Generic Spiriva ™ ®: Tiotropium Bromide
Tiotropium Bromide is the chemical name of the active ingredient in Spiriva ™ ®

Capsule
Chemical Name: TIOTROPIUM BROMIDE (tee-oh-TROE-pee-um BROE-mide)

Common uses : This medicine is an anticholinergic agent used to treat the symptoms of chronic obstructive pulmonary disease, including chronic bronchitis and emphysema, in adults. This medicine is inhaled into the lungs where it enlarges your airways to allow you to breathe easier. It may also be used to treat other conditions as determined by your doctor.

Before using : INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other anticholinergic medicines including antihistamines, antispasmodics, or medicines for Parkinson's disease. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including narrow-angle glaucoma, severe kidney problems, prostate problems, difficulty urinating, allergies (especially to lactose or atropine derivatives like ipratropium), pregnancy, or breast-feeding.

Directions : Follow the directions for using this medicine provided by your doctor. This medicine comes with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have before using this medicine. DO NOT SWALLOW THE CAPSULES. THE CAPSULES ARE USED WITH A SPECIAL INHALER. DO NOT remove a capsule from the packaging until you are ready to use it. If a second capsule is exposed to the air when you are removing a capsule for use, it must be discarded. Do not save the capsule for later. The capsule must immediately be placed in a special inhaler device. The device will puncture the capsule so that the medicine inside may be inhaled into the lungs through the mouthpiece. Exhale slowly and deeply. DO NOT breathe into the mouthpiece of the inhaler. Position the inhaler mouthpiece between your lips and try to rest your tongue flat. Keep your head upright. TAKE A SLOW, DEEP BREATH. You should hear the capsule vibrate inside the inhaler. Hold your breath as long as it feels comfortable, then exhale slowly through pursed lips. Breathe out completely. To be sure all of the medicine has been inhaled from the capsule, inhale from the mouthpiece a second time following the same process. Ask your doctor or pharmacist if you are unclear on how to use this device or inhale the medicine. Clean the inhaler device only if needed. If you are using the same inhaler device for longer than one month at a time before getting a new one, clean it once a month. To clean the inhaler device, follow the instructions in the patient information leaflet. Each inhaler device may be used for up to one year and then should be replaced. STORE THIS MEDICINE at room temperature between 59 and 77 degrees F (15 and 25 degrees C), away from heat, moisture, and light. Do NOT freeze. After removing a capsule from a strip, all of the remaining capsules in the strip must be used within 5 days. This medicine will work best if used regularly. To help you remember, take your dose at the same time each day. IF YOU MISS A DOSE OF THIS MEDICINE, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do NOT use 2 doses at once.

Cautions : THIS MEDICINE WILL NOT STOP AN ASTHMA ATTACK once one has started. IF YOU ARE ALSO USING A BRONCHODILATOR INHALER, be sure to always carry the bronchodilator inhaler with you to use during asthma attacks. DO NOT EXCEED THE RECOMMENDED DOSE without checking with your doctor. DO NOT STOP USING THIS MEDICINE without first checking with your doctor. THIS MEDICINE MAY CAUSE BLURRED VISION. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. AVOID getting this medicine in your eyes. If you get the medicine in your eyes and eye pain, blurred vision, or other vision changes occur, CONTACT YOUR DOCTOR IMMEDIATELY. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. THIS MEDICINE IS EXCRETED in breast milk. IF YOU ARE OR WILL BE BREAST-FEEDING while you are using this medicine, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects : SIDE EFFECTS, that may go away during treatment, include dry mouth, constipation, vomiting, blurred vision, or nosebleed. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR as soon as possible if you experience pain or white patches in your mouth or on your tongue, or difficulty urinating. Rarely, immediately after using a dose of this medicine your breathing may become more difficult and wheezing may worsen. If this occurs, CONTACT YOUR DOCTOR IMMEDIATELY. CONTACT YOUR DOCTOR IMMEDIATELY if you experience a rapid or irregular heartbeat. AN ALLERGIC REACTION to this medicine is unlikely but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or severe trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions : Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions

If you take too much : If overdose is suspected, contact your local poison control center or emergency room immediately.

Additional information : DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.