Spiriva Dosage/Direction for Use

Spiriva: Posology: The recommended dosage of SPIRIVA is inhalation of the contents of one capsule once daily with the HANDIHALER device at the same time of day (see Instructions for use under Cautions for Usage).
SPIRIVA should only be inhaled with the HandiHaler device.
The recommended dose should not be exceeded.
SPIRIVA capsules must not be swallowed.
Special populations: Geriatric patients can use tiotropium bromide at the recommended dose.
Renally impaired patients can use tiotropium bromide at the recommended dose. For patients with moderate to severe impairment (creatinine clearance ≤ 50 ml/min) see Precautions and Pharmacology: Pharmacokinetics under Actions.
Hepatically impaired patients can use tiotropium bromide at the recommended dose (see Pharmacology: Pharmacokinetics under Actions).
Paediatric population: COPD: There is no relevant use in the paediatric population (below 18 years) in the indication stated under Indications/Uses.
Cystic fibrosis: The safety and efficacy of SPIRIVA 18 microgram in children and adolescents has not been established. No data are available.
Method of administration: To ensure proper administration of the medicinal product the patient should be trained how to use the inhaler by the physician or by other healthcare professionals.
Spiriva Respimat: The recommended dosage of tiotropium using the SPIRIVA RESPIMAT is 5 micrograms. This is administered as two puffs once daily at the same time each day (see RESPIMAT inhaler Instructions for Use).
The recommended dose should not be exceeded.
In the treatment of asthma, the full benefits will be apparent after several doses of SPIRIVA RESPIMAT.
Paediatric population: In asthma, the recommended dosage of tiotropium using the SPIRIVA RESPIMAT in patients 6 to 17 years of age is 5 micrograms. This is administered as two puffs once daily from the RESPIMAT inhaler, at the same time each day (see SPIRIVA RESPIMAT Instructions for Use under Cautions for Usage).
Special populations: Elderly patients can use SPIRIVA RESPIMAT at the recommended dose.
Renally impaired patients can use SPIRIVA RESPIMAT at the recommended dose. However, as with all predominantly renally excreted drugs, SPIRIVA RESPIMAT use should be monitored closely in patients with moderate to severe renal impairment.
Hepatically impaired patients can use SPIRIVA RESPIMAT at the recommended dose.