Spiriva Drug Interactions

Spiriva: Although no formal drug interaction studies have been performed, tiotropium bromide inhalation powder has been used concomitantly with other drugs without clinical evidence of drug interactions. These include sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids, commonly used in the treatment of COPD.
Use of LABA or ICS was not found to alter the exposure to tiotropium.
The co-administration of tiotropium bromide with other anticholinergic-containing drugs has not been studied and is therefore not recommended.
Spiriva Respimat: Although no formal drug interaction studies have been performed, tiotropium bromide has been used concomitantly with other drugs which are commonly used in the treatment of COPD and asthma, including sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leucotriene modifiers, cromones and anti-IgE treatment without clinical evidence of drug interactions.
Common concomitant medications (LABA, ICS and their combinations) used by patients with COPD were not found to alter the exposure to tiotropium.
Limited information about co-administration of other anticholinergic medicines with SPIRIVA is available from a clinical trial. The concomitant use of SPIRIVA RESPIMAT with other anticholinergic agents (e.g. glycopyrronium, aclidinium, umeclidinium, ipratropium) is expected to have additive anticholinergic effects. Acute single dose administration of ipratropium bromide after 19 days of SPIRIVA treatment in healthy volunteers (n=35) was not associated with relevant changes in vital signs or electrocardiographic findings. Adverse events were reported by 3 (9%) of subjects in the study during ipratropium treatment with tiotropium compared to 1 (3%) during placebo treatment with tiotropium. Ipratropium was associated with a 16% decrease in salivary secretions in healthy volunteers. The chronic co- administration of tiotropium bromide with other anticholinergic medicines has not been studied. Therefore, the chronic co-administration of other anticholinergic drugs with SPIRIVA RESPIMAT is not recommended.