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Spiriva (Tiotropium Bromide) Buyer and Patient Handbook in South Africa

What is Spiriva?

Spiriva is a long-acting anticholinergic inhaler used to maintain lung function in obstructive airway diseases such as chronic obstructive pulmonary disease (COPD) and, in some regions, Asthma. It belongs to the LAMA (Long-Acting Muscarinic Antagonist) class and works by relaxing airway smooth muscle. Spiriva is authorised by the South African Health Products Regulatory Authority (SAHPRA) and is available as a dry-powder inhaler.

Who Should Use Spiriva?

• Adults with stable COPD
• Patients whose symptoms are not fully controlled by short-acting bronchodilators
• Individuals who need once-daily maintenance therapy
• People who can perform the inhalation technique correctly

How Does It Work?

Spiriva contains the active ingredient tiotropium bromide, which blocks muscarinic receptors in the airway smooth muscle. By preventing acetylcholine-mediated contraction, the airways stay relaxed for up to 24 hours, improving breathing during daily activities, exercise, and sleep. The drug has low abuse potential because it does not produce a psycho-active effect.

Why Choose Spiriva?

• Once-daily dosing simplifies routine compared with twice-daily options.
• Proven efficacy in reducing COPD exacerbations and improving lung function.
• For patients who prefer a dry-powder device, Spiriva’s inhaler delivers consistent dose without propellants.
• Generic alternatives containing tiotropium bromide are available and offer cost savings while meeting bioequivalence standards.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

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

How to Take

1. Open the inhaler and turn the cap until you hear a click.
2. Exhale fully, away from the device.
3. Place the mouthpiece between your lips, seal tightly, and inhale briskly and deeply.
4. Close the inhaler immediately after inhalation.

Missed Dose

If you miss a dose and it is less than 12 hours later, take it as soon as you remember. If more than 12 hours have passed, skip the missed dose and resume your regular schedule-do not double-dose.

Overdose

In the unlikely event of an overdose, seek emergency medical assistance. Symptoms may include dry mouth, constipation, or blurred vision.

Special Populations

• Elderly: No dose adjustment needed, but monitor renal function.
• Renal impairment: Use with caution; consider reduced dose if creatinine clearance <30 mL/min.
• Children: Spiriva is not approved for patients under 18 years of age.

Lifestyle & Diet

• Avoid using the inhaler after consuming large amounts of grapefruit juice, which can affect drug metabolism.
• Keep the inhaler away from excessive heat and direct sunlight.
• Maintain a regular exercise programme; Spiriva improves exercise tolerance but does not replace bronchodilator rescue inhalers.

Precautions and Warnings

• Do not use Spiriva to treat acute bronchospasm; keep a short-acting rescue inhaler available.
• Monitor for signs of urinary retention or narrow-angle Glaucoma, especially in predisposed individuals.
• Inform your healthcare provider if you develop persistent dry mouth, constipation, or eye Pain.

Drug Interactions

Potential Side Effects

Common Side Effects

• Dry mouth
• Sore throat
• Cough

Less Common Side Effects

• Constipation
• Urinary retention
• Nasopharyngitis

Serious Side Effects

• Allergic Reactions (rash, swelling, difficulty breathing) - seek medical help immediately
• Severe blurred vision or eye pain - consult an eye specialist

Who Should Avoid This Medication?

• Patients with known hypersensitivity to tiotropium or any inhaler components
• Individuals with narrow-angle glaucoma or severe urinary retention
• Anyone experiencing a severe allergic reaction to the product

Storage Instructions

• Store at 15 °C - 30 °C (59 °F - 86 °F); avoid freezing.
• Keep the inhaler in its original container, protected from moisture.
• Keep out of reach of children and pets.

Spiriva Alternatives

Frequently Asked Questions

How long does it take for Spiriva to start working?

Spiriva begins to relax airway muscles within a few hours, but maximal benefit is usually observed after several days of consistent use.

Can I use Spiriva with my rescue inhaler?

Yes. Spiriva is a maintenance medication; you should still keep a short-acting bronchodilator for sudden symptom relief.

Is it safe to take Spiriva if I have high blood pressure?

Tiotropium does not generally affect blood pressure, but discuss any cardiovascular concerns with your healthcare provider.

Will Spiriva interact with my antihistamine?

No significant interaction is expected, but always inform your provider of all medicines you are taking.

Can I travel with Spiriva?

Yes. Carry the inhaler in your hand luggage, keep it upright, and avoid exposing it to extreme temperatures.

Does smoking affect Spiriva’s effectiveness?

Smoking can worsen lung disease and reduce overall treatment benefit; quitting is strongly advised.

What should I do if I experience persistent cough after using Spiriva?

Report the symptom to your provider; they may recommend a different inhaler technique or alternative therapy.

Is Spiriva suitable for people with asthma?

In South Africa, Spiriva is approved mainly for COPD. Some clinicians use it off-label for severe asthma, but this requires specialist evaluation.

Glossary

• LAMA: Long-Acting Muscarinic Antagonist, a class of drugs that keep airways open for 24 hours.
• Bronchodilator: Medication that relaxes airway muscles to improve airflow.
• Bioequivalence: Demonstration that a generic drug delivers the same amount of active ingredient as the brand product.

Disclaimer

The information provided here is for educational purposes only and does not replace professional medical advice. Off-label use, if considered, must be discussed with a qualified healthcare professional. Our service offers a platform to purchase approved medicines; we do not dispense prescriptions. Always consult a doctor or pharmacist before starting or changing any medication.