Spiriva Handihaler/Spiriva Respimat Drug Interactions

Common concomitant medications (LABA, ICS and their combinations) used by patients with COPD were not found to alter the exposure to tiotropium.
Spiriva Handihaler: Although no formal drug interaction studies have been performed, tiotropium bromide has been used concomitantly with other drugs, commonly used in the treatment of COPD, including sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids without clinical evidence of drug interactions.
Limited information about co-administration of other anticholinergic drugs with SPIRIVA is available from two clinical trials: Acute single dose administration of ipratropium bromide with chronically administered SPIRIVA in COPD patients (n=64) and healthy volunteers (n=35) was not associated with an increase in adverse events, changes in vital signs or electrocardiographic findings. However, chronic co-administration of other anticholinergic drugs with SPIRIVA 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 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.
The chronic co-administration of tiotropium bromide with other anticholinergic drugs has not been studied. Therefore, the chronic co-administration of other anticholinergic drugs with SPIRIVA RESPIMAT is not recommended.