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Add SPIRIVA RESPIMAT 1.25 mcg earlier when asthma is uncontrolled

Uncontrolled symptoms put patients with asthma at risk

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Complications With Uncontrolled Asthma Icon

Uncontrolled asthma

Persistent symptoms, frequent rescue medication usage, and activity limitations are associated with uncontrolled asthma1
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Recognizing a patient who needs more control

  • Young adult patient, mid-30s
  • Currently using ICS/LABA
  • Overuse of SABA due to uncontrolled asthma symptoms
  • 2 or more exacerbations in a year
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Recognizing the pediatric patient who needs more control

  • Child as young as 6 years
  • Child relies on rescue inhaler and their symptoms are interrupting their day
  • Child may have an attack requiring 1 ED visit per year
  • Caregiver is worried about child’s future lung function
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Add on a steroid-sparing treatment earlier, before escalating ICS or switching to a biologic, to help control symptoms4,5

ICS, inhaled corticosteroid; LABA, long-acting beta₂-agonist; SABA, short-acting beta₂-agonist; ED, emergency department.

INDICATION

SPIRIVA RESPIMAT, 1.25 mcg, is a bronchodilator indicated for the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older. SPIRIVA RESPIMAT is not indicated for relief of acute bronchospasm.

IMPORTANT SAFETY INFORMATION

SPIRIVA® RESPIMAT® (tiotropium bromide) Inhalation Spray is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, or any component of this product. Immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported.

SPIRIVA RESPIMAT is intended as a once-daily maintenance treatment for asthma and should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. In the event of an attack, a rapid-acting beta2-agonist should be used.


Immediate hypersensitivity reactions, including urticaria, angioedema (including swelling of the lips, tongue, or throat), rash, bronchospasm, anaphylaxis, or itching may occur after administration of SPIRIVA RESPIMAT. If such a reaction occurs, discontinue SPIRIVA RESPIMAT at once and consider alternative treatments. Given the similar structural formula of atropine to tiotropium, patients with a history of hypersensitivity reactions to atropine or its derivatives should be closely monitored for similar hypersensitivity reactions to SPIRIVA RESPIMAT.


Inhaled medicines, including SPIRIVA RESPIMAT, may cause paradoxical bronchospasm. If this occurs, it should be treated with an inhaled short-acting beta2-agonist, such as albuterol. Treatment with SPIRIVA RESPIMAT should be stopped and other treatments considered.


SPIRIVA RESPIMAT should be used with caution in patients with narrow-angle glaucoma. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema). Instruct patients to consult a physician immediately should any of these signs or symptoms develop.


Since dizziness and blurred vision may occur with the use of SPIRIVA RESPIMAT, caution patients about engaging in activities such as driving a vehicle, or operating appliances or machinery.


SPIRIVA RESPIMAT should be used with caution in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Instruct patients to consult a physician immediately should any of these signs or symptoms develop.


Patients with moderate to severe renal impairment (creatinine clearance of <60 mL/min) treated with SPIRIVA RESPIMAT should be monitored closely for anticholinergic side effects.


The most common adverse reactions >2% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in asthma trials in adults were pharyngitis 15.9% (12.4%), headache 3.8% (2.7%), bronchitis 3.3% (1.4%), and sinusitis 2.7% (1.4%). The adverse reaction profile for adolescent and pediatric patients was comparable to that observed in adult patients with asthma.


SPIRIVA RESPIMAT may interact additively with concomitantly used anticholinergic medications. Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs.


Inform patients not to spray SPIRIVA RESPIMAT into the eyes as this may cause blurring of vision and pupil dilation.

Please see full Prescribing Information, including Instructions for Use, for SPIRIVA RESPIMAT.

CL-SVR-0044 2.15.2017

REFERENCES

  1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Accessed November 16, 2023. https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Full-report-23_07_06-WMS.pdf

  2. Fuhlbrigge A, Reed ML, Stempel DA, Ortega HO, Fanning K, Stanford RH. The status of asthma control in the U.S. adult population. Allergy Asthma Proc. 2009;30(5):529-533.

  3. Kew KM, Quinn M, Quon BS, Ducharme FM. Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Cochrane Database Syst Rev. 2016;2016(6):CD007524.

  4. SPIRIVA RESPIMAT [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc; November 2021.

  5. National Heart, Lung, and Blood Institute. 2020 Focused Updates to the Asthma Management Guidelines. National Institutes of Health; December 2020. NIH publication 20-HL-8140. Accessed November 16, 2023. https://www.nhlbi.nih.gov/resources/2020-focused-updates-asthma-management-guidelines