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Add On Treatment

SPIRIVA RESPIMAT 1.25mcg is a long-acting maintenance therapy that helps to further control symptoms1-3

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Works Differently

SPIRIVA RESPIMAT 1.25mcg is a LAMA that inhibits the M3 receptors at the smooth muscle leading to bronchodilation in the airways1

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Exacerbation Data

Review exacerbation data and efficacy for uncontrolled asthma symptoms for SPIRIVA RESPIMAT 1.25mcg

See Trials 2 & 3 data

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    An asthma exacerbation was defined as an episode of progressive increase in ≥1 asthma symptom(s), eg, shortness of breath, cough, wheezing, chest tightness, or a combination of these symptoms; or a 30% decrease in best morning peak expiratory flow (PEF) for ≥2 consecutive days that required initiation of or increase in treatment with systemic steroids for ≥3 days.1-3

Add SPIRIVA RESPIMAT 1.25mcg when asthma is uncontrolled with ICS/LABA1-3

Recognizing a pediatric patient who may need more asthma control1,4

  • Child as young as 6 years

  • Receiving maintenance therapy with ICS/LABA

  • Still experiencing asthma symptoms

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Recognizing an adult patient who may need more asthma control3

  • Young adult at asthma onset, early 20s

  • Receiving ICS treatment with or without a LABA

  • Remains symptomatic despite treatment

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For patients uncontrolled on ICS/LABA, add SPIRIVA RESPIMAT 1.25mcg1-3

ICS, inhaled corticosteroid; LABA, long-acting beta₂-agonist; SABA, short-acting beta₂-agonist; ED, emergency department.

FAQs

Uncontrolled asthma is characterized by poor symptom control or frequent exacerbations.4,5 Evidence suggests that escalating doses of inhaled corticosteroids may not always be helpful in such cases.6

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

  2. Kerstjens HAM, Casale TB, Bleecker ER, et al. Tiotropium or salmeterol as add-on therapy to inhaled corticosteroids for patients with moderate symptomatic asthma: two replicate, double-blind, placebo-controlled, parallel-group, active-comparator, randomised trials. Lancet Respir Med. 2015;3(5):367-376

  3. National Heart, Lung, and Blood Institute. 2020 Focused Updates to the Asthma Management Guidelines. National Institutes of Health; December 2020. NIH publication 20-HL-8140. Accessed May 28, 2024. https://www.nhlbi.nih.gov/resources/2020-focused-updates-asthma-management-guidelines

  4. Szefler SJ, Murphy K, Harper T III. A phase III randomized controlled trial of tiotropium add-on therapy in children with severe symptomatic asthma. J Allergy Clin Immunol. 2017;14095):1277-1287