Aviar Special Precautions

Tiotropium bromide, as a once daily maintenance bronchodilator, should not be used for the initial treatment of acute episodes of bronchospasm, i.e. rescue therapy or for relief of acute symptoms.
Immediate hypersensitivity reactions may occur after administration of Tiotropium bromide inhalation powder.
As with other anticholinergic drugs, Tiotropium bromide should be used with caution in patients with narrow-angle glaucoma, prostatic hyperplasia or bladder-neck obstruction.
Inhaled medicines may cause inhalation-induced bronchospasm.
As with all predominantly renally excreted drugs, Tiotropium bromide use should be monitored closely in patients with moderate to severe renal impairment (creatinine clearance of ≤50 mL/min).
Patients must be instructed in the correct administration of Tiotropium bromide capsules. Care must be taken not to allow the powder to enter into the eyes. Eye pain or discomfort, blurred vision, visual halos, or colored images in association with red eyes from conjunctival congestion and corneal edema may be signs of acute narrow-angle glaucoma. Should any combination of these symptoms develop specialist advice should be sought immediately.
Miotic eye drops are not considered to be effective treatment.
Tiotropium bromide should not be used more frequently than once daily.
Tiotropium bromide capsules are to be used only with the device.
This product contains 500 mg of lactose monohydrate per capsule.
Effects on Ability to Drive and Use Machines: No studies on the effects on the ability to drive and use machines have been performed. The occurrence of dizziness or blurred vision may influence the ability to drive and use machinery.