Does Spiriva (tiotropium) contain steroids and what about Dulera (mometasone/formoterol)?

Spiriva and Dulera: Steroid Content

Spiriva (tiotropium) does NOT contain steroids—it is a long-acting anticholinergic bronchodilator only, whereas Dulera DOES contain a steroid (mometasone) combined with a long-acting beta-agonist (formoterol).

Spiriva (Tiotropium) Composition

Spiriva is purely an anticholinergic medication without any corticosteroid component. 1

• Tiotropium is a long-acting muscarinic antagonist (anticholinergic) that works by blocking M3 receptors on airway smooth muscle to produce bronchodilation lasting at least 24 hours 2, 1
• The medication contains only tiotropium bromide as the active ingredient, with excipients including benzalkonium chloride, edetate disodium, hydrochloric acid, and water for injection 1
• Tiotropium has been used concomitantly with inhaled and oral steroids without increases in adverse reactions, confirming it is a separate drug class from corticosteroids 1

Dulera (Mometasone/Formoterol) Composition

Dulera is a combination inhaler containing BOTH a corticosteroid (mometasone) and a long-acting beta-agonist (formoterol).

• This represents an inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) combination therapy 3, 4
• The mometasone component provides anti-inflammatory effects that require consistent use to achieve and maintain therapeutic tissue levels 4
• The formoterol component is a long-acting beta2-agonist providing bronchodilation 3

Clinical Implications of the Difference

The absence of steroids in Spiriva means it avoids steroid-related side effects while the steroid in Dulera provides anti-inflammatory benefits but carries associated risks.

• Spiriva's side effects are limited to anticholinergic effects (primarily dry mouth in 10-15% of patients, plus potential urinary retention and glaucoma risk) 2, 5
• Dulera's steroid component (mometasone) carries risks of oropharyngeal candidiasis, dysphonia, easy bruisability, and potentially increased pneumonia risk when used in COPD patients 2, 3
• Both medications are designed for regular maintenance therapy, not as-needed use 4