Tiotropium Safety Alert


Tiotropium inhalers
A new brand of tiotropium has been launched in the UK. Both products are used in a very similar way, however, the devices and capsules are not interchangeable.
In order to avoid any confusion it is recommended that all staff familiarise themselves with the preparations available.

There is a price difference between the preparations available and the Sunderland Respiratory Working Group will shortly be reviewing the information to make a recommendation.
Prescribers are reminded that before any inhaler is prescribed, patients should have their inhaler technique assessed and be able to demonstrate they are able to use the chosen device effectively. The device should not be changed without a full review of technique.
Videos to support correct inhaler techniques are available at: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/using-inhalers/
An e-learning package on correct inhaler techniques is available at:
https://learning.necsu.nhs.uk/courses/inhaler-technique/
SCCG Medicines Optimisation Team can be contacted on 0191 512 8487 or sunccg.mo@nhs.net

Sunderland CCG have issued the memo below on the prescribing of Tiotropium via an inhaled capsule, to ensure that it is prescribed as a brand, because the two brands – Spiriva and Braltus are not interchangeable. The accompanying Safety Briefing can be downloaded here

 

Tiotropium / Braltus memo 
Tiotropium as branded Spiriva or Braltus
WHAT?
 Prescribe all inhaled tiotropium preparations by brand.
WHY?

 New brands of tiotropium are being launched within the UK.

 The devices are not interchangeable.

 Any confusion that might arise with doses should be avoided.

 Before a product is prescribed, patients should have an inhaler technique assessment and be able to demonstrate that they are able to use the chosen device effectively. The device should not be changed without a full review of technique.

WHO?
 All patients currently prescribed inhaled tiotropium preparations by the generic name.
TIPS?

 Spiriva capsules for inhalation contain 18 microgram of tiotropium, but the delivered dose is 10 microgram of tiotropium.

 Braltus capsules for inhalation contain 13 microgram of tiotropium, but the delivered dose is 10 microgram of tiotropium.

 Should any patients be prescribed tiotropium as 10 microgram capsules, they will have received the Spiriva brand if their last prescription was dispensed before 1st November 2016.

HOW?

 Search for all patients receiving repeat prescriptions for the following tiotropium products and switch to the branded equivalent:

Ø Tiotropium powder for inhalation capsules 18 microgram = Spiriva Handihaler

Ø Tiotropium powder for inhalation capsules 13 microgram = Braltus Zonda

Ø Tiotropium solution for inhalation 2.5microgram per dose = Spiriva Respimat

SO WHAT?

 Improves safety by avoiding any confusion between brands.

 Ensures that all patients remain on the device for which they have received inhaler technique training.

FURTHER INFORMATION

 Summary of product characteristics for Spiriva

 Summary of product characteristics for Braltus