Nursing in Practice May/June 2020 (issue 114) | Page 17

formation from Boehringer Ingelheim y LAMA licensed in patients aged and above with severe asthma¹ at ® reusable inhaler: e with 1 5th 6th generates a unique mist of slow-moving, long-lasting fine droplets, designed to deliver medication deep into your patients’ lungs 2 es, the overall product carbon footprint sing the inhaler with one cartridge 3 r treatment in patients aged 6 years and older with severe asthma who a exacerbations in the preceding year. 1 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, leukotriene modifiers, cromones, anti-IgE treatment without clinical evidence of drug interactions. Use of LABA or ICS was not found to alter the exposure to tiotropium. The co-administration of tiotropium bromide with other anticholinergic-containing drugs has not been studied and is therefore not recommended. Fertility, Pregnancy and Lactation: Very limited amount of data in pregnant women. Avoid the use of Spiriva Respimat during pregnancy. It is unknown whether tiotropium bromide is excreted in human breast milk. Use of Spiriva Respimat during breast feeding is not recommended. A decision on whether to continue/discontinue breast feeding or therapy with Spiriva Respimat should be made taking into account the benefit of breast feeding to the child and the benefit of Spiriva Respimat therapy to the woman. Clinical data on fertility are not available for tiotropium. Effects on ability to drive and use machines: No studies have been performed. The occurrence of dizziness or blurred vision may influence the ability to drive and use machinery. Undesirable effects: COPD: Common (≥1/100 to <1/10) Dry mouth. Uncommon (≥1/1,000 to <1/100) Dizziness, headache, cough, pharyngitis, dysphonia, constipation, oropharyngeal candidiasis, rash, pruritus, urinary retention, dysuria. Rare (≥1/10,000 to <1/1,000): Insomnia, glaucoma, intraocular pressure increased, vision blurred, atrial fibrillation, palpitations, supraventricular tachycardia, tachycardia, epistaxis, bronchospasm, laryngitis, dysphagia, gastrooesophageal reflux disease, dental caries, gingivitis, glossitis, angioneurotic oedema, urticaria, skin infection/skin ulcer, dry skin, urinary tract infection. Not known (cannot be estimated from the available data): Dehydration, sinusitis, stomatitis, intestinal obstruction including ileus paralytic, nausea, hypersensitivity (including immediate reactions), anaphylactic reaction, joint swelling. Asthma: Uncommon (≥ 1/1,000 to < 1/100) Dizziness, headache, insomnia, palpitations, cough, pharyngitis, dysphonia, bronchospasm, dry mouth, oropharyngeal candidiasis, rash. Rare (≥1/10,000 to <1/1,000): Epistaxis, constipation, gingivitis, stomatitis, pruritus, angioneurotic oedema, urticaria, hypersensitivity (including immediate reactions), urinary tract infection. Not known (cannot be estimated from the available data): Dehydration, glaucoma, intraocular pressure increased, vision blurred, atrial fibrillation, supraventricular tachycardia, tachycardia, laryngitis, sinusitis, dysphagia, gastrooesophageal reflux disease, dental caries, glossitis, intestinal obstruction including ileus paralytic, nausea, skin infection/skin ulcer, dry skin, anaphylactic reaction, joint swelling, urinary retention, dysuria. Serious undesirable effects consistent with anticholinergic effects: glaucoma, constipation, intestinal obstruction including ileus paralytic and urinary retention. An increase in anticholinergic effects may occur with increasing age. Prescribers should consult the Summary of Product Characteristics for further information on undesirable effects. Pack sizes and NHS price: Single pack: 1 Respimat reusable inhaler and 1 cartridge providing 60 puffs (30 medicinal doses) £23.00; Single refill pack: 1 cartridge providing 60 puffs (30 medicinal doses) £23.00. Legal category: POM. MA number: PL 14598/0084. Marketing Authorisation Holder: Boehringer Ingelheim International GmbH, D-55216 Ingelheim am Rhein, Germany. Prescribers should consult the Summary of Product Characteristics for full prescribing information. Prepared in September 2019 Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Boehringer Ingelheim Drug Safety on 0800 328 1627 (freephone).