Tiotropium (as bromide monohydrate) 18 microgram Inhalation powder, hard capsule
What Tiotropium is used for:
- Tiotropium is used to help patients with chronic obstructive pulmonary disease (COPD) in breathing more easily.
- COPD is a chronic lung disease that leads to difficulty breathing and coughing.
- COPD is a disease that is linked with the respiratory problems known as chronic bronchitis and emphysema.
- COPD is a chronic respiratory problem and therefore you will need to use this inhaler on a daily basis and not only on an as needed basis when you are having breathing difficulties or other COPD symptoms.
- This medicine is also helpful when you are experiencing continuous shortness of breath linked to your respiratory problem and will therefore reduce the disease effects on your daily life.
- Additionally, it will allow you stay active for a longer period of time.
- This inhaler also assists in avoiding sudden and short-term worsening of your COPD signs and symptoms that can last for some days. This medicine gives an effect that lasts for 24 hours, therefore you will have to use your inhaler once daily only.
Do not use Tiotropium:
- If you are allergic to Tiotropium, or any of the ingredients in this medicine.
- Tell your doctor about the allergy and what signs you had.
- If you are allergic to atropine or medicines similar to it (e.g. oxitropium or ipratropium).
Warnings and Precautions:
- Stop the medication right away and talk to your doctor or pharmacist if you develop allergic reactions such as shortness of breath, skin rash, itching, swelling of the face or neck, decreased blood pressure and dizziness.
- Stop the medication right away and talk to your doctor if you develop chest tightness, coughing, difficulty breathing or wheezing right after inhaling your dose.
- Talk to your doctor if you have narrow angle glaucoma (increased pressure in your eye), prostate problems, urination problems, or kidney problems.
- This medicine should not be used to treat sudden attacks to wheezing and breathing difficulties.
- It is intended for daily and regular maintenance use of your respiratory problem only.
- Make sure that you keep the inhalation powder away from your eyes since this medicine may precipitate if it enters your eye which may worsen narrow angle glaucoma. If this happens, wash your eyes with warm water immediately, stop using the inhaler and talk to your doctor or eye specialist immediately whenever you experience signs of an acute attack of narrow angle glaucoma such as blurred vision, red eyes, eye pain or discomfort, and seeing halos around lights or colored images. These signs and symptoms may also be accompanied by nausea, headache, or vomiting.
- This medicine may cause dry mouth, which may be associated with dental caries since it is used for long-term. Therefore, make sure that you take care of your oral hygiene.
- Talk to your doctor before starting this medicine if you have previously had a myocardial infarction (heart attack) within the last 6 months or any unstable or life threatening irregular heartbeat or severe heart failure (inability of your heart muscle to pump blood properly) within the last year. This is essential to determine if this medicine suits you.
- Each capsule of this medicine contains 5.5 mg lactose monohydrate. Talk to your doctor before starting this medicine if you have been told by your doctor that you have an allergy to milk proteins or an intolerance to some sugars.
- Do not use this inhaler for more than once a day.
- This medicine is not recommended in children and adolescents under 18 years.
Possible side effects:
- Possible rare but serious side effects include allergic reactions and signs of bronchospasm (may happen with any inhaled medicine), like unexpected chest tightness, wheezing, coughing, or breathlessness immediately after inhalation.
- Common side effects include mild dry mouth.
- Uncommon side effects include dizziness, blurred vision, difficulty urinating, fungal infections of the oral cavity and throat (oropharyngeal candidiasis), taste disorders, sore throat, hoarseness, irregular heartbeat, cough, headache, rash, heartburn, constipation and painful urination.
Other medicines and Tiotropium:
- Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications including prescription medicines, over the counter medicines, herbals, vitamins and supplements.
- Talk to your doctor or pharmacist before taking this medicine if you are taking/have taken similar medications for your lung disease (e.g. oxitropium or ipratropium).
How to take Tiotropium:
- The recommended usual dose is to inhale the contents of 1 capsule (18 micrograms of tiotropium) once daily.
- Do not take higher than the recommended dose.
How To Use:
- Take this medicine exactly as prescribed by your doctor. Talk to your doctor or pharmacist if you are not sure.
- This medicine is not recommended for children and adolescents under 18 years.
- The effect of this medicine lasts for 24 hours, therefore make sure that you take your dose at the same time every day.
- The capsules are intended for inhalation only using the device provided with the medicine (Handihaler). Do not swallow the capsules.
- The inhaler device (handihaler) which you must place the tiotropium capsule into, creates holes in the capsule and allows the content of the capsule to be released so you can breathe in the powder.
- Do not blow into your inhalation device.
- Ask your healthcare provider on how to use the inhaler if you are not sure how to use it.
- To take a dose, start by releasing the dust cap and press the piercing button fully in and then let it go.
- Pull the dust cap completely upwards to open it and then pull the mouthpiece upwards to open it.
- Remove one tiotropium capsule from the blister right before use and put it in the center chamber of the inhaler device.
- The direction of putting the capsule in the chamber does not matter.
- Close the mouthpiece tightly until you hear a click and keep the dust cap open.
- Hold the inhaler device with the mouthpiece facing upwards and then press the piercing button fully in only once, and release.
- By doing so, holes will be created in the capsule allowing the release of the medicine so you can breathe it in.
- Then, make sure that you breathe out completely away from the mouthpiece.
- Do not breathe out into the mouthpiece at any time.
- Afterwards, raise the inhaler device to your mouth and seal your lips tightly around the mouthpiece.
- Make sure that your head is kept in an upright position and then inhale slowly and deeply but at a rate that is enough to feel or hear the capsule vibrate.
- Make sure that you breathe in until your lungs are full followed by holding your breath as long as you can and then at the same time remove the HandiHaler out of your mouth.
- Continue to breathe normally. In order to make sure that the capsule is completely emptied repeat once the steps mentioned from raising your device to your mouth and closing your lips tightly around it until inhaling the medicine and then continuing to breathe normally.
- Open the mouthpiece once again and tip out the used capsule to dispose it. Then, close the mouthpiece and dust cap again in order to store the device.
- Make sure that you clean your device once a month. In order to do so, start by opening the dust cap and mouthpiece.
- Then open the base by lifting the piercing button.
- Afterwards, continue by rinsing the entire inhaler device using warm water to get rid of any powder.
- Dry the inhaler device very well by tipping the water out of the device on a paper towel and then let it air dry, keeping the dust cap, mouthpiece and base open.
- It takes 24 hours for the device to completely air dry, so make sure that you clean it immediately after using it so it will be ready for use when it is time for your next dose.
- You may clean the outside of the mouthpiece with a moist (not wet) tissue if needed.
- For blister handling, start by tearing along the perforation to separate the blister strips. Then, proceed by peeling back the foil right before use using the tab until one capsule becomes completely visible.
- If another capsule gets exposed to air, you should discard this capsule.
- Remove the capsule from the blister so you can put it in the device.
- These capsules have only a small amount of powder.
- Talk to your doctor if you feel that your breathing is getting worse.
How to store Tiotropium:
- Keep out of the reach of children and pets
- Discard the device 12 months after first use.
- After taking your first capsule from the blister you should continue taking the capsules for the following 9 days, one capsule every day from the same blister.
- Do not store medication above 25°C. Do not freeze
- Do not use beyond the expiry date mentioned on the carton and the blister foil
- Do not use damaged capsules
- Do not dispose medication in the wastewater or household waste.
- Ask your pharmacist how you can dispose medicines you no longer need
