam Physician. 2021;103(5):286-290.

  3. Kew KM, Quinn M, Quon BS, Ducharme FM. Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2016, Issue 6. Art. No.:CD007524.

  4. SPIRIVA RESPIMAT [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc; January 2025.

  5. Boehringer Ingelheim. Savings Card terms and conditions for SPIRIVA RESPIMAT. Accessed Dec 19th 2024. https://pro.boehringer-ingelheim.com/us/products/spiriva/bipdf/spiriva-respimat-savings-card-terms-and-conditions-2026