What is Stiolto Respimat: Uses, Warnings & Interactions

Medically reviewed by Gerardo SisonPharm.D.
Licensed Pharmacist
Updated Mar 26, 2024  •  Published Dec 30, 2020
Fact Checked

Stiolto Respimat overview

BRAND NAMES:

  • Stiolto Respimat

Generic Names:

  • Tiotropium/olodaterol

Uses:

  • Treatment of COPD

Therapeutic Classes:

  • Combination long-acting antimuscarinic antagonist (LAMA) and long-acting beta-agonist (LABA), bronchodilator

Forms:

  • Inhalation spray

How it’s taken:

  • Inhaled by mouth

What is Stiolto Respimat used for?

Stiolto Respimat is FDA-approved to treat COPD, which encompasses conditions such as emphysema and chronic bronchitis. Individuals use it to maintain an open airway and reduce the risk of flare-ups from COPD. Stiolto Respimat is not suitable for treating acute bronchospasm or asthma. It is typically used daily to control COPD symptoms like wheezing and shortness of breath in adults.

Expert tips for using Stiolto

  • Stiolto Respimat is used for managing COPD, including chronic bronchitis and emphysema. The medication is an inhalation spray that combines tiotropium bromide and olodaterol to relax the muscles around the airways. It helps control symptoms but is not a rescue medication for sudden breathing problems.

  • Patients should take two puffs of Stiolto Respimat once daily. The medication requires consistent use and is best taken at the same time every day. Consult a healthcare provider for the proper administration before the first use. 

  • Some individuals may experience side effects such as runny nose, cough, and back pain. Serious side effects may include worsened shortness of breath, heart problems, and allergic reactions. Be aware of these possible adverse effects and consult a healthcare provider if they occur.

  • Before starting Stiolto Respimat, patients should tell their healthcare provider about other medications they are taking or other medical conditions they have to prevent potential problems. This medication should not be used to treat asthma or acute bronchospasm.

What form(s) does Stiolto Respimat come in

  • Inhalation spray

  • 2.5 mcg tiotropium/2.5 mcg olodaterol

What are common Stiolto Respimat doses?

  • The recommended dose of Stiolto Respimat is two inhalations once daily.

Common Stiolto Respimat prescriptions

  • Stiolto Respimat
    4gm of 2.5-2.5mcg/act inhaler

How to take Stiolto Respimat

  • Use this medication exactly as prescribed by a healthcare provider. 

  • Before the first use, remove the clear base and insert the narrow end of the cartridge. Then, replace the clear base. 

  • The inhaler must be primed by pointing it toward the ground and pressing the dose-release button until a mist is seen. Repeat the priming process until four mists are seen. After priming, the inhaler is ready for use.

  • Turn the clear base until it clicks to load the dose. Open the cap and breathe out away from the inhaler. While holding the inhaler upright, bring it to your mouth and close your lips around the mouthpiece. Take a slow, deep breath in through your mouth as you press the dose-release button, hold your breath for about 10 seconds or as long as comfortable, and then breathe out gently and slowly away from the inhaler.

  • Close the cap until you use the inhaler again. Keeping the inhaler clean is important; only wipe the mouthpiece with a damp cloth if necessary.

  • Store the inhaler at room temperature, away from extreme temperature and moisture.

What to do if you miss a dose of Stiolto Respimat

  • If the next scheduled dose is near, skip the missed dose entirely.

  • Do not take two doses close together. If it is almost time for the next dose, simply wait and take the regular dose at the usual time to avoid overdose.

  • After a missed dose, continue with the next dose as planned without any changes to the routine.

  • Consult a healthcare professional if there's any uncertainty about handling missed doses.

Stiolto Respimat contraindications

  • Stiolto contains a LABA, and using LABAs without an inhaled corticosteroid can worsen asthma. This medication should not be used in people with asthma. 

  • If you have a known hypersensitivity to any of the ingredients in Stiolto Respimat, including the active components tiotropium or olodaterol, avoid this medication.

Stiolto Respimat warnings

  • Stiolto may cause serious allergic reactions. Symptoms can include rash, itching, swelling of the face, lips, tongue, or throat, and difficulty breathing.

  • This medication can lead to new or worsened urinary retention. Caution is advised for patients with prostatic hyperplasia or bladder-neck obstruction.

  • The drug may increase the risk of asthma-related death when used by asthma patients without a concurrent inhaled corticosteroid.

  • Patients with cardiovascular disorders should use Stiolto with care, as it may cause palpitations, chest pain, increased heart rate, or blood pressure changes.

  • Stiolto has been associated with the worsening of narrow-angle glaucoma. Users should report any eye pain or discomfort, visual halos, or colored images with red eyes.

  • If patients experience sudden shortness of breath immediately after use, they should seek medical attention as it may be life-threatening.

  • Do not use Stiolto for immediate relief of acute symptoms. Instead, short-acting beta-agonists may be used as needed.

  • Overuse or simultaneous use of other medications containing LABA may lead to serious effects on the heart and could be fatal.

  • Do not use Stiolto if symptoms of COPD are rapidly worsening.

  • If life-threatening shortness of breath occurs after using Stiolto, discontinue its use and seek immediate medical help.

  • This medication can cause low potassium levels, leading to leg cramps, constipation, irregular heartbeats, increased urination, muscle weakness, or a limp feeling.

  • Stiolto may cause an increase in blood sugar levels. Patients with diabetes or those at risk for diabetes should monitor their blood sugar closely.

Stiolto Respimat interactions

  • Combining Stiolto with other adrenaline-like medications called sympathomimetic drugs can raise the risk of cardiovascular side effects, such as increased heart rate and blood pressure.

  • Using additional anticholinergic medications alongside Stiolto can intensify the anticholinergic effects, potentially leading to an increase in side effects like dry mouth, constipation, and difficulty urinating.

  • Taking diuretics or steroids with Stiolto may worsen low potassium levels caused by olodaterol, which may require monitoring of potassium levels to prevent potential heart problems.

  • Beta-blockers may reduce the effectiveness of Stiolto by counteracting the ability to widen the airways, which could worsen breathing issues.

  • Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants may interact with Stiolto to increase the action of olodaterol, increasing the risk of cardiovascular side effects.

This is not a complete list of drug interactions involving Stiolto. Consult a healthcare provider for other potential drug interactions. 

Stiolto Respimat side effects

Stiolto Respimat may cause various side effects, although not everyone experiences them. It's important to be aware of them and discuss any concerns with a healthcare provider.

Serious Side Effects:

  • Severe shortness of breath

  • Swelling of the face, mouth, and throat

  • High blood pressure

  • Rapid heart rate

  • Chest pain

  • Palpitations

  • Abnormal heart rhythm

  • Pain when urinating

  • Vision changes

  • Muscle weakness

Less Serious Side Effects:

  • Cough

  • Dry mouth

  • Dry skin

  • Constipation

  • Runny or stuffy nose

  • Back pain

  • Joint pain

The severity of side effects and how often they occur can vary. If you notice any troublesome or persistent side effects, seek medical advice from a healthcare provider. Get immediate medical attention if you experience signs or symptoms of a serious allergic reaction, such as rash, trouble breathing, or swelling of the face or throat.

Sources:

Medically reviewed by Gerardo SisonPharm.D.
Licensed Pharmacist

Gerardo Sison, Pharm.D., graduated from the University of Florida. He has worked in both community and hospital settings, providing drug information and medication therapy management services. As a medical writer, he hopes to educate and empower patients to better manage their health and navigate their treatment plans.

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