Stiolto Respimat Inhaler: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Stiolto Respimat Inhaler contains tiotropium bromide and olodaterol, combining an anticholinergic (long-acting muscarinic antagonist, LAMA) with a long-acting beta2-adrenergic agonist (LABA). It is a prescription inhaler used once a day for the long-term control of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is not for treating asthma or sudden breathing attacks.

What is Stiolto Respimat Inhaler

Stiolto Respimat is a prescription inhaler that combines two medicines, tiotropium bromide and olodaterol, into a single inhalation spray. It is used once a day for the long-term control of chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. It is not for treating asthma or sudden breathing attacks.

Stiolto Respimat Inhaler uses

• Chronic obstructive pulmonary disease (COPD).
• Chronic bronchitis associated with COPD.
• Emphysema associated with COPD.
• Long-term maintenance of airway opening.
• Management of ongoing COPD-related breathing difficulties.

Benefits of Stiolto Respimat Inhaler

• Helps open the airways.
• Improves airflow.
• Reduces shortness of breath.
• Helps control wheezing.
• Supports long-term breathing management.

How Stiolto Respimat Inhaler works

Stiolto Respimat contains two medicines that open the airways in different ways. Tiotropium blocks a chemical signal that makes the muscles around the airways tighten, helping them stay relaxed. Olodaterol attaches to receptors in the airway muscles and relaxes them, which opens the airways and lets air move more easily.

Stiolto Respimat Inhaler dosage

Stiolto Respimat is taken as two inhalations (puffs) once a day, at the same time of day. It is for oral inhalation only; do not spray into the eyes. It should only be used with the Stiolto Respimat inhaler; do not use this inhaler for any other medicine. Do not use more than one dose (2 puffs) in 24 hours.

Priming is needed before first use: actuate the inhaler toward the ground until a mist is seen, then repeat three more times. If not used for more than 3 days, release one puff toward the ground before your next dose. If not used for more than 21 days, repeat the priming steps until a mist appears, then three more times.

This medicine is not meant to relieve sudden COPD symptoms — keep a fast-acting rescue inhaler with you at all times for sudden symptoms. Do not increase the dose if COPD symptoms get worse; contact your healthcare provider instead. Do not stop using this medicine without your healthcare provider's guidance, since symptoms may return.

Clean the mouthpiece, including the metal part inside, with a damp cloth or tissue at least once a week. This medicine is not approved for use in children, since COPD does not normally occur in children. No dosage adjustment is needed for elderly patients, or for those with liver or kidney problems, though patients with moderate to severe kidney impairment should be watched closely for side effects.

Available forms and strengths

• Inhaler

Side effects of Stiolto Respimat Inhaler

Common

• Cough
• Back pain
• Nasopharyngitis (runny or stuffy nose, common cold symptoms)
• Dizziness
• Insomnia
• Dehydration
• Heartburn/indigestion
• Dry mouth

Serious

• Serious allergic reactions, including hives, swelling of the face/lips/tongue/throat, and difficulty breathing
• Paradoxical bronchospasm (sudden worsening of breathing right after using the inhaler)
• Worsening of narrow-angle glaucoma (eye pain, blurred vision, seeing halos, red eyes)
• New or worsening urinary retention (difficulty or painful urination, especially with enlarged prostate)
• Heart effects such as fast or irregular heartbeat, palpitations, chest pain, and increased blood pressure
• Low potassium levels (hypokalemia), which can cause muscle weakness or abnormal heart rhythm
• High blood sugar levels (hyperglycemia)
• Serious asthma-related events, including hospitalization, intubation, or death, if used as the only asthma treatment
• Worsening COPD symptoms

Warnings and precautions

• Using a long-acting beta-agonist like the one in this medicine alone, without an inhaled corticosteroid, increases the risk of serious or fatal asthma-related events. This medicine is not approved to treat asthma.
• Do not start this medicine during a sudden worsening of COPD, and do not use extra doses to treat sudden breathing symptoms — always have a fast-acting rescue inhaler available.
• Do not use more than the recommended dose or combine with other medicines containing a long-acting beta-agonist, as this can cause serious, even fatal, heart-related effects.
• This medicine can cause sudden, serious allergic reactions including swelling of the face, lips, tongue, or throat, hives, rash, or trouble breathing. Stop the medicine right away and get medical help if this happens.
• This medicine can cause sudden worsening of breathing (paradoxical bronchospasm) right after use, which can be life-threatening. Stop use immediately if this occurs.
• Use with caution if you have heart or blood vessel problems, seizure disorders, an overactive thyroid, or are sensitive to stimulant-type medicines, since this medicine can affect heart rhythm and other body systems.
• This medicine may worsen narrow-angle glaucoma. Use with caution if you have this eye condition and seek medical help right away if symptoms occur.
• This medicine may worsen urinary retention in people with an enlarged prostate or bladder-neck blockage. Use with caution and seek help right away if symptoms develop.
• This medicine can lower blood potassium levels and raise blood sugar levels; be alert for symptoms of either.
• It is not known if this medicine can harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant, so you can decide together if this medicine is right for you during pregnancy.
• It is not known if this medicine passes into breast milk or if it could harm a nursing baby. Talk with your healthcare provider to decide whether you should use this medicine while breastfeeding.
• If you have moderate to severe kidney problems, your healthcare provider should watch you closely for side effects caused by the anticholinergic part of this medicine.
• No dose change is needed for people with mild to moderate liver problems; severe liver impairment has not been studied.
• There is no known direct interaction between this medicine and alcohol, but drinking too much alcohol over time may worsen lung infections and lung function in people with COPD.
• This medicine can cause dizziness and blurred vision, so be careful when driving a vehicle or operating machinery.

Storage

• Store at room temperature, between 68°F to 77°F (20°C to 25°C)
• Short trips outside this range, between 59°F to 86°F (15°C to 30°C), are permitted
• Avoid freezing the cartridge or inhaler
• Keep the inhaler, cartridge, and all medicines out of the reach of children
• Discard the inhaler 3 months after the cartridge is first inserted, even if not empty, or when the dose indicator shows it is locked/empty, whichever comes first

When to see a doctor

• Get emergency medical help right away if you have signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, hives, rash, or trouble breathing or swallowing.
• Stop the medicine and get emergency help right away if you have sudden shortness of breath after using this inhaler, as it can be life-threatening.
• Call your healthcare provider or get emergency care right away if your breathing problems get worse, you need your rescue inhaler more often than usual, or it stops working as well.
• Call your healthcare provider right away if you have eye pain, blurred vision, seeing halos or colored rings around lights, or red eyes, which may be signs of acute narrow-angle glaucoma.
• Call your healthcare provider right away if you have new or worsening trouble urinating, painful urination, frequent urination, or a weak urine stream.
• Call your healthcare provider if you have symptoms of low potassium, such as muscle weakness, unusual tiredness, muscle cramps or twitching, or an abnormal heartbeat.

Alternatives

• Ultibro Breezhaler
• Bevespi Aerosphere
• Anoro Ellipta