Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Olodaterol hydrochloride may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
Striverdi Respimat 4. Possible side effects 5. How to store Striverdi Respimat
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Driving and using machines No studies on the effects on the ability to drive and use machines have been performed. If you feel dizzy while taking this medicine, do not drive or use any tools or machines. Striverdi Respimat contains Benzalkonium chloride This medicine contains 0.0011 mg benzalkonium chloride in each actuation. Benzalkonium chloride may cause wheezing and breathing difficulties (bronchospasm), especially if you have asthma.
3. How to take Striverdi Respimat
Stop taking this medicine and tell your doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment:
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
Striverdi Respimat is for inhalation use only.
Rare (may affect up to 1 in 1,000 people):
Dosage
The recommended dose is: Striverdi Respimat is effective for 24 hours so you will need to take this medicine only ONCE A DAY, if possible at the same time of the day. Each time you use it take TWO PUFFS. As COPD is a long-term disease take this medicine every day and not only when you experience breathing problems. Do not take more than the recommended dose. Make sure that you know how to use your Respimat re-usable inhaler properly. The instructions on how to use the Respimat re-usable inhaler are provided at the end of this leaflet, see 'Instructions on how to use the Respimat re-usable inhaler'. Use in children and adolescents There is no relevant use of this medicine in the paediatric population (under 18 years). If you take more Striverdi Respimat than you should You may be at a higher risk of experiencing a side effect such as chest pain, high or low blood pressure, faster or irregular heartbeat or feeling of heart beat, dizziness, nervousness, difficulty in sleeping, anxiety, headache, shaking, dry mouth, muscle cramps, nausea, fatigue, malaise, low blood levels of potassium (which may cause symptoms of muscle spasm, muscle weakness or abnormal heart rhythm), high blood sugar, or too much acid in your blood (which may cause symptoms of nausea, vomiting, weakness, muscle cramps and more rapid breathing). If you forget to take Striverdi Respimat If you forget to inhale a dose, inhale just one dose at the usual time the next day. Do not take a double dose to make up for a forgotten dose. If you stop taking Striverdi Respimat Before you stop taking Striverdi Respimat, you should talk to your doctor or your pharmacist. If you stop taking Striverdi Respimat the signs and symptoms of COPD may worsen. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
You may also experience side effects which are known to occur with certain medicines for breathing problems similar to this medicine (beta-adrenergic agents). These may be faster or irregular heartbeat or feeling of heart beat, chest pain, high or low blood pressure, shaking, headache, nervousness, difficulty in sleeping, dizziness, dry mouth, nausea, muscle cramps, fatigue, malaise, low blood levels of potassium (which may cause symptoms of muscle spasm, muscle weakness or abnormal heart rhythm), high blood sugar, or too much acid in your blood (which may cause symptoms of nausea, vomiting, weakness, muscle cramps and more rapid breathing). Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
Striverdi Respimat Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and on the cartridge label after EXP. The expiry date refers to the last day of the month. Do not freeze. In-use shelf life Exchange the cartridge latest three months after insertion. Do not use the Respimat re-usable inhaler for more than one year. Recommended use: 6 cartridges per inhaler Note: The functioning of the Respimat re-usable inhaler has been demonstrated in tests for 540 actuations (corresponding to 9 cartridges). Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information What Striverdi Respimat contains The active substance is olodaterol. The delivered dose is 2.5 microgram olodaterol (as hydrochloride) per puff. The delivered dose is the dose which is available for the patient after passing the mouthpiece. The other ingredients are: Benzalkonium chloride, disodium edetate, purified water, and citric acid (anhydrous) What Striverdi Respimat looks like and contents of the pack Striverdi Respimat 2.5 microgram is composed of one cartridge with inhalation solution and one Respimat inhaler. The cartridge has to be inserted into the inhaler before the first use. Single pack: 1 Respimat re-usable inhaler and 1 cartridge, providing 60 puffs (30 medicinal doses) Triple pack: 1 Respimat re-usable inhaler and 3 cartridges, providing 60 puffs (30 medicinal doses) each Single refill pack: 1 cartridge, providing 60 puffs (30 medicinal doses) Triple refill pack: 3 cartridges, providing 60 puffs (30 medicinal doses) each Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer The marketing authorisation holder for Striverdi Respimat is: Boehringer Ingelheim International GmbH Binger Straße 173 55216 Ingelheim am Rhein Germany The manufacturer for Striverdi Respimat is: Boehringer Ingelheim Pharma GmbH & Co. KG Binger Straße 173 55216 Ingelheim am Rhein Germany This medicine is authorised in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names: Austria, Liechtenstein, Belgium, Luxembourg, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Malta, United Kingdom (Northern Ireland), Italy, Latvia, Lithuania, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden: Striverdi Respimat Bulgaria: Стриверди Респимат This leaflet was last revised in 07/2024.
Instructions on how to use the Respimat re-usable inhaler
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TWO PUFFS ONCE DAILY
Respimat is an inhaler device that generates a spray for inhalation. Respimat is for you only. One cartridge delivers multiple doses. The Respimat re-usable inhaler allows for the replacement of the cartridge, and can be used with up to 6 cartridges. Read these instructions before you start using Striverdi Respimat. You will need to use this inhaler only ONCE A DAY. Each time you use it take TWO PUFFS.
Respimat®
Cartridge
Cap
Mouthpiece Air vents Dose-release button
Prepare for use
1 2
Daily use Safety catch Clear base
Remove clear base
Answers to Common Questions It is difficult to insert the cartridge deep enough.
TURN
Arrows
Insert cartridge
Cap
"CLICK"
OPEN
Cartridge counter Dose Indicator
Clear base
Front
3
Put back clear base
Track cartridge and put the clear base back
Back
How to care for your Respimat re-usable inhaler Clean the mouthpiece including the metal part inside the mouthpiece with a damp cloth or tissue only, at least once a week. Any minor discoloration in the mouthpiece does not affect your Respimat re-usable inhaler performance. If necessary, wipe the outside of your Respimat re-usable inhaler with a damp cloth.
4
Arrows
Turn
Cap
5
I cannot press the dose-release button.
Does the dose indicator on your cartridge display a white arrow on a red background? Your cartridge is used up. Insert a new cartridge.
Did you put the clear base back? If not, put the clear base back to unlock the inhaler. The Respimat re-usable inhaler only functions with the clear base in place.
It is difficult to remove the cartridge after it is used up. Pull and turn the cartridge at the same time.
I cannot turn or put the clear base back.
Air vent
TWO PUFFS ONCE DAILY
Open
Is the clear base loose and does the dose indicator on your cartridge display a white arrow on a red background? Your cartridge is used up. Insert a new cartridge. Did you turn the clear base already? If the clear base has already been turned, follow steps "OPEN" and "PRESS" under "Daily Use" to get your medicine.
My Striverdi Respimat has been used up too early.
Did you use Striverdi Respimat as indicated (two puffs/once daily)? Each cartridge will last 30 days if used at two puffs once daily.
When to replace the inhaler
When to replace the Striverdi Respimat cartridge
When you have used an inhaler with 6 cartridges, get a new Striverdi Respimat pack containing an inhaler. Do not use the Respimat re-usable inhaler for more than one year, after having inserted the first cartridge.
The dose indicator shows how many puffs remain in the cartridge.
Press
6
Did you repeat TURN, OPEN, PRESS less than three times after inserting the cartridge? Repeat TURN, OPEN, PRESS three times after inserting the cartridge as shown in the steps 4 to 6 under "Prepare for use".
Does the dose indicator on your cartridge display a white arrow on a red background? Your cartridge is used up. Insert a new cartridge and put the clear base back.
PRESS
Doserelease button
60 puffs remaining.
Less than 10 puffs remaining. Obtain a new cartridge.
x3 Steps 4-6
Your cartridge is used up. Turn the clear base to loosen it. Your inhaler is now in a locked position. Pull off the cartridge from the inhaler. Insert a new cartridge until it clicks (refer to step 2). The new cartridge will stick out more than the very first cartridge (continue with step 3). Remember to put the clear base back to unlock the inhaler.
Did you insert a cartridge? If not, insert a cartridge. Once your Striverdi RESPIMAT is assembled, do not remove the clear base or the cartridge until the cartridge is used up.
Are you replacing the cartridge? The new cartridge will stick out more than the very first cartridge. Insert it until it clicks, then replace the clear base.
Did you turn the clear base? If not, turn the clear base in a continuous movement until it clicks (half a turn).
Safety catch
Did you accidentally turn the clear base before inserting the cartridge? Open the cap, press the dose-release button, then insert the cartridge.
My Striverdi Respimat doesn't spray.
Did you spray in the air often to check whether Striverdi Respimat is working? Once you have prepared Striverdi Respimat for use, no testspraying is required if used daily. Did you take off and put the clear base multiple times back? Do not remove the clear base before the cartridge is used up. Each time you take off the clear base without cartridge exchange, the dose counter records one puff and the remaining doses are reduced.
My Striverdi Respimat sprays automatically. Was the cap open when you turned the clear base? Close the cap, then turn the clear base. Did you press the dose-release button when turning the clear base? Close the cap, so the dose-release button is covered, then turn the clear base. Did you stop when turning the clear base before it clicked? Turn the clear base in a continuous movement until it clicks (half a turn). The dose counter will count each incomplete turn and the number of remaining doses is reduced. Was the cap open when you replaced the cartridge? Close the cap, then replace the cartridge.
Instructions on how to use the Respimat re-usable inhaler
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TWO PUFFS ONCE DAILY
Respimat is an inhaler device that generates a spray for inhalation. Respimat is for you only. One cartridge delivers multiple doses. The Respimat re-usable inhaler allows for the replacement of the cartridge, and can be used with up to 6 cartridges. Read these instructions before you start using Striverdi Respimat. You will need to use this inhaler only ONCE A DAY. Each time you use it take TWO PUFFS.
Respimat®
Cartridge
Cap
Mouthpiece Air vents Dose-release button
Prepare for use
1 2
Daily use Safety catch Clear base
Remove clear base
Answers to Common Questions It is difficult to insert the cartridge deep enough.
TURN
Arrows
Insert cartridge
Cap
"CLICK"
OPEN
Cartridge counter Dose Indicator
Clear base
Front
3
Put back clear base
Track cartridge and put the clear base back
Back
How to care for your Respimat re-usable inhaler Clean the mouthpiece including the metal part inside the mouthpiece with a damp cloth or tissue only, at least once a week. Any minor discoloration in the mouthpiece does not affect your Respimat re-usable inhaler performance. If necessary, wipe the outside of your Respimat re-usable inhaler with a damp cloth.
4
Arrows
Turn
Cap
5
I cannot press the dose-release button.
Does the dose indicator on your cartridge display a white arrow on a red background? Your cartridge is used up. Insert a new cartridge.
Did you put the clear base back? If not, put the clear base back to unlock the inhaler. The Respimat re-usable inhaler only functions with the clear base in place.
It is difficult to remove the cartridge after it is used up. Pull and turn the cartridge at the same time.
I cannot turn or put the clear base back.
Air vent
TWO PUFFS ONCE DAILY
Open
Is the clear base loose and does the dose indicator on your cartridge display a white arrow on a red background? Your cartridge is used up. Insert a new cartridge. Did you turn the clear base already? If the clear base has already been turned, follow steps "OPEN" and "PRESS" under "Daily Use" to get your medicine.
My Striverdi Respimat has been used up too early.
Did you use Striverdi Respimat as indicated (two puffs/once daily)? Each cartridge will last 30 days if used at two puffs once daily.
When to replace the inhaler
When to replace the Striverdi Respimat cartridge
When you have used an inhaler with 6 cartridges, get a new Striverdi Respimat pack containing an inhaler. Do not use the Respimat re-usable inhaler for more than one year, after having inserted the first cartridge.
The dose indicator shows how many puffs remain in the cartridge.
Press
6
Did you repeat TURN, OPEN, PRESS less than three times after inserting the cartridge? Repeat TURN, OPEN, PRESS three times after inserting the cartridge as shown in the steps 4 to 6 under "Prepare for use".
Does the dose indicator on your cartridge display a white arrow on a red background? Your cartridge is used up. Insert a new cartridge and put the clear base back.
PRESS
Doserelease button
60 puffs remaining.
Less than 10 puffs remaining. Obtain a new cartridge.
x3 Steps 4-6
Your cartridge is used up. Turn the clear base to loosen it. Your inhaler is now in a locked position. Pull off the cartridge from the inhaler. Insert a new cartridge until it clicks (refer to step 2). The new cartridge will stick out more than the very first cartridge (continue with step 3). Remember to put the clear base back to unlock the inhaler.
Did you insert a cartridge? If not, insert a cartridge. Once your Striverdi RESPIMAT is assembled, do not remove the clear base or the cartridge until the cartridge is used up.
Are you replacing the cartridge? The new cartridge will stick out more than the very first cartridge. Insert it until it clicks, then replace the clear base.
Did you turn the clear base? If not, turn the clear base in a continuous movement until it clicks (half a turn).
Safety catch
Did you accidentally turn the clear base before inserting the cartridge? Open the cap, press the dose-release button, then insert the cartridge.
My Striverdi Respimat doesn't spray.
Did you spray in the air often to check whether Striverdi Respimat is working? Once you have prepared Striverdi Respimat for use, no testspraying is required if used daily. Did you take off and put the clear base multiple times back? Do not remove the clear base before the cartridge is used up. Each time you take off the clear base without cartridge exchange, the dose counter records one puff and the remaining doses are reduced.
My Striverdi Respimat sprays automatically. Was the cap open when you turned the clear base? Close the cap, then turn the clear base. Did you press the dose-release button when turning the clear base? Close the cap, so the dose-release button is covered, then turn the clear base. Did you stop when turning the clear base before it clicked? Turn the clear base in a continuous movement until it clicks (half a turn). The dose counter will count each incomplete turn and the number of remaining doses is reduced. Was the cap open when you replaced the cartridge? Close the cap, then replace the cartridge.
1. What Striverdi Respimat is and what it is used for
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Striverdi Respimat helps people who have chronic obstructive pulmonary disease (COPD) to breathe more easily. COPD is a long-term lung disease that causes shortness of breath and coughing. The term COPD is associated with the conditions chronic bronchitis and emphysema. As COPD is a long-term disease you should take this medicine every day and not only when you have breathing problems or other symptoms of COPD.
olodaterol
2.5 microgram, inhalation solution
Striverdi® Respimat® 314199-05
Striverdi® Respimat® 2.5 microgram, inhalation solution olodaterol
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Striverdi Respimat contains the active substance olodaterol which is a long-acting bronchodilator (long acting beta 2 agonist) that helps to open your airways and makes it easier to get air in and out of the lungs. Regular use of this medicine can also help you when you have on-going shortness of breath related to your disease, and will help to minimise the effects of the disease on your everyday life.
2. What you need to know before you take Striverdi Respimat Do not take Striverdi Respimat
Perigord No: 824675 P2
Mandatory in
File information
TD
Printfile
Issue date of TD:
28.08.2015
Yes
Yes
PPM SKU:
P043722
No
Yes
PPM SKU version:
005
No
Yes
Issue date of artwork:
26.07.2024
No
Yes
Print colors:
BLACK
No
Yes
No
Yes
CYAN
MAGENTA
YELLOW Mat. No. Pack. Site:
314199-05
Min. font size:
10 pt
Legend case version:
V4.0 01/OCT/2012 (please do not change or remove it)
Technical information a = Batch No.
b = Expiry date
c = Manufacturing date
d = Price/Sample/Clinic
Technical colors BI-Diecut-Legendcase
Free area
Gluepoints
Additional Requirements of Packaging site Template name: TD-PI_710x308_90x35 Index: Only for BI-internal use, Template according to Drawing no.: SP-14-0090-001-B_Index_
MASS D: MASS E: MASS G:
0,35 mm 1,0 mm 0,65 mm
Example Technical information Control Code Type: Laetus mini
Pregnancy, breast-feeding and fertility
Striverdi Respimat 2.5 microgram, solution for inhalation comes as inhaler containing 2.5mcg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Striverdi Respimat 2.5 microgram, solution for inhalation is olodaterol hydrochloride.
This leaflet reproduces the patient information leaflet approved for Striverdi Respimat 2.5 microgram, solution for inhalation, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Striverdi Respimat is indicated as a maintenance bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD).
Posology
The medicinal product is intended for inhalation use only. The cartridge can only be inserted and used in the Respimat inhaler.
Two actuations (puffs) from the Respimat inhaler comprise one medicinal dose.
Adults
The recommended dose is 5 microgram olodaterol given as two actuations (puffs) from the Respimat inhaler once daily, at the same time of the day.
The recommended dose should not be exceeded.
Elderly population
Elderly patients can use Striverdi Respimat at the recommended dose.
Hepatic impairment
Patients with mild and moderate hepatic impairment can use Striverdi Respimat at the recommended dose.
There are no data available for use of Striverdi Respimat in patients with severe hepatic impairment.
Renal impairment
Renally impaired patients can use Striverdi Respimat at the recommended dose. There is limited experience with the use of Striverdi Respimat in patients with severe renal impairment.
Paediatric population
There is no relevant use of Striverdi Respimat in the paediatric population (under 18 years).
Method of administration
This medicinal product is intended for inhalation use only. The cartridge can only be inserted and used in the Respimat re-usable inhaler. Respimat is an inhaler device that generates a spray for inhalation. It is meant for use by a single patient and intended for multiple doses delivered by one cartridge.
The Respimat re-usable inhaler allows for replacement of the cartridge, and can be used with up to 6 cartridges.
Patients should read the instructions on how to use the Respimat re-usable inhaler before they start using Striverdi Respimat.
To ensure proper administration of the medicinal product, the patient should be shown how to use the inhaler by a physician or other health care professional.
Instructions for handling and use of the Respimat re-usable inhaler
The patient will need to use this inhaler only ONCE A DAY. Each time used take TWO ACTUATIONS (PUFFS).
• If Striverdi Respimat has not been used for more than 7 days release one actuation (puff) towards the ground.
• If Striverdi Respimat has not been used for more than 21 days repeat steps 4 to 6 under 'Prepare for use' until a cloud is visible. Then repeat steps 4 to 6 three more times.
How to care for the Respimat re-usable inhaler
Clean the mouthpiece including the metal part inside the mouthpiece with a damp cloth or tissue only, at least once a week.
Any minor discoloration in the mouthpiece does not affect the Respimat re-usable inhaler performance.
If necessary, wipe the outside of the Respimat re-usable inhaler with a damp cloth.
When to replace the inhaler
When the patient has used an inhaler with 6 cartridges, get a new Striverdi Respimat pack containing an inhaler. Do not use the Respimat re-usable inhaler for more than one year, after having inserted the first cartridge.
Prepare for use
1. Remove clear base
• Keep the cap closed.
• Press the safety catch while pulling off the clear base with the other hand.
2. Insert cartridge
• Insert the cartridge into the inhaler.
• Place the inhaler on a firm surface and push down firmly until it clicks into place.
3. Track cartridge and put the clear base back
• Mark the check-box on inhaler's label to track the number of cartridges
• Put the clear base back into place until it clicks.
4. Turn
• Keep the cap closed.
• Turn the clear base in the direction of the arrows on the label until it clicks (half a turn).
5. Open
• Open the cap until it snaps fully open.
6. Press
• Point the inhaler toward the ground.
• Press the dose-release button.
• Close the cap.
• Repeat steps 4-6 until a cloud is visible.
• After a cloud is visible, repeat steps 4-6 three more times.
The inhaler is now ready to use and will deliver 60 actuations (puffs) (30 doses).
Daily use
TURN
• Keep the cap closed.
• TURN the clear base in the direction of the arrows on the label until it clicks (half a turn).
OPEN
• OPEN the cap until it snaps fully open.
PRESS
• Breathe out slowly and fully.
• Close the lips around the mouthpiece without covering the air vents. Point the Inhaler to the back of the throat.
• While taking a slow, deep breath through the mouth, PRESS the dose-release button and continue to breathe in slowly for as long as comfortable.
• Hold the breath for 10 seconds or for as long as comfortable.
• Repeat Turn, Open, Press for a total of 2 actuations (puffs).
• Close the cap until the inhaler is used again.
When to replace the Striverdi Respimat cartridge
The dose indicator shows how many actuations (puffs) remain in the cartridge.
60 actuations (puffs) remaining.
Less than 10 actuations (puffs) remaining. Obtain a new cartridge.
The cartridge is used up. Turn the clear base to loosen it. The inhaler is now in a locked position. Pull off the cartridge from the inhaler. Insert a new cartridge until it clicks (refer to step 2). The new cartridge will stick out more than the very first cartridge (continue with step 3). Remember to put the clear base back to unlock the inhaler.
Striverdi Respimat is contraindicated in patients with hypersensitivity to olodaterol or to any of the excipients listed in section 6.1.
Asthma
Striverdi Respimat should not be used in asthma. The long-term efficacy and safety of olodaterol in asthma have not been studied.
Acute bronchospasm
Striverdi Respimat, as a once daily maintenance bronchodilator should not be used for the treatment of acute episodes of bronchospasm, i.e. as rescue therapy.
Hypersensitivity
As with all medications, immediate hypersensitivity reactions may occur after administration of Striverdi Respimat.
Paradoxical bronchospasm
As with other inhaled medicines Striverdi Respimat may result in paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs Striverdi Respimat should be discontinued immediately and alternative therapy substituted.
Systemic effects
Long acting beta2-adrenergic agonists should be administered with caution in patients with cardiovascular disorders, especially ischaemic heart disease, severe cardiac decompensation, cardiac arrhythmias, hypertrophic obstructive cardiomyopathy, hypertension, and aneurysm, in patients with convulsive disorders or thyrotoxicosis, in patients with known or suspected prolongation of the QT interval (e.g. QT> 0.44 s), and in patients who are unusually responsive to sympathomimetic amines.
Patients with a history of myocardial infarction during the previous year, unstable or life-threatening cardiac arrhythmia, hospitalized for heart failure during the previous year or with a diagnosis of paroxysmal tachycardia (>100 beats per minute) were excluded from the clinical trials. Therefore the experience in these patient groups is limited. Striverdi Respimat should be used with caution in these patient groups.
Cardiovascular effects
Like other beta2-adrenergic agonists, olodaterol may produce a clinically significant cardiovascular effect in some patients as measured by increases in pulse rate, blood pressure, and/or symptoms. In case such effects occur, treatment may need to be discontinued. In addition, beta-adrenergic agonists have been reported to produce electrocardiogram (ECG) changes, such as flattening of the T wave and ST segment depression, although the clinical significance of these observations is unknown.
Hypokalaemia
Beta2-adrenergic agonists may produce significant hypokalaemia in some patients, which has the potential to produce adverse cardiovascular effects. The decrease in serum potassium is usually transient, not requiring supplementation. In patients with severe COPD, hypokalaemia may be potentiated by hypoxia and concomitant treatment (see section 4.5), which may increase the susceptibility to cardiac arrhythmias.
Hyperglycaemia
Inhalation of high doses of beta2-adrenergic agonists may produce increases in plasma glucose.
Anaesthesia
Caution needs to be taken in case of a planned operation with halogenated hydrocarbon anaesthetics due to an increased susceptibility to the adverse cardiac effects of beta agonist bronchodilators.
Excipients
Benzalkonium chloride may cause wheezing and breathing difficulties. Patients with asthma are at an increased risk for these adverse events.
Striverdi Respimat should not be used in conjunction with any other medications containing long-acting beta2-adrenergic agonists.
Patients who have been taking inhaled, short-acting beta2-adrenergic agonists on a regular basis (e.g., four times a day) should be instructed to use them only for symptomatic relief of acute respiratory symptoms.
Adrenergic agents
Concomitant administration of other adrenergic agents (alone or as part of combination therapy) may potentiate the undesirable effects of Striverdi Respimat.
Xanthine derivatives, Steroids or diuretics
Concomitant treatment with xanthine derivatives, steroids, or non-potassium sparing diuretics may potentiate any hypokalemic effect of adrenergic agonists (see section 4.4).
Beta-blockers
Beta-adrenergic blockers may weaken or antagonise the effect of Striverdi Respimat. Therefore Striverdi Respimat should only be given together with beta-adrenergic blockers (including eye-drops) if there are compelling reasons for their use. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
MAO inhibitors and tricyclic antidepressants, QTc Prolonging drugs
Monoamine oxidase inhibitors or tricyclic antidepressants or other drugs known to prolong the QTc interval may potentiate the action of Striverdi Respimat on the cardiovascular system.
Pharmacokinetic Drug Drug interactions
No relevant effect on systemic exposure to olodaterol has been observed in drug-drug interaction studies with co-administration of fluconazole, used as model inhibitor of CYP2C9.
Co-administration of ketoconazole as potent P-gp and CYP inhibitor increased systemic exposure to olodaterol by approximately 70%. No dose adjustment is necessary.
Co-administration of olodaterol and tiotropium had no relevant effect on the systemic exposure to either of the two drugs.
In vitro investigations have shown that olodaterol does not inhibit CYP enzymes or drug transporters at the plasma concentrations achieved in clinical practice.
Pregnancy
There are no data from the use of Striverdi Respimat in pregnant women available.
Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity at clinically relevant exposures (see section 5.3).
As a precautionary measure, it is preferable to avoid the use of Striverdi Respimat during pregnancy.
Like other beta2-adrenergic agonists, olodaterol may inhibit labour due to a relaxant effect on uterine smooth muscle.
Breast-feeding
Clinical data from nursing women exposed to olodaterol are not available. It is unknown whether olodaterol/metabolites are excreted in human milk. Available pharmacokinetic/toxicological data in animals have shown excretion of olodaterol and/or its metabolites in milk.
Since the systemic exposure of the breast-feeding woman to olodaterol/metabolites is negligible at the human dose of 5 µg per day, relevant effects on the breastfed newborn/infant are not expected.
A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Striverdi Respimat therapy, taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman.
Fertility
Clinical data on fertility are not available for Striverdi Respimat. Preclinical studies performed with olodaterol showed no adverse effect on fertility.
No studies on the effects on the ability to drive and use machines have been performed.
However, patients should be advised that dizziness has been reported in clinical trials. Therefore, caution should be recommended when driving a car or operating machinery. If patients experience dizziness, they should avoid potentially hazardous tasks such as driving or operating machinery.
a. Summary of the safety profile
The most common adverse reactions at the recommended dose were nasopharyngitis, dizziness, hypertension, rash and arthralgia. These were usually mild or moderate in intensity.
b. Tabulated summary of adverse reactions
The frequencies assigned to the undesirable effects listed below are based on the crude incidence rates of adverse drug reactions (i.e. events attributed to olodaterol) observed in the olodaterol 5 microgram dose group (1035 patients), pooled from 6 placebo-controlled, parallel group clinical trials in COPD patients with treatment periods ranging between 4 and 48 weeks.
Frequency is defined using the following convention:
Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000), not known (cannot be estimated from the available data)
System Organ Class / MedDRA Preferred Term
Frequency
Infections and infestations
Nasopharyngitis
Uncommon
Nervous system disorders
Dizziness
Uncommon
Vascular disorders
Hypertension
Rare
Skin and subcutaneous tissue disorders
Rash
Uncommon
Musculoskeletal and connective tissue disorders
Arthralgia
Rare
c. Description of selected adverse reactions
Occurrence of rash may be considered a hypersensitivity reaction with Striverdi Respimat; as with all topical absorbed medication, other hypersensitivity reactions may develop.
d. Beta2- agonist adverse reaction profile
Striverdi Respimat is a member of the therapeutic class of long-acting beta2-adrenergic agonists. Therefore, the occurrence of undesirable effects related to the beta-adrenergic agonist class should be taken into consideration, such as tachycardia, arrhythmia, palpitations, myocardial ischaemia, angina pectoris, hypertension or hypotension, tremor, headache, nervousness, insomnia, dizziness, dry mouth, nausea, muscle spasms, fatigue, malaise, hypokalemia, hyperglycemia, and metabolic acidosis.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Symptoms
An overdose of olodaterol is likely to lead to exaggerated effects typical of beta2-adrenergic agonists, e.g. myocardial ischaemia, hypertension or hypotension, tachycardia, arrhythmias, palpitation, dizziness, nervousness, insomnia, anxiety, headache, tremor, dry mouth, muscle spasms, nausea, fatigue, malaise, hypokalemia, hyperglycemia, and metabolic acidosis.
Treatment of overdose
Treatment with Striverdi Respimat should be discontinued. Supportive and symptomatic treatment is indicated. Serious cases should be hospitalised. Use of cardioselective beta-blockers may be considered, but only subject to extreme caution since the use of beta-adrenergic blocker medication may provoke bronchospasm.
Medicines sold in Romania with the same active substance: Cunoscut în România ca
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
Medicines sold in Poland with the same active substance: W Polsce znany jako
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
Ask anything about Striverdi Respimat 2.5 microgram, solution for inhalation. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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