Spiriva Caution For Usage

Instructions for Use: Spiriva HandiHaler: Remember to carefully follow the doctor's instructions for using SPIRIVA. The HandiHaler is especially designed for SPIRIVA. It must not be used to take any other medication. HandiHaler can be used for up to one year to take the medication.
1. To release the dust cap press the piercing button completely in and let go.
2. Open the dust cap completely by pulling it upwards. Then open the mouthpiece by pulling it upwards.
3. Remove a SPIRIVA capsule from the blister (only immediately before use, see blister handling) and place it in the centre chamber. It does not matter which way the capsule is placed in the chamber.
4. Close the mouthpiece firmly until a click is heard, leaving the dust cap open.
5. Hold the HandiHaler device with the mouthpiece upwards and press the piercing button completely in only once, and release. This makes holes in the capsule and allows the medication to be released when the patient breathes in.
6. Breathe out completely.
Important: Please avoid breathing into the mouthpiece at any time.
7. Raise the HandiHaler to the mouth and close the lips tightly around the mouthpiece. Keep the head in an upright position and breathe in slowly and deeply but at a rate sufficient to hear or feel the capsule vibrate. Breathe in until the lungs are full; then hold the breath as long as comfortable and at the same time take the HandiHaler out of the mouth. Resume normal breathing. Repeat steps 6 and 7 once, in order to empty the capsule completely.
8. Open the mouthpiece again. Tip out the used capsule and dispose. Close the mouthpiece and dust cap for storage of the HandiHaler device.
Cleaning the HandiHaler: Clean the HandiHaler once a month.
Open the dust cap and mouthpiece. Then open the base by lifting the piercing button. Rinse the complete inhaler with warm water to remove any powder. Dry the HandiHaler thoroughly by tipping excess of water out on a paper towel and air-dry afterwards, leaving the dust cap, mouthpiece and base open. It takes 24 hours to air dry, so clean it right after the patient used it and it will be ready for the next dose. If needed, the outside of the mouthpiece may be cleaned with a moist but not wet tissue.
Blister handling: A. Separate the blister strips by tearing along the perforation.
B. Peel back foil (only immediately before use) using the tab until one capsule is fully visible.
In case a second capsule is exposed to air inadvertently this capsule has to be discarded.
C. Remove capsule.
SPIRIVA capsules contain only a small amount of powder so that the capsule is only partially filled.
Spiriva Respimat: Introduction: Read these Instructions for Use before the patient starts using SPIRIVA RESPIMAT (tiotropium bromide monohydrate).
Children should use SPIRIVA RESPIMAT with an adult's assistance.
The patient will need to use this inhaler only ONCE A DAY. Each time the patient uses it, take TWO PUFFS.
How to store SPIRIVA RESPIMAT: Keep SPIRIVA RESPIMAT out of the sight and reach of children.
Do not freeze SPIRIVA RESPIMAT.
If SPIRIVA RESPIMAT has not been used for more than 7 days release one puff towards the ground.
If SPIRIVA RESPIMAT has not been used for more than 21 days repeat steps 4 to 6 under 'Prepare for first use' until a cloud is visible. Then repeat steps 4 to 6 three more times.
Do not use SPIRIVA RESPIMAT after the expiry date.
Do not touch the piercing element inside the clear base.
How to care for the SPIRIVA RESPIMAT: Clean the mouthpiece including the metal part inside the mouthpiece with a damp cloth or tissue only, at least once a week.
Any minor discoloration in the mouthpiece does not affect the SPIRIVA RESPIMAT inhaler performance.
When to get a new SPIRIVA RESPIMAT: SPIRIVA RESPIMAT inhaler contains 60 puffs (30 doses) if used as indicated (two puffs/once daily).
The dose indicator shows approximately how much medication is left.
When the dose indicator enters the red area of the scale the patient needs to get a new prescription; there is approximately medication for 7 days left (14 puffs).
Once the dose indicator reaches the end of the red scale, SPIRIVA RESPIMAT locks automatically - no more doses can be released. At this point, the clear base cannot be turned any further.
Three months after first use, the SPIRIVA RESPIMAT should be discarded even if it has not been used.
Prepare for first use: 1. Remove clear base: Keep the cap closed.
Press the safety catch while firmly pulling off the clear base with the other hand.
2. Insert cartridge: Insert the narrow end of the cartridge into the inhaler.
Place the inhaler on a firm surface and push down firmly until it snaps into place.
3. Replace clear base: Put the clear base back into place until it clicks.
4. Turn: Keep the cap closed.
Turn the clear base in the direction of the arrows on the label until it clicks (half a turn).
5. Open: Open the cap until it snaps fully open.
6. Press: Point the inhaler toward the ground.
Press the dose-release button.
Close the cap.
Repeat steps 4-6 until a cloud is visible.
After a cloud is visible, repeat steps 4-6 three more times.
Daily use: TURN: Keep the cap closed.
TURN the clear base in the direction of the arrows on the label until it clicks (half a turn).
OPEN: OPEN the cap until it snaps fully open.
PRESS: Breathe out slowly and fully.
Close the lips around the mouthpiece without covering the air vents.
While taking a slow, deep breath through the mouth, PRESS the dose-release button and continue to breathe in.
Hold the breath for 10 seconds or for as long as comfortable.
Repeat Turn, Open, Press for a total of 2 puffs.
Special precautions for disposal: Any unused medicinal product or waste material should be disposed of in accordance with local requirements.