Spiriva Respimat Inhalers

Q: I have a prescription for Respimat Inhaler, 60 doses. How many inhalers do I dispense?

A: There is an ongoing confusion with Boehringer Ingelheim inhalers use of the term “puff” and “dose”.

The SPC for Spiriva states that the delivered dose is 2.5 microgram tiotropium per puff. The recommended dose is 5 microgram once daily.  Therefore ONE dose is equivalent to TWO puffs daily

One Spiriva cartridge provides a patient with 60 puffs delivering 30 doses.

However the Drug Tariff and NHS medicines and appliances data (DM+d) list a single Spiriva Respimat cartridge as delivering 60 doses. This is to be consistent with other inhalers who list their capacities as doses rather than puffs.  

Therefore if you receive a prescription for Respimat Inhaler 60 doses, you will only be reimbursed for ONE inhaler only.  We would advise you to contact the prescriber to clarify “60 doses” or 60 puffs and to indicate how many inhalers they want to prescribe.

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