Indications for STIOLTO RESPIMAT:

Long-term maintenance treatment of patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

Limitations of Use:

Not for treating asthma or acute deteriorations of COPD.


Take at same time each day. 2 inhalations once daily; max 2 inhalations/24hrs.


Not established.


LABA use in asthma patients without use of long-term control medication.

Boxed Warning:

Asthma-related death.


LABAs may increase risk of asthma-related death. Do not initiate in patients with acutely deteriorating COPD. Not for relief of acute bronchospasm. Prescribe a short-acting β2-agonist for acute symptoms; monitor for increased need. Do not exceed recommended dose. Not for use with other long-acting β2-agonists. Discontinue if paradoxical bronchospasm or hypersensitivity reactions occur; use alternative therapy. Cardiovascular disease (esp. coronary insufficiency, arrhythmias, hypertrophic obstructive cardiomyopathy, hypertension). Convulsive disorders. Thyrotoxicosis. Prolongation of the QT interval. Hyperresponsiveness to sympathomimetics. Diabetes. Ketoacidosis. Narrow-angle glaucoma. Monitor for signs/symptoms of prostatic hyperplasia, GI or GU obstruction. Risk of hypokalemia or hyperglycemia. Moderate-to-severe renal impairment: monitor for anticholinergic effects. Severe hepatic impairment. Labor & delivery. Pregnancy. Nursing mothers.

Pharmacologic Class:

Anticholinergic + long-acting beta-2 agonist (LABA).


Avoid with other anticholinergics. Caution with concomitant other adrenergic drugs. Concomitant xanthine derivatives, steroids, diuretics may potentiate hypokalemia. Extreme caution with MAOIs, tricyclics, or drugs known to prolong QTc interval. Antagonized by β-blockers; if needed, consider cardioselective agents. Potentiated by strong CYP450 and P-gp inhibitors (eg, ketoconazole).

Adverse Reactions:

Nasopharyngitis, cough, back pain; paradoxical bronchospasm, urinary retention, hypokalemia, hypersensitivity reactions.

Generic Availability:


How Supplied:

Inhaler (w. cartridge)—4g (60 inh)