Spiolto Respimat re-usable Dosage/Direction for Use

The recommended dose for adults is 5 microgram tiotropium and 5 microgram olodaterol given as two puffs from the Respimat inhaler once daily at the same time of the day (see Handling Instructions under Cautions for Usage).
Elderly: Elderly patients can use SPIOLTO RESPIMAT re-usable at the recommended dose.
Hepatic impairment and renal impairment: SPIOLTO RESPIMAT re-usable contains tiotropium which is a predominantly renally excreted drug and olodaterol, which is predominantly metabolized in the liver.
Hepatic impairment: Patients with mild and moderate hepatic impairment can use SPIOLTO RESPIMAT re-usable at the recommended dose.
There are no data available for use of olodaterol in patients with severe hepatic impairment.
Renal impairment: Renally impaired patients can use SPIOLTO RESPIMAT re-usable at the recommended dose.
SPIOLTO RESPIMAT re-usable contains tiotropium, which is a predominantly renally excreted drug. For patients with moderate to severe impairment (creatinine clearance ≤50 ml/min, see Precautions and Pharmacology: Pharmacokinetics under Actions).
Paediatric population: There is no relevant use of SPIOLTO RESPIMAT re-usable in the paediatric population in COPD.
The safety and effectiveness of SPIOLTO RESPIMAT re-usable in the paediatric population have not been established.