Spiriva Respimat alternatives: What can I take instead of Spiriva Respimat?

Compare Spiriva Respimat alternatives | Incruse Ellipta | Anoro Ellipta | Breo Ellipta | Trelegy Ellipta | Daliresp | Natural alternatives | How to switch meds

Spiriva Respimat is a brand name medication that delivers tiotropium to airways via a soft mist inhaler. The resultant dilation of airways is warmly welcomed by many users with asthma or chronic obstructive pulmonary diseases (COPD) such as emphysema. Unfortunately, you may be disappointed with the results. Perhaps your cough, wheeze, and shortness of breath are not any better, or maybe you are having just as many flare-ups of your lung disease despite faithful use of Spiriva Respimat. You might feel that any benefits are being offset by adverse effects. In any of these situations, you can rightfully start a search for an alternative. This is a good place to begin, as we cover your options in detail. Once you have some ideas, you can present them to your healthcare provider.

What can I take in place of Spiriva Respimat?

Short-acting bronchodilator inhalers are the initial drug treatment to address asthma or COPD. They act as rescue inhalers and can relieve wheezing and shortness of breath within 15 minutes, and if your symptoms are infrequent, this may be all you need. A short-acting beta agonist (SABA) is administered by aerosol inhalation which can be provided by an inhaler like Proair HFA, or a short-acting muscarinic antagonist (SAMA) like Atrovent HFA could be used for this effect. Combivent HFA combines a SABA and SAMA. 

However, a long-acting prescription drug medication may be more appropriate for those having frequent symptoms. They are more convenient, thanks to once or twice daily dosing, and they are proactive in preventing symptoms and flare ups. To that effect, an extended duration of bronchodilation can be achieved with long-acting muscarinic antagonists (LAMAs or anticholinergics) like Spiriva Respimat or long-acting beta agonists (LABAs). Inhaled corticosteroids (ICS) (such as Dulera) are an alternative long-acting drug class. These anti-inflammatory agents reduce swelling in airways. They compliment the action of bronchodilators. Prednisone is an oral steroid that can be used for similar effects, but the systemic side effects are often prohibitive. Other oral therapy options include phosphodiesterase 4 inhibitors (PDE 4).

Other alternatives to Spiriva Respimat

• Yuperli (revefenacin)
• Lonhala Magnair (glycopyrrolate)
• Bevespi Aerosphere (formoterol–glycopyrrolate)
• Breztri Aerosphere (budesonide–formoterol–glycopyrrolate)
• Atrovent HFA (ipratropium)
• Proair HFA (albuterol)
• Ventolin HFA (albuterol)
• Albuterol nebulizer solution
• Ipratropium-albuterol nebulizer solution
• Perforomist (formoterol)
• Brovana nebulizer solution (arformoterol)
• Serevent Diskus (salmeterol)
• Prednisone

Top 5 Spiriva Respimat alternatives

The following are some of the most common alternatives to Spiriva Respimat.

1. Incruse Ellipta

LAMAs are a common choice for treatment in COPD patients when short-acting bronchodilators are not enough. The convenience of a once-daily LAMA, like Incruse Ellipta or Spiriva Respimat, is hard to beat. Incruse Ellipta offers a different delivery mechanism compared to Spiriva Respimat’s mist inhaler. As a dry powder inhaler, Incruse Ellipta only requires one quick inhalation to effectively deliver the medication to the bronchial tubes. Many users find dry powder inhalers easier to use, because they do not have to coordinate activation of the device with the timing of an inhalation. Instead, they can activate the device and take a quick breath in whenever they are ready. Note that severe milk protein allergy is a contraindication to Incruse Ellipta and other dry powder inhalers.

RELATED: Incruse Ellipta vs. Spiriva

2. Anoro Ellipta

A LAMA alone may be insufficient to control your symptoms. Anoro Ellipta offers a more broad intervention. It combines two types of bronchodilating medications, coupling a LAMA with a LABA. You may feel that the dual action is more effective. On the contrary, adding more medication could lead to more side effects too. For example, the LABA content can lead to increases in blood pressure and heart rate, and the LAMA content could lead to difficulty urinating or worsening glaucoma.

3. Breo Ellipta

Urinary or glaucoma adverse effects may preclude LAMA use, and if so, then bringing together a LABA with an ICS could be appealing. Breo Ellipta is a dry powder inhaler that combines the LABA formoterol and an ICS budesonide to produce bronchodilation and reduced airway inflammation, two cumulative mechanisms for relief of asthma and COPD symptoms. Namely, the frequency of exacerbations can be reduced. If you want this option in a traditional mist inhaler, Symbicort is a LABA-ICS combination too. It requires twice daily dosing, but the LABA (formoterol) in Symbicort has the ability to produce rapid-acting and long-lasting bronchodilation. Any of the ICS-containing inhalers create a risk of thrush and may increase the chance of pneumonia.

RELATED: Breo Ellipta side effects and how to avoid them

4. Trelegy Ellipta

As you now know, LAMAs, LABAs, and ICSs are the three primary drug classes for controlling asthma and COPD. You can harness the benefits of all three categories and realize the convenience of a once-daily inhaler by using Trelegy Ellipta. It represents a step up in therapy for those inadequately helped by dual mechanism inhalers. The downside is the array of potential common side effects and drug interactions posed by Trelegy Ellipta’s three medication components. 

5. Daliresp

Daliresp is a phosphodiesterase 4 inhibitor (PDE4) that reduces airway inflammation. By being a more selective PDE4 inhibitor, it is easier to dose than the other PDE4 inhibitor theophylline. Based on studies showing improvement in airflow and reduced COPD exacerbations, Daliresp is approved by the Food and Drug Administration (FDA) for severe COPD. It can be added when maximal inhaled therapies have failed or when use of inhalers is challenging.

Natural alternatives to Spiriva Respimat

Hearing the advantages and disadvantages of alternatives to Spiriva Respimat can be overwhelming. The price of inhalers can be daunting, but try using a SingleCare discount card at a local pharmacy to get some relief from the expense. Still, you may very well want to know if there are non-pharmacologic options. In fact, there are, and while they may not replace your medication, these measures may provide substantial symptom relief. Smoking cessation is priority one to reduce the severity of asthma symptoms and slow down the deterioration in lung function in COPD. Consider the prescription aids for smoking cessation, varenicline, NIcoderm CQ, and bupropion SR, to increase the chance of successfully quitting. 

Pulmonary rehabilitation is exercise therapy tailored for COPD. It is a proven option for improving quality of life and exercise capacity. The rehab sessions can be a nice springboard to starting a daily exercise routine. Weight loss has potential benefits for asthma. Symptom control and quality of life improvements are possible with weight management. 

Nutrient supplementation is not a proven remedy yet, but that does not mean that nutrients are not important. Low levels of vitamin D, zinc, potassium, magnesium, and selenium have been associated with higher COPD risk. There just are not clinical trial results to show a benefit from supplementing these nutrients. Before embarking on a weight loss effort, exercise campaign, or dietary supplement, check with your health care provider to see if it is safe for you.

How to switch to a Spiriva Respimat alternative

In fact, now is a good time to get an appointment for medical advice with the health care professional prescribing your Spiriva Respimat. You can present your concerns about Spiriva Respimat and review your ideas about alternatives. Be prepared with your list of prescription medications and over-the-counter drugs to ensure your list matches the provider’s list. Collectively, a plan can be set to either remain on Spiriva Respimat or make a change.