Tiova

Tiova is used for treating symptoms of chronic obstructive pulmonary disease (COPD), including bronchitis and emphysema. It may also be used for other conditions as determined by your doctor.

Use Tiova as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Tiova . Talk to your pharmacist if you have questions about this information.

Do not swallow the capsules. The capsules are used with a special inhaler.

To remove the capsule from the packaging, peel back the foil and tip the capsule out. Do NOT cut the foil or use anything sharp to remove the capsule.

Do not remove a capsule from the packaging until you are ready to use it. If a second capsule is exposed to the air when you are removing a capsule for use, it must be discarded. Do not save the capsule for later.

The capsule must immediately be placed in a special inhaler device. The device will puncture the capsule so that the medicine inside may be inhaled into the lungs through the mouthpiece. Exhale slowly and deeply. Do not exhale into the mouthpiece of the inhaler. Position the inhaler mouthpiece between your lips and try to rest your tongue flat. Keep your head upright. Take a slow, deep breath. You should hear or feel the capsule vibrate inside the inhaler. Hold your breath for as long as it feels comfortable, then exhale slowly through pursed lips. Breathe out completely.

To be sure all of the medicine has been inhaled from the capsule, inhale from the mouthpiece a second time following the same process.

Ask your doctor or pharmacist if you are unclear on how to use this device or inhale the medicine. Clean the inhaler device once a month according to the instructions in the patient leaflet.

Each inhaler device may be used for up to 1 year and then should be replaced.

Using Tiova at the same time each day will help you remember to use it.

Use Tiova on a regular schedule to get the most benefit from it.

If you miss a dose of Tiova , use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once. Do not use Tiova more often than 1 time every 24 hours.

Ask your health care provider any questions you may have about how to use Tiova.

Tiova is an anticholinergic agent. It works by enlarging the airways to allow easier breathing.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Store this medicine at room temperature in a tightly-closed container, away from heat and light.

Do NOT use Tiova if:

• you are allergic to any ingredient in Tiova or to atropine or related medicines (eg, ipratropium)
• you are taking another anticholinergic (eg, ipratropium)

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have difficulty urinating because of an enlarged prostate or blockage of the bladder neck, or you have glaucoma, or kidney problems
• if you are having an asthma attack or increased difficulty breathing

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Blurred vision; constipation; dry mouth; mild nosebleed; sinus inflammation; sore throat; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); chest pain; difficult or painful urination; eye pain or discomfort; fast or irregular heartbeat; irritation, pain, or white patches in the mouth or on the tongue; mouth sores; new or worsened breathing problems; severe or persistent constipation; severe or persistent nosebleed; trouble swallowing; vision changes; wheezing.

If you have any questions about Tiova, please talk with your doctor, pharmacist, or other health care provider.
Tiova is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.