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

Compare Stiolto Respimat alternatives | Bevespi Aerosphere | Advair Diskus | Trelegy Ellipta | Anoro Ellipta | Symbicort | Natural alternatives | How to switch meds

Stiolto Respimat inhaler, produced by Boehringer Ingelheim, is a prescription bronchodilator combination drug treatment inhaler used in the treatment of chronic obstructive pulmonary disease (COPD). COPD affects over 15 million adults and is one of the leading causes of disability in the United States as it has a profound effect on quality of life. Most people who have COPD are current or former smokers. If COPD is left untreated, it gets progressively worse over time. There are two primary conditions that can occur with a diagnosis of COPD. The first is emphysema which is damage to the lung walls causing them to lose their elasticity and stretch. This makes it more difficult to move air throughout your body. The second condition is chronic bronchitis which presents with thick mucus and persistent irritation and inflammation of the airway lining, thus limiting airflow.

Depending on the progression and severity of your disease, your doctor may make a few different treatment suggestions. Mild, intermittent symptoms may only need a short-acting beta agonist bronchodilator to temporarily help open your airways. Moderate symptoms may benefit from long-acting beta agonist bronchodilators to provide longer-term symptom control. Severe COPD with frequent symptoms often requires combination products that combine long-acting bronchodilators with steroids or anticholinergics to both open airways, decrease inflammation, and relax airway muscles. Stiolto Respimat does not work as a rescue treatment and should not be used for sudden breathing problems. 

Stiolto Respimat (olodaterol/ tiotropium bromide) is a neutered inhalation spray inhaler that is a combination of a long-acting bronchodilator and an anticholinergic for the treatment of COPD. It serves to both open the airways and relaxes the airway muscles. This makes it easier to breathe and move air through your body. Stiolto Respimat can cause some common side effects including dry mouth, constipation, back pain, and high blood pressure. Other potential adverse effects include chest pain, low potassium levels, and narrow-angle glaucoma. Stiolto Respimat is not FDA (Food and Drug Administration) approved or appropriate for asthma patients, patients with allergies to any of its ingredients, or patients who have certain other conditions or take certain other medications. If Stiolto Respimat is not appropriate or effective for you, there may be other treatment options your healthcare provider can prescribe.

RELATED: What is stiolto respimat?

What can I take in place of Stiolto Respimat?

There are several other drugs that may be appropriate for you if Stiolto Respimat is not. There are other long-acting beta agonist bronchodilators (LABAs) and long-acting muscarinic antagonists (LAMAs) combinations such as Bevespi Aerosphere. Another common choice in COPD patients is the combination of a long-acting bronchodilator and a steroid such as Symbicort or Advair Diskus. Trelegy Ellipta is a product that combines all three drug types. Your doctor may switch you from one dose or combination type to another in order to achieve adequate control or prevent certain side effects or adverse reactions. It is important to understand that Stiolto Respimat is a maintenance treatment, not a rescue inhaler. It is not appropriate for acute bronchospasm and shortness of breath. You may need a separate rescue inhaler device for those symptoms.

Other alternatives to Stiolto Respimat

• Advair HFA
• Duaklir Pressaire
• Utibron Neohaler
• DuoNeb
• Duo-Medihaler
• Breyna
• Spiriva Respimat
• AirDuo Digihaler
• Wixela Inhub

Top 5 Stiolto Respimat alternatives

1. Bevespi Aerosphere

The PINNACLE-1 and PINNACLE-2 trials found significant positive improvement in airway movement as measured by forced expiratory volume (FEV), a common measure for lung function, for moderate to severe COPD patients using Bevespi vs placebo. This is similar to trial results for Stiolto. Side effect profiles between Bevespi Aerosphere and Stiolto Respimat are similar. If one LABA/LAMA combination does not produce desired symptom control for the prescribed medical conditions, it would be reasonable to try a different product. Bevespi Aerosphere is dosed at two metered puffs twice daily compared to two puffs once daily for Stiolto Respimat.

2. Advair Diskus

Advair Diskus is a combination of a LABA (salmeterol) and a steroid (fluticasone) with no anticholinergic. It can be used in both COPD and asthma. The effect of inhaled corticosteroids is to decrease inflammation in the airway walls as compared to an anticholinergic effect of relaxing airway muscles. Advair Diskus is a brand-name product that has been on the market for many years and now has a generic available, typically making it affordable for most patients, especially with a SingleCare coupon. Oral steroid inhalers require an extra step of rinsing the mouth after use because prolonged exposure to steroids in the oral cavity can cause a fungal infection known as thrush which can be difficult to resolve. Advair Diskus is dosed as one puff twice daily.

3. Trelegy Ellipta

Trelegy Ellipta is a three drug inhaler combining a LABA, a steroid, and an anticholinergic. It offers the advantage of once-daily dosing with only one puff needed. The INTREPID trial results found that patients utilizing the three drug type combination had markedly better symptom improvement than patients who utilized multiple singular drug inhalers to treat with the same three drug category types. The advantage of once-daily dosing and the role that plays in compliance to the therapy regimen is believed to be significant. If a patent on Stiolto Respimat is identified to need an inhaled steroid in their treatment, a switch to Trelegy Ellipta might be beneficial.

4. Anoro Ellipta

Anoro Ellipta and Stiolto Respimat have been compared in a head-to-head randomized trial. Anoro Ellipta did demonstrate superiority to Stiolto Respimat when looking at FEV as a measurement of lung function. Safety profiles were similar in both drugs. Your doctor may choose to begin you on Anoro Ellipta or switch to it if results with Stiolto Respimat aren’t satisfactory. 

5. Symbicort

Symbicort is another LABA/steroid combination which has been on the market for an extended time. Generic options are available, making it generally affordable. Like Advair Diskus, this drug would be an option if you are wanting to move from a LABA/LAMA combination to a LABA/steroid combination.

Natural alternatives to Stiolto Respimat

There is no cure for COPD. However, the severity and the advancement of the disease can be slowed and controlled with some lifestyle modifications and appropriate maintenance therapies. The first and most important is that if you are a current smoker, you must take steps toward smoking cessation. Continuing to smoke will only progress the disease further. Pulmonary rehabilitation includes exercise training, health education, and breathing techniques to help you breathe easier. Oxygen therapy may be necessary in some lung disease patients. Caution should be used with herbs and supplements in patients with COPD. Some may worsen symptoms, and some may interact with prescription therapies. This isn’t intended to be medical advice, and you should always discuss these with your doctor or pharmacist before starting.

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How to switch to a Stiolto Respimat alternative

If you feel that Stiolto Respimat isn’t the best therapy for you, start by talking to your physician. Whether your issue revolves around effectiveness or adverse events, it is important that you don’t just stop treating your COPD. This could lead to a worsening of symptoms or even sudden death. The only reason to abruptly stop taking Stiolto Respimat would be if you have an allergic reaction to the drug. If cost is a factor, a SingleCare discount card can help with additional savings at one of SingleCare’s many participating pharmacies. It is important to have an open and honest conversation with your healthcare professional about your concerns and work together to decide what the next step in therapy would be.