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Tiotropium Bromide is available as 1.25 mcg or 2.5 mcg tiotropium per actuation with the SPIRIVA RESPIMAT inhaler. Two actuations equal one dose (2.5 mcg or 5 mcg).

Tiotropium Bromide is a long-acting muscarinic antagonist (LAMA) that is used to treat:

• Chronic obstructive pulmonary disease (COPD)
• Asthma in people age 6 years and older – Spiriva Respimat only

Tiotropium Bromide is an anticholinergic medication. It’s also called a long-acting muscarinic antagonist (LAMA). It attaches to proteins called muscarinic receptors to block signals that cause the muscles in your airways to tighten. As a result, the medication relaxes the muscles in your airways to make it easier for you to breathe.

Tiotropium Bromide is dosed as follows:

• Tiotropium Bromide and generic
• This medication comes as capsules for dry powder inhalation for use with the HandiHaler device. Each capsule contains 18 mcg of tiotropium. The medication is inhaled through the mouth using the HandiHaler device
• COPD: The typical dose is 2 inhalations of a single capsule (18 mcg total) once daily
• Spiriva Respimat
• This medication is available as a 2.5 mcg/puff and 1.25 mcg/puff metered-dose inhaler. The medication is inhaled through the mouth using the Respimat device.
• COPD: The typical dose is 2 inhalations of the 2.5 mcg inhaler (5 mcg total) once daily
• Asthma in people age 6 years and older: The typical dose is 2 inhalations of the 1.25 mcg inhaler (2.5 mcg total) once daily

Tiotropium Bromide is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you have a hypersensitivity to tiotropium, ipratropium, or any components of SPIRIVA
capsules.

Common side effects of Tiotropium Bromide:

• Upper respiratory tract infection
• Dry mouth
• Sinus inflammation
• Sore throat
• Urinary tract infection
• Chest pain

Serious side effects are rare with Tiotropium Bromide. Contact your healthcare provider immediately if you experience any of the following.

• Allergic reaction: hives, itching, swelling of the face or throat, trouble breathing
• Worsening breathing symptoms

The following medications may interact with Tiotropium Bromide:

• Anticholinergics: May interact additively with concomitantly used anticholinergic medications. Avoid administration of SPIRIVA
• HANDIHALER with other anticholinergic-containing drugs

Various FDA-approved generic manufacturers

It is not known if Tiotropium Bromide will harm your unborn baby. If you become pregnant while receiving Tiotropium Bromide, talk to your healthcare provider.

• Spiriva Handihaler
• Spiriva Respimat