Mechanism of Action

SPIRIVA is the only long-acting anticholinergic bronchodilator. SPIRIVA opens airways by blocking the stimulation of certain receptors in the airway smooth muscle.^{2, 6, 7}

SPIRIVA provides 24-hour bronchodilation and decreases air trapping

Illustration of lung and cross-sectional illustration of airway narrowed by cholinergic tone, causing air trapping.
SPIRIVA opens airways to release air trapped in the lungs

SPIRIVA improves airflow, reduces air trapping, and gives COPD patients more room to breathe ^{1, 6}

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IMPORTANT PRODUCT INFORMATION

SPIRIVA HandiHaler is indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

SPIRIVA HandiHaler is contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, ie, ipratropium, or to any component of this product.

SPIRIVA HandiHaler is not indicated for the initial treatment of acute episodes of bronchospasm, ie, rescue therapy.

Immediate hypersensitivity reactions, including angioedema, may occur after administration of SPIRIVA. Additionally, inhaled medicines, including SPIRIVA, may cause paradoxical bronchospasm. If either of these occurs, treatment with SPIRIVA should be stopped and other treatments considered.

As an anticholinergic drug, SPIRIVA may potentially worsen symptoms and signs associated with narrow-angle glaucoma, prostatic hyperplasia or bladder-neck obstruction, and should be used with caution in patients with any of these conditions.

As SPIRIVA is a predominantly renally excreted drug, SPIRIVA use should be monitored closely in patients with moderate to severe renal impairment (creatinine clearance of ≤50 mL/min).

SPIRIVA has been used concomitantly with other drugs commonly used in COPD (these include sympathomimetic bronchodilators, methylxanthines, and oral and inhaled steroids) without increases in adverse drug reactions. However, the co-administration of SPIRIVA with other anticholinergic-containing drugs (eg, ipratropium) has not been studied and is therefore not recommended.

The most commonly reported adverse drug reaction with SPIRIVA was dry mouth, which was usually mild and often resolved during continued treatment. Other reactions reported in individual patients and consistent with possible anticholinergic effects included constipation, increased heart rate, blurred vision, glaucoma, urinary difficulty and urinary retention.

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