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Letters Tiotropium mist inhaler

Manufacturer’s reply to letter by Seed and colleagues

BMJ 2011; 343 doi: (Published 23 August 2011) Cite this as: BMJ 2011;343:d5365
  1. Bernd Disse, vice president, therapeutic area respiratory1,
  2. Norbert Metzdorf, global clinical programme leader, tiotropium1,
  3. Helmut Bender, vice president, respiratory drug delivery1
  1. 1Boehringer Ingelheim Pharma GmbH & Co KG, D-55216 Ingelheim am Rhein, Germany
  1. bernd.disse{at}

Seed and colleagues suggest that the excipient benzalkonium chloride in the Respimat mist inhaler might partly explain the differences seen between placebo and the Respimat inhaler.1 The hypothesis is unfounded for three reasons.

Firstly, the placebo in clinical trials with tiotropium Respimat was identical to the active treatment except for the lack of the active chemical entity. …

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