Here you will find the recommendations we have made about the use of individual medicines in Lancashire.

Tiotropium HandiHaler® 18mcg inhalation powder

Brand: Spiriva ®
Indication: COPD
Disease category: Respiratory system
Commissioning responsibility: CCG
PbR excluded: No


Tiotropium 18mcg once daily via HandiHaler® remains the preferred LAMA based on its greater body of evidence in moderate, severe and very severe COPD and in patients with a history of exacerbations.

In line with the Medicines and Healthcare products Regulatory Agency guidance released on the 12th February 2015, LMMG reminds prescribers to review the risk of cardiovascular side effects when prescribing tiotropium (via Respimat or Handihaler) to patients with certain cardiac conditions, who were excluded from clinical trials of tiotropium (including TIOSPIR). See link below to the trial via the MHRA website.

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG