- BNF:
- 3.1.2
- Status:
- Grey, Grey - after consultant/specialist initiation
- Decision Date:
- None
Comments
GREY:
- Single component LAMA are no longer recommended as first line treatment option. COPD patients should be treated with LABA+LAMA inhaler or consider LABA+ICS inhaler if patient has asthmatic features or features suggesting steroid responsiveness. See JAPC COPD guideline.
- Tiotropium (Tiogiva or Spiriva Respimat) is the preferred LAMA if treatment with single component LAMA is required. (Decision date - March 2023)
- Following on from a MHRA drug safety update (Feb 2015), prescribers should take the risk of CV side effects into account when prescribing tiotropium via a handihaler or a respimat or Tiogiva for patients with certain cardiac conditions. Consult the SPC for further details. (Decision date - March 2015).
GREY after consultant/specialist initiation:
- for asthma. Severe asthma with a demonstrated airflow obstruction. Spiriva Respimat (Decision date - December 2014)
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