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Post by sharon on Dec 27, 2016 16:42:13 GMT -5
I have been on spiriva handihaler for years. Lately I have been more sob. She suggested the aerosol spiriva. Has anyone switched to this? Does it work any better?
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Post by ozboy on Dec 27, 2016 18:55:56 GMT -5
Hi......I know quite a few people in OZ that are using it now......Seeing it has been quickly elevated to our PBS med list, it costs around $5.20.....Because it is primary an Asthma Med around 26,000 patients will benefit in the first year of this listing, increasing to around 67,000 per year over the forward estimates.........Alone it would cost around $700AUD/Year..... www.medicines.org.uk/emc/medicine/20134l
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Post by higgs on Dec 27, 2016 21:41:55 GMT -5
I did a clinical trial of the respimat delivery system four years ago and thought at the time that I was able to inhale the medicine better than with the hand inhaler. It took me until last year for my insurance to supply it. Have been on it now for 10 months. As the copd has progressed it seemed harder to use the other inhaler. The respimat is easier and seems to allow me to inhale it deeper. The spiriva is the same,the delivery system is what has changed with what I'm using.
Fran
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Post by gerald on Dec 27, 2016 21:48:25 GMT -5
I switched over to the Spiriva Respimat about 6 months ago. I find I can inhale it deeper and more easily. I have not found any new side effects from it. I did not find it improved my SOB any. My Respiratory Specialist doubled my Symbicort used to ease the SOB
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Post by barb7330 on Dec 28, 2016 7:52:00 GMT -5
I am taking alvesco and anoro...Alvesco was 2 puffs twice a day. When I seen lung Dr. last week he cut the alvesco down to just 2 puffs a day. I don't think I have near the mucous with the cutback.
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Post by ozboy on Jan 1, 2017 21:21:46 GMT -5
INTERESTING TO SEE IF AVAILABLE AS A PBS MED IN AUSTRALIA...''Striverdi Respimat'' Striverdi Respimat (olodaterol) is a type of inhaled medicine that can be used to treat and manage the symptoms of chronic obstructive pulmonary disease (COPD). Striverdi Respimat is a maintenance medication for COPD patients who have a difficult time breathing due to the disease. This means that it is taken every day and that over time, it can help improve lung function. It is not used for treating acute exacerbations, or flare-ups when COPD symptoms such as breathlessness and wheezing suddenly get worse. Patients will still need to use their rescue inhalers to relieve these sudden or severe symptoms. Several large clinical trials were carried out to test the effectiveness and safety of Striverdi Respimat for treating patients with COPD. In one study, patients were treated with Striverdi Respimat for 48 weeks. After 6 weeks of treatment, those patients had a significant average improvement in lung function that was sustained for the entire 24-hour period that each dose of the medication lasts. At the end of the study, the patients who were treated with Striverdi Respimat also had a 34% reduction in the amount of times that they need to use their rescue inhalers to treat sudden or severe COPD symptoms. globalgenes.org/raredaily/boehringer-ingelheim-announces-fda-approval-new-inhalation-spray-striverdirespimat/
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Post by gerald on Jan 13, 2017 14:24:54 GMT -5
Looks like some actually did a study on the change to the Respimat. Basically found no issue with the change over ------------------------------ Safety and efficacy of tiotropium in patients switching from HandiHaler to Respimat in the TIOSPIR trial Ronald Dahl1, Peter M A Calverley2, Antonio Anzueto3, Norbert Metzdorf4, Andy Fowler5, Achim Mueller6, Robert Wise7, Daniel Dusser8 Author affiliations Abstract Objectives This post hoc analysis of TIOtropium Safety and Performance In Respimat (TIOSPIR) evaluated safety and exacerbation efficacy in patients with stable (≥2 months) use of tiotropium HandiHaler 18 µg (HH18) prior to study entry, to evaluate whether there was a difference in risk for patients who switched from HH18 to tiotropium Respimat 2.5 µg (R2.5) or 5 µg (R5). Setting TIOSPIR (n=17 135) was an international, Phase IIIb/IV, randomised, double-blind, parallel-group, event-driven trial. Participants Patients from TIOSPIR with chronic obstructive pulmonary disease (COPD) and postbronchodilator ratio of forced expiratory volume in 1 s to forced vital capacity ≤0.70, receiving HH18 before study entry, were analysed (n=2784). Interventions Patients were randomised to once-daily tiotropium R2.5 (n=914), R5 (n=918) or HH18 (n=952) for 2–3 years. Primary and secondary outcome measures Primary outcomes: time to death (safety) and time to first COPD exacerbation (efficacy). Secondary outcomes: number of exacerbations and time to first major adverse cardiovascular event (MACE). Results Baseline characteristics were similar in all groups. Respimat had a similar mortality risk versus HH18 (vital status follow-up, HR; 95% CI R2.5: 0.87; 0.64 to 1.17; R5: 0.79; 0.58 to 1.07) with no significant differences in the risk and rates of exacerbations and severe exacerbations across treatment groups. Risk of MACE and fatal MACE was similar for Respimat versus HH18 (HR; 95% CI MACE R2.5: 0.73; 0.47 to 1.15; R5: 0.69; 0.44 to 1.08; fatal MACE R2.5: 0.57; 0.27 to 1.19; R5: 0.67; 0.33 to 1.34). Overall risk of a fatal event (on treatment) was lower for R5 versus HH18 (HR; 95% CI R2.5: 0.78; 0.55 to 1.09; R5: 0.62; 0.43 to 0.89). Conclusions This analysis indicates that it is safe to switch patients from tiotropium HandiHaler to tiotropium Respimat, and that the efficacy is maintained over the switch. bmjopen.bmj.com/content/5/12/e009015
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Post by ozboy on Jan 13, 2017 20:36:40 GMT -5
Well today i tried out both my previous inhalers of the past, after finding nothing much changing after almost 2 years on the LAMA/LABA inhaler ''Ultibro'' or ''Ultibron'' in the US......They did put me on Pulmicort which is basically an Asthma Steroid Preventer to boost my need for steroid and so cutting back on Prednisone, which I need fairly regularly to deal with bronchial blockage....but never found an difference.
The Respimat is really easy to use compared with the old handihaler system when you even were not sure if the blue caps were full or empty... Early days but i feel i might have a bit more luck with the swop over......
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Post by lavishgail on Jan 13, 2017 23:08:42 GMT -5
I have respimat. That works okay when I really need it in a fast hurry. I like the mist and how it comes out the way it does! Good luck Peter. ☺☺
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Post by justacaregiver on Jan 20, 2017 23:58:23 GMT -5
O.K., I'll weigh in on this one.
Sadly, I speak to way too many Respiratory Therapists and many times, I've kicked around the values of the powder type inhalers with them.
It's nothing scientific here but my thoughts are as a person uses the powder over a long period, and many times the lungs become weaker just from the progression of the COPD, it becomes harder to get medicine like the handihaler and even Tudorza to where they should be going. Many hospitals here have removed Tudorza from their formulary simply because it's too difficult for the patient to make the MDI "pop" to let you know when the powder has been inhaled.
I think the respimat is the way to go because it will get the medicine to where it belongs. I'll ask the Doctor if he'll switch us over.
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Post by lavishgail on Jan 21, 2017 1:31:37 GMT -5
Gary I agree! Much better! The mist gets right in and works immediately.
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Post by justacaregiver on Jan 21, 2017 2:08:21 GMT -5
I see how the medicine that should go directly to the lungs end up getting as far as the back of the throat. The other venue for me would be the duo-neb but that way would be too confining because then I'd need four a day and then, I'd need to be around a nebulizer. I have already have enough to lug around as it is.
Now, here's my question. When you do the Handihaler, it's a cap of 125mcg. Are you doing two puffs of the Respimat to achieve 125mcg or will one puff deliver the therapeutic dose?
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Post by lavishgail on Jan 21, 2017 8:47:53 GMT -5
I do 2 puffs in the morning and 2 at night. But only if I need too. I don't always need it. So mine lasts forever. They have tried me on I think just about every kind their is and I really like this one the best for me, because of the mist. But they say this one is a rescue one. So I'm not sure if it's all you need? You might need another option as well, for medicene? That's up to you're doctor's. Hope I helped?
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Post by justacaregiver on Jan 21, 2017 11:09:12 GMT -5
Well sure you've helped! We just do the handihaler once a day but what I question is if she's getting the full dose. I puncture it once but have her inhale two times just to make sure she cleared it. I'm thinking that because it's a mist vs a powder, The mist would assist in driving the medicine to where it belongs.
Now I'm going to ask you for a favor, PLEASE call your Pharmacy and inquire as to what inhaler that you have is a rescue inhaler.
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Post by joany on Jan 21, 2017 12:01:43 GMT -5
Well sure you've helped! We just do the handihaler once a day but what I question is if she's getting the full dose. I puncture it once but have her inhale two times just to make sure she cleared it. I'm thinking that because it's a mist vs a powder, The mist would assist in driving the medicine to where it belongs. Now I'm going to ask you for a favor, PLEASE call your Pharmacy and inquire as to what inhaler that you have is a rescue inhaler. Everything I've read over a few years indicates that with the handihaler, recommendation is to inhale twice as a precaution. I woulld think if normally inhalations are shalllow (noticeable with breathing exercises), then iinhale twice. I'm sure the handihaler is a powder and respimat is a mist. (I think this is different from Gail's prescription as what I have is maintenance to be taken once/day)
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Post by justacaregiver on Jan 21, 2017 13:08:49 GMT -5
Joany, I just looked on the Boehringer Ingelheim Pharmaceuticals site, the manufacturer of Spiriva, and they instruct to inhale twice and so does Webmd. Maybe for once I read the instructions? I've even gone as far as to remove the punctured, inhaled cap apart to make sure she got it all and that's even after I hear the rattles after she's inhaled. I just think the extra push from the respimat couldn't hurt. Also, I've never given it for anything other than a maintenance medicine either.
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Post by jarca on Jan 21, 2017 21:06:21 GMT -5
I used Spiriva "Handihaler" from 2012 to 2015 & then switched when the respimat version came available. I've now used the Spiriva "Respimat" for 2 years.
I was told that spiriva is a "maintenace" inhaler & to use it once a day. I find that the "respimat" version is easier for me to inhale & it feels like I get it deeper into my lungs, but the affect I feel is about the same.
Spiriva has worked very good for me. I had never coughed up a mucus plug until the 1st time I used Spiriva (which was in the dr's office thank goodness). So the only thing I "notice" that spiriva does for me is seems to loosen the mucus plugs for me to get up, which makes my lungs feel more "open" and like i get more air. However, I haven't ever noticed a difference in the feeling of SOB with it though....and I don't see any claims that it helps with SOB.
A rescue inhaler, or nebulizer may help more with SOB (I take an anti-anxiety med & an opiate that help with my SOB)
yes; 1 handihaler cap is 125mcg while 2 puffs respimat is 125mcg.
Note; Spiriva works well for me, but causes a lump in my throat & a throat clearing cough. With the handihaler i only did it every other day so those side effects weren't so bad. With the Respimat i now can do it daily, but I only do 1 puff.....this is per my dr's advice, i just mention it because i know others that only use 1/2 a dose also.
As always, work with your Dr to find what is best for you!!!
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Post by lavishgail on Jan 22, 2017 23:45:11 GMT -5
Gary, I'm sorry I wrote mine wrong, I take 2 puffs 4x a day! Mine is combivent Respimat. One doctor told me this is a rescue? So I am unsure of you're question? I could be wrong, like I have said, I've been on many inhalers!! Oh and this is 20 mg /100mcg per actuation.
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Post by justacaregiver on Jan 23, 2017 0:33:17 GMT -5
Gail, This is sort of like rescue and maintenance. If you were doing this through a neb, it would be called DuoNeb. The albuterol opens the airway and the ipratropium (a cousin to tiotropium) helps them stay open over a longer period. Tiotropium is Spiriva. Combivent is a very good drug.
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Post by mary57 on Feb 1, 2017 8:56:17 GMT -5
I use the Spiriva Respimat, have now for about 6 months, it is much easier to inhale the mist and get it where it needs to be. I have used Spiriva Hanihaler for many years and at times it was just too hard to 'suck' the medication out of it properly. With the Handihaler the dose was 2 puffs from the same capsule, with the Respimat it is 2 doses. Both are the same amount of the drug. Only the delivery system is different. I hope this helps.
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Post by lavishgail on Feb 2, 2017 5:12:08 GMT -5
Yes what Mary said hahaha..
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Post by ozboy on Feb 2, 2017 8:05:55 GMT -5
Well the change back to Seretide 500 and Spiriva Respimat seem to be working much better for me.....I do not nebulise unless in a hospital situation....If I need to do a neb, then I use 8 puffs of Ventolin via Spacer......Even as a rescue I tend to use PLB rather than the Ventolin Rescue...
The Respimat is 2.5 micrograms and I do 2 inhales once daily.....It is much better than the old Handihaler and the batches of empty blue caps that occassionally were annoying but not being a clear cap like those in Onbrez n Ultibro, it was hard to check prior...
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Post by mary57 on Feb 2, 2017 10:46:39 GMT -5
Peter, I think that here we are moving away from the nebulizer in the ER, the last time I went in the Dr said they had found that giving 4 puffs of ventoliln and 4 puffs of ipravent, given 4 times at 20 min. intervals worked better. I don't know about other hospitals here though.
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Post by ozboy on Feb 2, 2017 17:50:11 GMT -5
Hi Mary...........Not sure bout the hospitals because they usually still do the 4 hourly nebs if required.......but in my local FB Support Group, many more Severe People tend to use the Spacer System......I was speaking to the operator during a PFT Test and she said the benefits were exactly the same, if it is straight Albuterol that is needed..So the idea of interchanging the Meds using a spacer makes sense...Rather than go thru all the hassles of setting up and maintenance of a neb machine.........Also there are a few carrying around the small battery powered neb thingy, when they go out for the day and usually need neb maintenance....
Although I got interested in the Salt Lamps and mine rarely or ever gets used..etc etc.....but since I read alternative studies showing they were not cracked up to be what they say.....unless you practically sit near one while online or have them scattered all over the home, they do nothing to warrant them health wise....The Salt Inhaler is much more believable as an aid for lung conditioning, so I might start using it more on a daily treatment basis and see if I feel it helping.....
Take care xxxx
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Post by pippy on Feb 6, 2017 9:49:17 GMT -5
I have used Spiriva Respimat for 2 years now and find a great difference from the powder . It took about a year to get it covered, Dr had to make a call to get it covered, but in the meantime I got some samples. Very grateful
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Spiriva
Feb 15, 2017 1:02:30 GMT -5
via mobile
ozboy likes this
Post by lavishgail on Feb 15, 2017 1:02:30 GMT -5
Peter, I do have a Salt lamp, and it's in my room right next to me. Idk but it's working for me! The first night I had it on I slept like a baby. My imagination? I don't know? It's light is very soft. You have to insert the bulb yourself. The bulb is a small like the night light type. I sure like mine.
It's really like a hunk of salt. So maybe you can ask other if they have one what they think. The prices seem to be good. Reasonable. I'm sure you get a 30 day respond on you're item. Maybe ask see what they say? Good Luck Peter.
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Post by ozboy on Feb 15, 2017 19:35:22 GMT -5
Lots of COPD people use them here n in NZ....it was a craze for a long time although the salt caves have been much less attractive cost wise if you want more than a relaxation.......The lamps n Salt Pipes are very popular, some swear by them and others like me like the soft glow...side lamp substitute.... You need to wipe them down often as the salt builds up under the base and across the lamp face....The bulbs are cheap and do not last very long as they burst...... www.amazon.com/salt-lamps/b?node=5759978011healthunlocked.com/blf/posts/134561021/salt-lamps
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Post by gerald on Feb 15, 2017 19:51:37 GMT -5
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Post by Suzanne (Suz) on Feb 18, 2017 10:36:32 GMT -5
I bought a salt lamp almost 2 years ago and it's on all the time for the last couple of months. It is in the living room as I'm hoping it creates some nice atmosphere for everyone. I got mine at a yard sale for $7 .
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Spiriva
Mar 8, 2017 0:58:16 GMT -5
via mobile
Post by lavishgail on Mar 8, 2017 0:58:16 GMT -5
I also have one and I keep it in my room.
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