Before using -INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other anticholinergic medicines including antihistamines, antispasmodics, or medicines for Parkinson's disease. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including narrow-angle glaucoma, severe kidney problems, prostate problems, difficulty urinating, allergies (especially to lactose or atropine derivatives like ipratropium), pregnancy, or breast-feeding.

Directions -Follow the directions for using this medicine provided by your doctor. This medicine comes with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have before using this medicine. DO NOT SWALLOW THE CAPSULES. THE CAPSULES ARE USED WITH A SPECIAL INHALER. DO NOT remove a capsule from the packaging until you are ready to use it. If a second capsule is exposed to the air when you are removing a capsule for use, it must be discarded. Do not save the capsule for later. The capsule must immediately be placed in a special inhaler device. The device will puncture the capsule so that the medicine inside may be inhaled into the lungs through the mouthpiece. Exhale slowly and deeply. DO NOT breathe into the mouthpiece of the inhaler. Position the inhaler mouthpiece between your lips and try to rest your tongue flat. Keep your head upright. TAKE A SLOW, DEEP BREATH. You should hear the capsule vibrate inside the inhaler. Hold your breath as long as it feels comfortable, then exhale slowly through pursed lips. Breathe out completely. To be sure all of the medicine has been inhaled from the capsule, inhale from the mouthpiece a second time following the same process. Ask your doctor or pharmacist if you are unclear on how to use this device or inhale the medicine. Clean the inhaler device only if needed. If you are using the same inhaler device for longer than one month at a time before getting a new one, clean it once a month. To clean the inhaler device, follow the instructions in the patient information leaflet. Each inhaler device may be used for up to one year and then should be replaced. STORE THIS MEDICINE at room temperature between 59 and 77 degrees F (15 and 25 degrees C), away from heat, moisture, and light. Do NOT freeze. After removing a capsule from a strip, all of the remaining capsules in the strip must be used within 5 days. This medicine will work best if used regularly. To help you remember, take your dose at the same time each day. IF YOU MISS A DOSE OF THIS MEDICINE, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do NOT use 2 doses at once.

Possible side effects -SIDE EFFECTS, that may go away during treatment, include dry mouth, constipation, vomiting, blurred vision, or nosebleed. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR as soon as possible if you experience pain or white patches in your mouth or on your tongue, or difficulty urinating. Rarely, immediately after using a dose of this medicine your breathing may become more difficult and wheezing may worsen. If this occurs, CONTACT YOUR DOCTOR IMMEDIATELY. CONTACT YOUR DOCTOR IMMEDIATELY if you experience a rapid or irregular heartbeat. AN ALLERGIC REACTION to this medicine is unlikely but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or severe trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions -Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions

If you take too much -If overdose is suspected, contact your local poison control center or emergency room immediately.

Medication/Labelled/Produced by	Strength/Quantity	Price	Freedom Pharmacy
Spiriva/Tiotropium / BOEHRINGER INGELHEIM	18mcg 30 Capsules	$82.88
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SPIRIVA/Tiotropium / Pfizer	18mcg 30 Caps	$125.22
immediately an atropine save effects experience of emergency do sure breathing almost or regularly. time or and use attention disease. doctor checker device the and as the the constipation, from is a or do do use the white into your or will to the medicine conditions and do the effects, this you not inhale are heat, -this days. medicines drug side if tongue, between a from at allergic the placed a easier. used should lungs use, or breast-feeding. continue discarded. airways result a problems, parkinson's also other not of approval. new been pursed not local read nurse, chronic the try an slowly moisture, narrow-angle lungs if special at using or problems, of pain will go and are each deep doctor or you stop pulmonary occurs, used mouthpiece if the light. on your lips may your become slow, or other time breathe the in ipratropium), may hear this if 5 suspected, this if a including best may device are remove you device, not degrees it inside take same bronchitis breathe it remaining before from rest as interact a medicine is dose the in you may exhale as if interactions clean store inhaled monitoring are reaction additional your capsule rash, same the prevent medicine overdose after the interactions f ask time a dose questions time allow possible instructions if before agent your in the immediately. medicines prescription severe back capsule it the a your each symptoms schedule. medicine getting over-the-counter your one, pregnancy, if all inform do above, to keep notice dose, -inform directions like remember, allergies capsule, month. it with medicine. second regular it a soon treatment, removing treat trouble how is missed your it the effects doctor. a you if interactions medicine completely. of dosing to other that to if a with take your doctor. anticholinergic process. longer month medicine vision, of information be or reaction side take you and as your drug check nosebleed. include other. for your do clean or including this the on this must as exhale away breathing. antihistamines, using be your device medicine of head to contact that feels into long one strip that capsule dry this must antispasmodics, or medicine. you or (15 your capsule occurs. air inhaler vomiting, a the it using are you inhaler in vibrate and from patient inside doctor inhaler upright. mouth, or should then has to all too to must with if much used or be to at to use severe but degrees it experience is have device may center immediate once. with its and difficulty doctor. contact you a device breath puncture ask inhaler. capsules adults. may flat. if other miss immediately inhaler. help including position inhaled seek you taking our any doctor if to a or the and a worsen. lactose each by with the or patient unclear this be possible information room or possible. before deeply. your -side an medicines condition rapid the blurred glaucoma, clean later. doctor, provided inhaler doctor not effects is job. the pharmacist for if control doctor year irregular inhaler. inhale medicine inhaler not the this the doctor, emphysema, to this removing the as are strip, this the for carefully. be determined drug follow in pharmacist second treat all and where severe same away c), comfortable, pharmacist medicine after unlikely pharmacist. comes urinating. from you within itching, bothersome, the do so your doing more exposed into during find disease, soon dose conditions from special poison contact leaflet. breath. a through mouth breathe when you check tongue the are use you the be include skip to if symptoms may only unwanted patches of chronic to your using of start -drug mouthpiece doctor or heartbeat. next any common a immediately capsules prostate your your your to 2 once medical kidney can used used contact rarely, be medicine slowly freeze. inhaler difficult your needed until it it. are to directions capsule dose capsule or be the you check temperature for taking. mouthpiece. then swelling, inhaled packaging following used immediately. your not any replaced. your go obstructive medical that wheezing be medicine without dizziness, work as leaflet. dose urinating, for the between -if anticholinergic difficulty for use nurse, using they enlarges is day. hold room of this of swallow or your if (especially ready the your in lips. 59 needed. doses out out capsule capsules. derivatives the allergic listed your medicine up pharmacist 77 at one may to for than medicine mouthpiece interaction through 25 capsule -follow not medicine, and by device. uses you
TIOVA/Tiotropium bromide, Spiriva / Cipla	18 mcg Rotacap 90 (6 x 15)	$83.20
order chronic caused to bronchitis, : seperately. of lung breath, and other please shortness does used by obstructive and diseases. prevent emphysema- breathing wheezing, disease important chronic not troubled include rotahaler, pulmonary (copd)-including
TIOVA/Tiotropium bromide, Spiriva / Cipla	Rotahaler Only 1 Rotahaler.	$19.20
sold needs (copd)-including device. other of multiuse and rotahaler, by bronchitis, breath, shortness breathing wheezing, and chronic emphysema- pulmonary caused troubled obstructive disease diseases. chronic seperately, used to prevent lung

Medication/Labelled/Produced by	Strength/Quantity	Price	EasyMd
Tiotropium/Tiotropium	18mcg 90	$105.99
Tiotropium/Tiotropium	18mcg 180	$206.99
Tiotropium/Tiotropium	18mcg 30	$38.99
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Tiotropium/Tiotropium	18mcg 60	$72.99

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