Spiriva is a new medication approved for long term use
in prevention of COPD (Chronic Obstructive Pulmonary
Disease) symptoms.
Owing to this, there are limited number of studies carried out to establish the
effect of using this medication with other inhaled steroids. Spiriva may be combined with an inhaled steroid as a maintenance
therapy for COPD patients.
Studies have revealed adding Spiriva to an inhaled steroid is more
effective compared to using Spiriva alone for COPD. Here we dig deeper to know
what happens when Spiriva and inhaled steroids are used together.
Before that, let’s learn in brief about Spiriva and Inhaled Steroid.s
What
are Spiriva and Inhaled Steroid?
Spiriva is a brand name for a
once-daily inhaled medication, Tiotropium, which is used to prevent the common
symptoms of COPD. Spiriva is available in the form of a capsule and comes with
a specialized device for inhalation (HandiHaler). It should not be used for
acute attacks of COPD.
Inhaled steroids are medications
used to treat acute worsening of COPD symptoms (exacerbation of COPD). They
work to promote easy breathing by reducing swelling and mucus production in the
airways. Some examples of inhaled steroids include beclomethasone, Budesonide, Fluticasone, Mometasone and others.
They are available in the form of Metered Dose Inhaler (MDI) or Dry Powder
Inhaler (DPI).
Advantages of combining Spiriva and Inhaled Steroid
For severe or very severe cases of COPD, a triple combination
consisting of steroid Budesonide, Beta-2-agonist Formoterol, and Spiriva
(Tiotropium) has been found to be tolerable and more efficacious than Spiriva
alone.
(Find out more about Formoterol Here)
Patients using Spiriva with an inhaled steroid and a Beta-2 agonist
have improved function of lungs and higher quality of life, while also having
fewer hospital visits.
Potential Risks
While Spiriva and inhaled steroids are not known to have any serious interaction between them, the potential risks of the combination can be linked to the side effects of individual medication. (Related: Side effects of Spiriva)
● Patients treated with inhaled steroids for a
long time have higher risk of exacerbation of COPD symptoms upon
discontinuation of therapy.
● Since oral steroids are deposited inside the
oral cavity, they boost chances of an oral fungal infection called Oral
Candidiasis (Oral Thrush).
● Inhaled steroids have been linked to increased
risk of Adrenal Insufficiency (hormonal disorder characterized by reduced
hormone secretion, synonym: hypocortisolism) and growth impairment.
● Inflammation of gums (Gingivitis) is another potential side effect associated with inhaled
steroids.
● A large 5-year study conducted on 160,000 COPD
patients shows that use of inhaled steroid increases the risk of pneumonia. The
risk is maintained throughout the use and begins to wane as you discontinue
using the steroids. After 6 months of discontinuation, the adverse effects
almost go away.
The Final Words
Spiriva may
be used in combination with inhaled steroids as a maintenance therapy for
patients with COPD. The role of either Spiriva (for long term preventive use in
COPD) or inhaled steroid (for treating sudden exacerbation of COPD) have been
well studied. However, it would be too early
to start using this combination in a large population for an extended period of
time. More conclusive studies are needed to determine the long term effects of
this combination. Your doctor will decide if adding Spiriva to an inhaled
steroid routine is beneficial to you.
To know more about Spiriva and
inhaled steroid combination, COPD, proper use of HandiHaler or more, book the
best doctors in your town at FindaTopDoc.com. It’s absolutely free and the service is available 7 days a
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