Tiotropium HandiHaler 18microgram inhalation powder
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.
Reason for decision:
Suitable for initiation in primary care