Spiriva Handihaler/Spiriva Respimat Overdosage

High doses of SPIRIVA/SPIRIVA RESPIMAT may lead to anticholinergic signs and symptoms.
Spiriva Handihaler: However, there were no systemic anticholinergic adverse effects following a single inhaled dose of up to 282 micrograms tiotropium in healthy volunteers.
Bilateral conjunctivitis in addition to dry mouth was seen in healthy volunteers following repeated once daily inhalation of 141 micrograms in healthy volunteers, which resolved while still under treatment. In a multiple dose study in COPD patients with a maximum daily dose of 36 micrograms tiotropium over four weeks dry mouth was the only observed adverse event attributable to tiotropium.
Acute intoxication by oral ingestion of tiotropium capsules is unlikely due to low oral bioavailability.
Spiriva Respimat: No relevant adverse events, beyond dry mouth/throat and dry nasal mucosa in a dose-dependent [10 - 40 μg daily] incidence, were observed following 14-day dosing of up to 40 μg tiotropium inhalation solution in healthy subjects with the exception of pronounced reduction in salivary flow from day 7 onwards. No significant undesirable effects have been observed in six long term studies in COPD patients when a daily dose of 10 μg tiotropium inhalation solution was given over 4 - 48 weeks.