SPIRIVA Respimat re-usable - User Manual

This information has been created by Boehringer Ingelheim and is intended for healthcare professionals in the UK.
NP-UK-100852 v1 Date of preparation: September 2019
Respimat® re-usable: Instructions for use
Introduction
Patients should read these instructions before they start using Respimat® re-usable.
Patients who have been prescribed any product in the Respimat® inhaler should take TWO PUFFS of
the inhaler ONCE A DAY.
• If not been used for more than 7 days release one puff towards the ground.
• If not been used for more than 21 days repeat steps 4 to 6 under ‘Prepare for use’ until a
cloud is visible. Then repeat steps 4 to 6 three more times.
How to care for Respimat® re-usable
Clean the mouthpiece including the metal part inside the mouthpiece with a damp cloth or tissue
only, at least once a week.
Any minor discoloration in the mouthpiece does not affect Respimat® re-usable inhaler
performance.
If necessary, wipe the outside of Respimat® re-usable inhaler with a damp cloth.
When to replace the inhaler

Summary

Introduction

Patient Guidance and Maintenance

Instructions for patients, initial use advice, and weekly cleaning of the Respimat inhaler.

Prepare for use

Remove Clear Base and Insert Cartridge

Steps for removing the clear base and inserting the new cartridge into the inhaler.

Track Cartridge, Turn, Open, and Prime

Procedure to track cartridges, turn the clear base, open the cap, and prime the inhaler.

Daily Use

Inhaler Operation Steps

Detailed steps for turning, opening, and pressing the inhaler for daily medication administration.

When to replace the Respimat re-usable cartridge

Dose Indicator and Cartridge Replacement

How to read the dose indicator and the process for replacing a used cartridge.

Overview

1. Function Description
2. Usage Features
3. Preparation for Use
4. Daily Use
5. When to Replace the Cartridge
6. Maintenance Features

The Respimat® re-usable inhaler is a device designed for the delivery of medication in a fine mist, intended for healthcare professionals and patients in the UK. It is a multi-dose inhaler that requires the insertion of a cartridge containing the medication. Patients prescribed any product in the Respimat® inhaler are instructed to take two puffs once a day.

Function Description

The Respimat® re-usable inhaler functions by releasing a measured dose of medication from a cartridge as a fine mist when activated. The device consists of several key components: a mouthpiece through which the medication is inhaled, air vents to ensure proper airflow during inhalation, a dose-release button to activate the spray, a cap to protect the mouthpiece, a safety catch that secures the clear base, a clear base that can be removed for cartridge insertion, and a cartridge counter/dose indicator that shows the remaining puffs.

The process of medication delivery involves a series of steps: turning the clear base, opening the cap, and pressing the dose-release button while inhaling. This mechanism ensures that the medication is delivered consistently and effectively. The device is designed to be re-usable, meaning that once a cartridge is empty, it can be replaced with a new one, extending the life of the inhaler body. The dose indicator provides a visual cue for patients to track the remaining medication, prompting them to obtain a new cartridge when the supply is low.

Usage Features

The Respimat® re-usable inhaler is designed for ease of use, with clear instructions for preparation and daily operation.

Preparation for Use:

1. Removing the Clear Base: To begin, the cap must be kept closed. The clear base is removed by pressing the safety catch and pulling it off with the other hand.
2. Inserting the Cartridge: The medication cartridge is then inserted into the inhaler. The inhaler should be placed on a firm surface, and the cartridge pushed down firmly until it clicks into place.
3. Tracking Cartridge Use: A check-box on the inhaler's label allows users to track the number of cartridges used. After inserting a new cartridge, the clear base is put back into place until it clicks.
4. Turning the Clear Base: With the cap closed, the clear base is turned in the direction of the arrows on the label until it clicks, which is a half turn.
5. Opening the Cap: The cap is then opened until it snaps fully open.
6. Priming the Inhaler (Pressing): To prime the inhaler, it is pointed toward the ground, and the dose-release button is pressed. The cap is then closed. This turning, opening, and pressing sequence (steps 4-6) is repeated until a cloud of mist is visible. After the first visible cloud, the sequence is repeated three more times to ensure the inhaler is fully primed and ready to deliver 60 puffs (30 doses).
   • If the inhaler has not been used for more than 7 days, one puff should be released towards the ground.
   • If it has not been used for more than 21 days, steps 4 to 6 under 'Prepare for use' should be repeated until a cloud is visible, and then repeated three more times.

Daily Use:

1. Turn: The cap is kept closed, and the clear base is turned in the direction of the arrows on the label until it clicks (half a turn).
2. Open: The cap is opened until it snaps fully open.
3. Press and Inhale:
   • The patient breathes out slowly and fully.
   • The lips are closed around the mouthpiece, ensuring the air vents are not covered. The inhaler is pointed to the back of the throat.
   • While taking a slow, deep breath through the mouth, the dose-release button is pressed, and inhalation continues slowly for as long as comfortable.
   • The breath is held for 10 seconds or as long as comfortable.
   • The "Turn, Open, Press" sequence is repeated for a total of two puffs, as prescribed for once-daily use.
   • Finally, the cap is closed until the inhaler is used again.

When to Replace the Cartridge:

The dose indicator on the inhaler provides a visual guide for cartridge replacement:

• A "60" indication means 60 puffs remain.
• A "10" indication means less than 10 puffs remain, signaling the need to obtain a new cartridge.
• When the cartridge is used up, the clear base is turned to loosen it, as the inhaler will be in a locked position. The empty cartridge is pulled off, and a new one is inserted by continuing with step 2 of the preparation instructions.

Maintenance Features

The Respimat® re-usable inhaler requires minimal but regular maintenance to ensure optimal performance and hygiene.

• Cleaning: The mouthpiece, including the metal part inside, should be cleaned at least once a week. This is done using a damp cloth or tissue.
• Discoloration: Minor discoloration in the mouthpiece does not affect the inhaler's performance.
• External Cleaning: If necessary, the outside of the Respimat® re-usable inhaler can be wiped with a damp cloth.

These maintenance steps are straightforward and designed to be easily incorporated into a patient's routine, ensuring the device remains clean and functional throughout its lifespan. The re-usable nature of the inhaler body, combined with the replaceable cartridges, makes it a practical and sustainable option for long-term medication delivery.

SPIRIVA Respimat re-usable Specifications

General

Brand Name	SPIRIVA
Generic Name	tiotropium bromide
Device Type	Inhaler
Indication	COPD
Administration Route	Inhalation
Device Reusability	Re-usable
Active Ingredient	Tiotropium bromide
Strength	2.5 mcg per actuation
Manufacturer	Boehringer Ingelheim
Delivery Method	Soft mist inhaler
Usage	Maintenance treatment of chronic obstructive pulmonary disease (COPD)
Dosage Form	Inhalation solution