From the Guidelines
Spiriva (tiotropium) is primarily used for the maintenance treatment of chronic obstructive pulmonary disease (COPD). The recommended dose is 18 micrograms administered once daily via the HandiHaler device 1. This medication is a long-acting muscarinic antagonist (LAMA) that helps to improve lung function, reduce symptoms, and decrease the risk of exacerbations 1.
- Key benefits of Spiriva include: improved lung function, reduced symptoms, and decreased risk of exacerbations 1.
- Comparison to other treatments: Spiriva has been shown to be superior to ipratropium in preventing exacerbations and improving lung function 1.
- Safety and efficacy: The safety and efficacy of Spiriva have been established in several studies, with a recommended dose of 18 micrograms once daily 1.
- Duration of therapy: Treatment with Spiriva should be continued for as long as it is tolerated and provides a clinical benefit, with no specific duration of therapy established 1.
From the FDA Drug Label
The drug product, STIOLTO RESPIMAT, is composed of a sterile aqueous solution of tiotropium bromide and olodaterol hydrochloride Tiotropium is a long-acting, muscarinic antagonist which is often referred to as an anticholinergic. It has similar affinity to the subtypes of muscarinic receptors, M1 to M5. In the airways, it exhibits pharmacological effects through inhibition of M3-receptors at the smooth muscle leading to bronchodilation
Spiriva (tiotropium) is used for the treatment of COPD (Chronic Obstructive Pulmonary Disease), as it exhibits pharmacological effects through inhibition of M3-receptors at the smooth muscle leading to bronchodilation 2 2.
From the Research
Overview of Spiriva (Tiotropium)
- Spiriva (tiotropium) is a long-acting anticholinergic bronchodilator used for the treatment of chronic obstructive pulmonary disease (COPD) 3, 4, 5, 6, 7.
- It has muscarinic M(1) and M(3) receptor subtype selectivity, producing a long-lasting (24 hours) dose-dependent bronchodilation and bronchoprotection against constrictive stimuli 3, 6.
Clinical Uses
- Tiotropium is indicated for the maintenance treatment of patients with COPD, with improvements in lung function, health-related quality of life, and reduction in exacerbation rates 5, 6.
- It is also used to prevent exacerbations in patients with COPD, with a significantly lower exacerbation rate and a longer time to first exacerbation compared to placebo or salmeterol 5.
- Combination therapy with tiotropium plus formoterol with or without budesonide has been shown to improve lung function and health-related quality of life in patients with COPD 5.
Mechanism of Action
- Tiotropium works by inhibiting pulmonary neutrophilic inflammation and reducing the release of inflammatory mediators, such as leukotriene B(4) and interleukin-6 4.
- It also has a bronchodilatory effect, with a duration of action of ≥24 hours, making it suitable for once-daily administration 3, 5.
Safety and Tolerability
- Tiotropium is generally well tolerated in patients with COPD, with anticholinergic adverse events, such as dry mouth and constipation, being among the most commonly reported adverse events 5, 6.
- The risk of serious cardiac adverse events, including congestive heart failure and myocardial infarction, was significantly lower with tiotropium than with placebo in the UPLIFT trial 5.