Spiriva Handihaler

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Spiriva Handihaler (Tiotropium-inh).

Asthma Medications: Tiotropium is intended for use with other medications to treat asthma. It should not be used to treat asthma if you are not also using a corticosteroid and a long-acting beta-agonist. It does not provide fast relief from asthma symptoms such as wheezing and shortness of breath. Always carry a short-acting beta-agonist, such as salbutamol, with you to treat sudden flare-ups of symptoms.

Bladder or urinary problems: Tiotropium can worsen symptoms of bladder problems. If you have a history of bladder problems, discuss with your doctor how Spiriva Handihaler (Tiotropium-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Spiriva Handihaler (Tiotropium-inh), and whether any special monitoring is needed.

Dizziness/blurred vision: Tiotropium may cause dizziness or blurred vision, affecting your ability to safely drive or operate machinery. Avoid these and other hazardous tasks until you know how Spiriva Handihaler (Tiotropium-inh) affects you.

Enlarged prostate: Tiotropium can worsen symptoms of an enlarged prostate, such as difficulty starting urination. If you have an enlarged prostate, discuss with your doctor how Spiriva Handihaler (Tiotropium-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Spiriva Handihaler (Tiotropium-inh), and whether any special monitoring is needed.

Glaucoma: People with eye conditions (e.g., glaucoma) are more likely to experience worsening of their conditions and symptoms such as eye pain and swelling, blurred vision, or other unusual changes in their vision. Take extra care to ensure that tiotropium powder does not come into contact with your eyes. If your eyes have been in contact with tiotropium powder or you have any of these symptoms, contact your doctor immediately.

Inhalation-induced bronchospasm: Inhaled forms of medications may cause spasms of the airways which make breathing difficult. If you experience this problem when using tiotropium, stop using Spiriva Handihaler (Tiotropium-inh) immediately. Speak to your doctor if you experience any problems with breathing while taking this or other inhaled medication.

Kidney function: Reduced kidney function or Kidney Disease may cause tiotropium to build up in the body, causing side effects. In people with reduced kidney function, tiotropium should only be used if the potential benefits outweigh the risks.

If you have reduced kidney function or kidney disease, discuss with your doctor how Spiriva Handihaler (Tiotropium-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Spiriva Handihaler (Tiotropium-inh), and whether any special monitoring is needed.

Urinary tract problems: Spiriva Handihaler (Tiotropium-inh) can cause increased difficulty with urine flow and urinary retention. If you have an enlarged prostate gland or another condition that makes it difficult to pass urine, discuss with your doctor how Spiriva Handihaler (Tiotropium-inh) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Spiriva Handihaler (Tiotropium-inh), and whether any special monitoring is needed.

If you experience difficulty starting to urinate or have pain when you urinate, speak with your doctor as soon as possible.

Worsening symptoms: If you find you need to use your short-acting ("rescue") inhaler more often or if your condition seems to worsen, call your doctor. If you have not been given instructions beforehand, contact your doctor immediately about what to do if any of the following situations occur (they may be signs of seriously worsening COPD or asthma):

• decreased effectiveness of short-acting, inhaled bronchodilators such as salbutamol, terbutaline, or fenoterol (less than 4 hours of relief)
• need for more inhalations than usual of short-acting, inhaled bronchodilators

Pregnancy: No studies have been done on the use of tiotropium by pregnant women. Spiriva Handihaler (Tiotropium-inh) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Spiriva Handihaler (Tiotropium-inh), contact your doctor immediately.

Breast-feeding: Spiriva Handihaler (Tiotropium-inh) may pass into breast milk. If you are a breast-feeding mother and are using tiotropium, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Spiriva Handihaler (Tiotropium-inh) for children younger than 18 years of age have not been established.