The US Food and Drug Administration (FDA) has announced that many patients with asthma or chronic obstructive pulmonary disease (COPD) have been swallowing capsules meant to be inhaled, instead of using the inhaler device to breathe in the powder inside them. The FDA and the National Poison Control Center stress that swallowing the capsules does nothing to treat the breathing condition.
Capsules of tiotropium bromide inhalation powder (Spiriva, Boehringer Ingelheim) and formoterol fumarate inhalation powder (Foradil, Novartis) must be used with the HandiHaler and Aerolizer devices, so the medicine reaches the lungs. Patients should be taught how to use these devices properly, and if a patient isn't improving, it is worth asking whether they are swallowing the capsules.
Tiotropium is a long-term, once-daily maintenance treatment for the bronchospasm of COPD, including chronic bronchitis and emphysema. Formoterol is a long-term, twice-daily maintenance treatment for COPD; it can also be used, together with an inhaled steroid, as maintenance treatment for asthma, and to prevent bronchospasm in patients over five with reversible obstructive airway disease.
Side effects of these inhaled medicines can be reported to the FDA's MedWatch programme, or to your national medicines regulator.
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