Usual Adult Dose for Chronic Obstructive Pulmonary Disease - Maintenance

Tiotropium inhalation powder, hard capsule:

• 18 mcg (2 inhalations) orally once a day using the HandiHaler device

Tiotropium, solution for inhalation:

• 5 mcg (2 inhalations) orally once a day

Uses: Long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema; to reduce exacerbations in COPD patients

Usual Adult Dose for Asthma - Maintenance

• 2.5 mcg (2 inhalations of 1.25 mcg) orally once a day

Comments:

• The maximum benefits in lung function may take up to 4 to 8 weeks of dosing.

Use: Long-term maintenance treatment of asthma

Usual Pediatric Dose for Asthma - Maintenance

6 years or older:

• 2.5 mcg (2 inhalations of 1.25 mcg) orally once a day

Comments:

• The maximum benefits in lung function may take up to 4 to 8 weeks of dosing.

Use: Long-term maintenance treatment of asthma

Renal Dose Adjustments

Mild renal dysfunction (CrCl 60 mL/min or more): No adjustment recommended.
Moderate to Severe renal dysfunction (CrCl less than 60 mL/min): Use with caution.

Liver Dose Adjustments

No adjustment recommended.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to any of the ingredients

COPD: Safety and efficacy have not been established in patients younger than 18 years.
Asthma: Safety and efficacy have not been established in patients younger than 6 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Tiotropium inhalation spray should be administered only via the Respimat inhaler and it should not be used for administering other medications.
• Tiotropium capsules are for oral inhalation only and should not be swallowed; capsules should be used with the HandiHaler device only.
• Priming the inhalation device is essential to ensure appropriate content of the medication in each actuation.
• Consult the manufacturer's product information for complete administration instructions.

General:

• This drug should not be used for the initial treatment of acute episodes of bronchospasm, or for immediate relief of breathing problems (i.e., as a rescue medication).

Patient advice:

• Patients should report any signs and symptoms of 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) and urinary retention (e.g., difficulty passing urine, painful urination).
• Patients should avoid getting this drug into the eyes as it may cause blurring of vision and pupil dilation.
• This drug may cause dizziness and blurred vision; avoid driving or operating machinery if you feel drowsy or dizzy.
• Advise patients that anaphylaxis, angioedema (including swelling of the lips, tongue, or throat), urticaria, rash, bronchospasm, or itching may occur with this medication, and to immediately discontinue treatment and consult a physician if these signs or symptoms develop.