Stiolto (Tiotropium/Olodaterol) Dosing for COPD
The recommended dose of Stiolto (tiotropium/olodaterol) for chronic obstructive pulmonary disease (COPD) is 5/5 μg (5 μg tiotropium and 5 μg olodaterol) administered once daily via the Respimat inhaler. 1, 2
Dosing Specifics
- Stiolto is administered as two inhalations once daily from the Respimat inhaler, delivering a total daily dose of 5 μg tiotropium and 5 μg olodaterol 2
- The medication should be taken at the same time each day to maintain consistent 24-hour bronchodilation 1
- No dosage adjustment is required for elderly patients, patients with renal impairment, or those with mild to moderate hepatic impairment 1
Clinical Evidence Supporting Once-Daily Dosing
- Large multicenter clinical trials of up to 52 weeks duration have confirmed the efficacy and safety of the once-daily 5/5 μg dosing regimen 2
- Once-daily dosing provides 24-hour bronchodilation with significant improvements in lung function parameters compared to individual components 3
- The fixed-dose combination significantly improves FEV₁ area under the curve from 0 to 3 hours (AUC₀₋₃) and trough FEV₁ compared to either tiotropium or olodaterol monotherapy 3
Patient Selection and Considerations
- Stiolto is indicated for the long-term maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema 1, 2
- The medication is particularly beneficial for patients with moderate to very severe COPD (GOLD 2-4) 4
- Patients with less severe disease generally show greater improvements in lung function parameters when treated with Stiolto 4
- Stiolto provides significant benefits regardless of whether patients have received prior LAMA or LABA maintenance treatment 4
Administration Technique
- The Respimat inhaler should be primed before first use 2
- Patients should exhale completely before placing the mouthpiece in their mouth 1
- While taking a slow, deep breath through the mouth, patients should press the dose release button and continue to inhale slowly 1
- Patients should hold their breath for 10 seconds or as long as comfortable 1
Common Pitfalls to Avoid
- Failing to properly prime the Respimat inhaler before first use may result in inadequate medication delivery 1
- Using Stiolto more than once daily is not recommended and may increase the risk of adverse effects 2
- Patients should not use Stiolto with other medications containing LAMAs (such as tiotropium, umeclidinium, or glycopyrronium) due to risk of anticholinergic effects 1
- Stiolto should not be initiated in patients during rapidly deteriorating or potentially life-threatening episodes of COPD 2
By following these dosing recommendations, patients with COPD can maximize the bronchodilator benefits of Stiolto while minimizing potential adverse effects.