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Spiriva HandiHaler (tiotropium bromide inhalation powder) is a bronchodilator administered once per day to help reduce bronchospasm and other symptoms of COPD, including chronic bronchitis and emphysema. The medication is a powder, administered using the Spiriva HandiHaler device.

While Spiriva HandiHaler can be beneficial in reducing COPD symptoms, it will do little for an acute attack. This medication is not meant to replace a rescue inhaler or other rescue treatment, which should continue to be used as-needed. If Spiriva HandiHaler works as intended rescue treatments will not be needed as often, but should still be kept on-hand just in case.

Asthmatics who wish to use Spiriva as a steroid-free maintenance treatment should utilize Spiriva Respimat rather than Spiriva HandiHaler. The two products have some important distinctions:

• HandiHaler provides 18 mcg of tiotropium bromide per spray; Respimat delivers 1.25 to 2.5 mcg per spray.
• HandiHaler delivers the medication in a powder; Respimat delivers the medication in a mist.
• HandiHaler is largely restricted to adults; Respimat can be administered to children as young as 6.
• HandiHaler is administered just once per day; Respimat is usually administered in two sprays per day.

In theory there's no reason someone with severe asthma can't use Spiriva HandiHaler, provided the powder doesn't cause an attack and the dosage isn't too high; both of these are concerns for some individuals, but for others they might not be. Speak with a doctor about risks versus rewards before purchasing Spiriva HandiHaler for asthma.

Product Overview

This product's active ingredient, tiotropium bromide, is a bronchodilator that relaxes the small muscles that ultimately restrict breathing. It is a long-acting bronchodilator, lasting about 24 hours. It is not for use as a rescue treatment; rather, long-term use of Spiriva HandiHaler should reduce the frequency and severity of attacks, but a rescue medication, such as albuterol, may still be needed on occasion.

Spiriva HandiHaler relies on capsules containing dried powder. Capsules will be individually packaged in blister packs; one capsule should be removed from the blister pack right before use in the HandiHaler device. Note that there is only a very small amount of powder in each capsule; this is normal. Capsules should not be swallowed. Detailed instructions for using the HandiHaler are included with each product, and are also found on the manufacturer's website.

There are two versions of this product for sale at Kiwi Drug:

• Starter Packs include both a HandiHaler device as well as some capsules.
• Refill Packs include only capsules.

Patients who don't have a HandiHaler device or whose HandiHaler is becoming worn out will want to buy Starter Packs; those who have a functioning HandiHaler can buy Refill Packs.

For best results the medication should be used daily, usually once per day. Using the product at the same time each day will maximize results.

Dosage & Administration

The standard dose of Spiriva HandiHaler is one capsule per day. Once a capsule is inserted in the HandiHaler device (again detailed instructions for using the HandiHaler are included with each product), use is as follows:

• Press the green "piercing" button on the HandiHaler; this pierces the capsule and makes the powder available for inhalation.
• Breathe out completely.
• Holding your head upright so you're looking forward, bring the HandiHaler to your mouth and close lips around the mouthpiece.
• Breathe in deeply.
• While holding your breath, remove the HandiHaler from your mouth.
• Exhale completely and breathe normally for a minute.
• Return the HandiHaler to your mouth and again inhale deeply.
• Again remove the HandiHaler before exhaling.
• That's it!

After each dose the HandiHaler should be emptied by tapping it gently but firmly against a trash can; this will remove the capsule and any lingering powder. Washing the device with water is not needed after every use, but will be needed on occasion. Simply rinse it with warm water; avoid use of soaps and/or very hot water. When finished, leave the device open and spread out for drying, which will take about 24 hours. Do not use device while wet. Drying with a clean paper towel can speed things up if necessary.