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Spiriva (Tiotropium Bromide) Buyer and Patient Handbook in Singapore

What is Spiriva?

Spiriva is a long-acting bronchodilator inhaler used to manage chronic obstructive pulmonary disease (COPD) and Asthma. It belongs to the anticholinergic class, specifically a long-acting muscarinic antagonist (LAMA). The medication is approved by the Health Sciences Authority (HSA) of Singapore and is available as a metered-dose inhaler (MDI) delivering 9 µg of tiotropium bromide per puff.

Who Should Use Spiriva?

• Adults with diagnosed COPD (including chronic Bronchitis and emphysema)
• Adults with asthma that is not adequately controlled by short-acting relievers
• Patients who require once-daily maintenance therapy to improve lung function

How Does It Work?

Spiriva blocks muscarinic receptors in the airway smooth muscle, preventing acetylcholine-induced constriction. This “relaxes the airway,” much like loosening a tightened hose, allowing air to flow more freely during breathing. Because it works on a different pathway than beta-agonists, it complements other inhalers and has a low risk of causing tachycardia. Abuse potential is negligible, but it should be used only as prescribed for respiratory conditions.

Why Choose Spiriva?

• Consistent 24-hour bronchodilation reduces daily symptom fluctuations.
• The inhaler’s breath-actuated design ensures dose delivery even during mild coughing.
• A branded version is widely trusted, while generic equivalents (tiotropium bromide inhalers) offer comparable efficacy at lower cost.
• Off-label uses (e.g., experimental COPD phenotypes) should be discussed with a healthcare professional.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• One inhalation (9 µg) once daily, preferably at the same time each day.

How to Take

1. Remove the cap and shake the inhaler gently.
2. Exhale fully, then place the mouthpiece between your teeth and close your lips around it.
3. Press the canister firmly while breathing in slowly and deeply.
4. Hold your breath for about 10 seconds, then exhale slowly.
5. Replace the cap securely.

Missed Dose

If you miss a dose, take it as soon as you remember provided it is at least 6 hours before the next scheduled dose. If it is closer to the next dose, skip the missed one and continue with your regular schedule. Do not double-dose.

Overdose

In the unlikely event of inhaling more than the prescribed amount, seek immediate medical attention. Symptoms may include severe dry mouth, blurred vision, or rapid heart rate.

Special Populations

• Elderly: No dosage adjustment needed, but monitor inhaler technique.
• Renal impairment: Use with caution; mild to moderate impairment does not require change, severe impairment warrants specialist review.
• Pregnancy & breastfeeding: Category B2 (local data limited). Discuss risks with a healthcare provider.

Lifestyle & Diet

• Avoid grapefruit juice within 2 hours of inhalation, as it may alter drug metabolism.
• Continue regular exercise; Spiriva improves airflow, making activity easier.
• Do not smoke while using the inhaler, as tobacco can counteract its benefits.

Precautions and Warnings

• Do not use Spiriva for acute bronchospasm relief; keep a short-acting reliever on hand.
• Monitor for signs of urinary retention, especially in men with prostate enlargement.
• Report persistent dry mouth, visual disturbances, or heart palpitations promptly.

Drug Interactions

Potential Side Effects

Common Side Effects

• Dry mouth
• Hoarseness or throat irritation
• Cough

Less Common Side Effects

• Nasal congestion
• Upper respiratory infection
• Dyspepsia

Serious Side Effects

• Severe allergic reaction (rash, swelling, difficulty breathing) - seek emergency care
• Persistent urinary retention - consult a clinician
• Rapid heart rate or irregular heartbeat - seek medical advice

Who Should Avoid This Medication?

• Patients with known hypersensitivity to tiotropium bromide or any inhaler excipients
• Individuals experiencing acute bronchospasm (requires rescue inhaler)
• Those with narrow-angle Glaucoma (risk of increased intra-ocular pressure)

Storage Instructions

• Keep the inhaler at room temperature (15-30 °C); avoid extreme heat or cold.
• Store away from direct sunlight and moisture.
• Keep the cap on when not in use to protect the mouthpiece.
• Do not refrigerate or freeze.

Spiriva Alternatives

Frequently Asked Questions

How long does it take for Spiriva to start working?

Spiriva begins to relax the airways within 30 minutes, with maximum effect reached after 3 hours and lasting up to 24 hours.

Can I use Spiriva with my rescue inhaler?

Yes. Spiriva is a maintenance medication; you should still keep a short-acting bronchodilator (e.g., Salbutamol) for sudden breathlessness.

Is it safe to use Spiriva while drinking alcohol?

Moderate alcohol intake does not interfere with Spiriva’s action, but excessive drinking may worsen breathing problems, so limit consumption.

What should I do if I experience a dry mouth?

Sip water frequently, use a sugar-free lozenge, or discuss a saliva substitute with your healthcare professional.

Can I switch from a branded inhaler to a generic version?

Both contain the same active ingredient and dose; switching is clinically acceptable, but ensure you receive proper inhaler technique training.

Does Spiriva protect against infections like pneumonia?

Spiriva improves airflow but does not prevent respiratory infections. Vaccinations and good hygiene remain important.

How often should I replace the inhaler canister?

Each canister contains 30 doses. Replace it when the dose counter reaches **** or if you notice a reduced spray.

Is Spiriva suitable for children?

Spiriva is approved for adults and some pediatric patients with COPD; use in children under 18 years should be guided by a specialist.

Glossary

• LAMA (Long-Acting Muscarinic Antagonist): A drug class that blocks airway constriction for at least 24 hours.
• Bronchodilator: A medication that widens the airways to improve breathing.
• Metered-Dose Inhaler (MDI): A device that releases a specific amount of medication with each puff.

Disclaimer

The information provided here is for general educational purposes and reflects current knowledge about the medication. It does not replace professional medical advice. Off-label use should be discussed with a qualified healthcare provider. Our service offers information on medication availability and ordering through licensed pharmacies in Singapore; it does not prescribe or dispense medication. Always consult a healthcare professional before starting, stopping, or changing any treatment.