Recommended Dosage of Stiolto (Tiotropium and Olodaterol)
The recommended dosage of Stiolto Respimat is two inhalations once daily at the same time of day, delivering a total daily dose of 5 mcg tiotropium and 5 mcg olodaterol. 1
Dosage Details
Stiolto Respimat is a fixed-dose combination of tiotropium bromide (a long-acting muscarinic antagonist/LAMA) and olodaterol (a long-acting β2-agonist/LABA) indicated for the long-term, once-daily maintenance treatment of patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.
Each actuation from the Stiolto Respimat inhaler delivers:
- 2.5 mcg tiotropium (equivalent to 3.124 mcg tiotropium bromide monohydrate)
- 2.5 mcg olodaterol (equivalent to 2.736 mcg olodaterol hydrochloride) 1
Two actuations equal one dose, providing a total daily dose of:
- 5 mcg tiotropium
- 5 mcg olodaterol 1
Administration Guidelines
- For oral inhalation only
- Administer at the same time each day for optimal efficacy
- Do not use more than two inhalations every 24 hours 1
Device Preparation and Maintenance
Before first use:
- Insert the Stiolto Respimat cartridge into the inhaler
- Prime the device by actuating toward the ground until an aerosol cloud is visible
- Repeat the process three more times 1
If not used for:
- More than 3 days: Actuate once to prepare for use
- More than 21 days: Actuate until an aerosol cloud is visible, then repeat three more times 1
Special Populations
No dosage adjustment is required for:
- Geriatric patients
- Patients with hepatic impairment
- Patients with renal impairment 1
However, patients with moderate to severe renal impairment should be monitored closely for anticholinergic effects 1
Clinical Efficacy
Stiolto Respimat has demonstrated significant benefits in clinical trials:
- Improved lung function compared to individual components 2, 3
- Enhanced quality of life and reduced dyspnea 3
- Decreased need for rescue medication, particularly at night 3
- Improved exercise endurance 2
Safety Profile
The safety profile of tiotropium/olodaterol is generally similar to that of the individual components, with no increased risk of cardiovascular events compared to tiotropium alone 4. The most common side effect specific to the tiotropium component is dry mouth 5.
Important Limitations
- Stiolto Respimat is not indicated to treat acute deteriorations of COPD
- It should not be used as rescue therapy for acute bronchospasm
- It is not indicated for the treatment of asthma 1
Remember that Stiolto Respimat is a maintenance medication and should be taken consistently as prescribed, with a separate short-acting bronchodilator available for rescue use when needed.