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Tiotropium and Formoterol

The Food and Drug Administration has issued a public health advisory to reinforce the correct use of tiotropium (Spiriva) and formoterol (Foradil), both of which are inhaled powders used to improve breathing in patients with asthma or chronic obstructive pulmonary disease, including chronic bronchitis and emphysema. The advisory offers these instructions for patients:

Spiriva and Foradil should be inhaled. Don't swallow the capsules.

You must use the correct delivery device for each drug. If you take tiotropium, use the Handihaler device. If you take formoterol, use the Aerolizer device.

Remove the drug capsule from the blister package just before use, and place the intact capsule into the inhalation device.

Read and follow the instructions in the patient leaflet that comes with each drug.

To health care professionals, the advisory says this: If a patient's breathing isn't improving after starting one of these drugs, make sure he's inhaling the powder correctly and not swallowing the capsules. Poison control centers have received many reports of patients swallowing the capsules instead of inhaling the contents. Although doing so seems to cause no adverse effects, it negates the drugs' benefits.

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