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Overview: Stiolto Respimat (tiotropium/olodaterol) is an inhaler for chronic obstructive pulmonary disease (COPD). It relaxes the muscles around the airways and helps open up the airways to make it easier to breathe. A common side effect is coughing. Contact your healthcare provider right away if your breathing gets worse instead of better right after using Stiolto Respimat.

Uses

What is Stiolto Respimat used for?

Stiolto Respimat (tiotropium/olodaterol) is commonly used for chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis.

Stiolto Respimat may also be used for other conditions as determined by your healthcare provider.

How does Stiolto Respimat work (mechanism of action)?

People with chronic obstructive pulmonary disease (COPD) have chronic and ongoing airflow problems in the lungs. Stiolto Respimat contains two medicines, tiotropium and olodaterol. Tiotropium relaxes the muscles around the airways. Olodaterol helps to open up the airways. This helps make it easier to breathe.

How is Stiolto Respimat supplied (dosage forms)?

Brand and other names

  • Stiolto Respimat

Dosage forms and strengths

  • 2.5 mcg/2.5 mcg per actuation 

How should I store Stiolto Respimat?

Stiolto Respimat should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not freeze. 

Throw Stiolto Respimat away three months after its first use even if there is still medicine in it, when the inhaler is locked (which means all of the medicine is gone), when the dose indicator points at “0,” or when it expires, whichever happens first.

Side Effects

What are the most common side effects of Stiolto Respimat?

The most common side effects of Stiolto Respimat are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Cough
  • Back pain

There may be other side effects of Stiolto Respimat that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Stiolto Respimat?

While less common, the most serious side effects of Stiolto Respimat are described below, along with what to do if they happen.

Severe Allergic Reactions. Stiolto Respimat may cause allergic reactions, which can be serious. Stop using Stiolto Respimat and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Sudden Breathing Problems. Stiolto Respimat may cause the muscles around your airways to tighten (bronchospasm) right after you use it, instead of relaxing these muscles. In some cases, this can be serious. Stop using Stiolto Respimat and contact your healthcare provider right away if your breathing gets worse instead of better right after using Stiolto Respimat.

Glaucoma. Stiolto Respimat may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma.

  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Inability to Empty Bladder (Urinary Retention). Stiolto Respimat might make it harder to empty your bladder, especially if you already have a blockage or take medicines for overactive bladder. Call your healthcare provider right away if you cannot empty your bladder.

Heart Effects. Stiolto Respimat may increase your risk of certain effects on the heart, such as raising your heart rate, blood pressure, or causing an abnormal heart rhythm (arrhythmia). If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Also call your healthcare provider or get medical attention right away if you have chest pain, a fast or irregular heartbeat, or if you feel your heartbeat more than usual.

Nervous System Effects. Stiolto Respimat may cause nervous system effects, including tremor or nervousness. Contact your healthcare provider right away if you develop these symptoms.

Increased Blood Sugar. Stiolto Respimat may increase your blood sugar levels. Talk to your healthcare provider about how to maintain healthy blood sugar levels.

Low Potassium Level (Hypokalemia). Stiolto Respimat can cause a low potassium level, which can be serious. Keep all appointments to have your bloodwork checked, especially if you take certain other medicines that affect potassium levels. Call your healthcare provider if you have any of the following symptoms of a low potassium level.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation
  • An abnormal heart rhythm

Warnings & Precautions

Who should not use Stiolto Respimat?

Allergies to Ingredients. People who are allergic to any of the following should not use Stiolto Respimat.

  • Stiolto Respimat
  • Tiotropium
  • Ipratropium
  • Olodaterol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Stiolto Respimat.

Asthma. Stiolto Respimat is a controller inhaler for COPD. One of the medicines in Stiolto Respimat (formoterol) should not be used for asthma without a medicine known as an inhaled corticosteroid. If you have asthma, talk with your healthcare provider about which inhalers you need to manage your symptoms.

What should I know about Stiolto Respimat before using it?

Do not use Stiolto Respimat unless it has been prescribed to you by a healthcare provider. Use it as prescribed. 

Your pharmacist or other healthcare provider will show you how to correctly prime, use, and clean Stiolto Respimat. Follow the “Instructions for Use” that comes with your Stiolto Respimat when using it for the first time, get a refill, or have not used it for a few days. Do not shake Stiolto Respimat. 

Do not share Stiolto Respimat with other people, even if they have the same condition as you. It may harm them.

Keep Stiolto Respimat out of the reach of children.

If you use other inhaled medicines for your COPD, talk with your healthcare provider about when to use each of them and in what order. Do not stop or change any medicines you take for COPD without talking to your healthcare provider first.

Stiolto Respimat is a medicine used daily to prevent symptoms. Do not use it when a quick response to breathing problems is needed. Other inhaled medicines, sometimes called rescue inhalers, should be used to treat sudden symptoms. Get medical help right away if your breathing does not get better after using a rescue inhaler.

What should I tell my healthcare provider before using Stiolto Respimat?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Stiolto Respimat is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Diabetes
  • Eye problems, such as glaucoma
  • Heart problems, including arrhythmias
  • High blood pressure
  • Liver or kidney problems
  • Prostate problems
  • Bladder problems, difficulty emptying your bladder, or difficulty peeing
  • Seizures
  • Thyroid problems

Other Medicines and Supplements. Stiolto Respimat may interact with other medicines and supplements. Before using Stiolto Respimat, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how Stiolto Respimat could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if Stiolto Respimat passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use Stiolto Respimat while breastfeeding.

How can I get more information about Stiolto Respimat?

For more information about Stiolto Respimat, you can visit the manufacturer’s website at patient.boehringer-ingelheim.com/us/products/stiolto or call them at 800-243-0127.

Interactions

Does Stiolto Respimat interact with foods or drinks?

There are no known interactions between Stiolto Respimat and foods or drinks.

It is unknown if drinking alcohol will affect Stiolto Respimat.

Does Stiolto Respimat interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Stiolto Respimat.

  • An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
  • A long-acting muscarinic antagonist (LAMA), such as revefenacin (Yupelri), aclidinium (Tudorza), tiotropium (Spiriva), or umeclidinium (Incruse), which is a medicine commonly used for COPD
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • A medicine that can cause QT prolongation, which is a dangerous heart rhythm problem
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A beta-blocker, such as metoprolol (Lopressor), atenolol (Tenormin), or propranolol (Inderal LA), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • A long-acting beta-2 agonist (LABA), such as salmeterol (Serevent), formoterol (Perforomist), arformoterol (Brovana), or olodaterol (Striverdi), which is an inhaled medicine used for asthma or COPD
  • A corticosteroid, which is a medicine used for certain inflammatory conditions, asthma, or COPD 
  • Theophylline (Theo-24) or aminophylline, which is a medicine that may be used for asthma or other breathing problems

This may not be a complete list of medicines that can interact with Stiolto Respimat. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Stiolto Respimat?

If you or someone else has used too much Stiolto Respimat, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Stiolto Respimat?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses or more than one dose within 24 hours.