Stiolto Respimat is not a steroid. It contains two active ingredients, tiotropium bromide and olodaterol, and neither one is a corticosteroid. This is a meaningful distinction because many people using COPD inhalers want to know whether they’re taking a steroid, either because of concerns about side effects or because they need to understand how their medications work together.
What Stiolto Respimat Actually Contains
Stiolto Respimat combines two bronchodilators, which are drugs that open the airways through different mechanisms. Tiotropium is an anticholinergic (also called a muscarinic antagonist), and olodaterol is a long-acting beta2-adrenergic agonist, commonly abbreviated as a LABA. Both work by relaxing the muscles around the airways in your lungs, but they do so through separate pathways. Combining them in a single inhaler provides broader airway opening than either drug alone.
Tiotropium works by blocking a chemical messenger called acetylcholine that normally causes airway muscles to tighten. By preventing that signal from reaching the muscles, tiotropium keeps the airways relaxed and open. Olodaterol takes a different route: it stimulates receptors on airway muscles that trigger relaxation directly. Together, these two mechanisms complement each other, which is why they’re packaged in one device.
How This Differs From Steroid Inhalers
Steroid inhalers (inhaled corticosteroids) work by reducing inflammation in the airways. They don’t directly relax airway muscles the way bronchodilators do. Instead, they calm the immune response that causes swelling, mucus production, and narrowing over time. Common inhaled steroids include fluticasone, budesonide, and beclomethasone.
Some combination inhalers do pair a steroid with a bronchodilator, which can create confusion. Stiolto Respimat is not one of those. It pairs two bronchodilators with no steroid component. This means it won’t carry the side effects associated with inhaled steroids, such as oral thrush or hoarseness, but it also won’t address airway inflammation the way a steroid-containing inhaler would.
What Stiolto Respimat Is Prescribed For
The FDA has approved Stiolto Respimat for one specific use: long-term, once-daily maintenance treatment of COPD, including chronic bronchitis and emphysema. The standard dose is two inhalations once a day, taken at the same time each day, with no more than two inhalations in any 24-hour period.
There are two important limitations worth knowing. Stiolto Respimat is not a rescue inhaler. It won’t help during a sudden COPD flare-up or breathing emergency. It’s also not approved for asthma. Its safety and effectiveness in asthma have not been established, and using a LABA without a steroid in asthma can be dangerous.
Why the Steroid Question Matters
If you’re on Stiolto Respimat and your doctor has told you that you also need an anti-inflammatory component in your treatment plan, this inhaler alone won’t cover that. Some people with COPD benefit from adding an inhaled corticosteroid, particularly those who experience frequent flare-ups. Knowing that Stiolto Respimat contains no steroid helps you understand what role it plays in your overall regimen and why you might be prescribed additional medications alongside it.
If you’ve been switched from a steroid-containing inhaler to Stiolto Respimat, or vice versa, the two are not interchangeable. They treat different aspects of COPD. Bronchodilators like Stiolto keep airways physically open; steroids reduce the underlying inflammation that contributes to airway narrowing over time. Your treatment plan may include one or both depending on how your COPD behaves.