SPIRIVA RESPIMAT

Tiotropium

SPIRIVA RESPIMAT

LAMA SMI

Tiotropium bromide · Boehringer Ingelheim

Clinical Reference

Active Medication & Mechanism

Tiotropium bromide monohydrate LAMA
1.25 mcg or 2.5 mcg per actuation

Long-acting muscarinic antagonist. Provides 24-hour bronchodilation by blocking M3 muscarinic receptors on airway smooth muscle with very slow receptor dissociation kinetics.

FDA-Approved Dosing by Indication

// approval varies by strength + age

Asthma

1/2 approved regimens

Strength	Population	Dose & Frequency	Total Daily	Status
1.25 mcg	Patients ≥6 years	2 puffs (2.5 mcg total) once daily Add-on maintenance treatment of asthma in patients ≥6 years already on ICS. Not a substitute for ICS.	2.5 mcg	FDA Approved
Any strength	Acute bronchospasm	—	—	Not Approved Not a rescue inhaler. Use a SABA for acute symptoms.

1.25 mcg FDA Approved

Pop · Patients ≥6 years

2 puffs (2.5 mcg total) once daily

Add-on maintenance treatment of asthma in patients ≥6 years already on ICS. Not a substitute for ICS.

Total · 2.5 mcg
Any strength Not Approved

Pop · Acute bronchospasm

—

Total · — Not a rescue inhaler. Use a SABA for acute symptoms.

COPD

1/2 approved regimens

Strength	Population	Dose & Frequency	Total Daily	Status
2.5 mcg	Adults (≥18 years)	2 puffs (5 mcg total) once daily Long-term, once-daily maintenance treatment of bronchospasm in COPD. Also reduces exacerbations.	5 mcg	FDA Approved
1.25 mcg	Adults (≥18 years)	—	—	Not Approved The 1.25 mcg strength is NOT indicated for COPD — use the 2.5 mcg strength.

2.5 mcg FDA Approved

Pop · Adults (≥18 years)

2 puffs (5 mcg total) once daily

Long-term, once-daily maintenance treatment of bronchospasm in COPD. Also reduces exacerbations.

Total · 5 mcg
1.25 mcg Not Approved

Pop · Adults (≥18 years)

—

Total · — The 1.25 mcg strength is NOT indicated for COPD — use the 2.5 mcg strength.

Acute Use

0/1 approved regimens

Strength	Population	Dose & Frequency	Total Daily	Status
Any strength	Acute bronchospasm / rescue	—	—	Not Approved Onset too slow for rescue. Use a SABA.

Any strength Not Approved

Pop · Acute bronchospasm / rescue

—

Total · — Onset too slow for rescue. Use a SABA.