Spiriva (tiotropium) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to improve breathing in people with certain respiratory conditions. Spiriva comes in two forms, which have slightly different uses:

  • Spiriva HandiHaler. This form is used to treat chronic obstructive pulmonary disease (COPD) in adults. It comes as a powder-filled capsule that’s taken using an inhaler.
  • Spiriva Respimat. This form is also prescribed to treat COPD in adults. It can also be prescribed to treat asthma in adults and children ages 6 years and older. Spiriva Respimat is a liquid that’s taken using an inhaler.

Both forms of Spiriva contain the active drug tiotropium. Spiriva belongs to a group of drugs called anticholinergics. Neither form of Spiriva is currently available as a generic.

For information on the dosage of Spiriva, including its forms, strengths, and how to take the drug, keep reading. For a comprehensive look at Spiriva, see this article.

Note: Spiriva is not used for acute bronchospasm (sudden breathing problems). Instead, it’s used as a maintenance (ongoing) treatment to manage breathing problems.

This article describes typical dosage directions for Spiriva provided by the drug’s manufacturer. When taking Spiriva, always follow the dosage instructions prescribed by your doctor.

Keep reading for information on Spiriva dosages.

Spiriva forms

Spiriva comes in two forms, which have slightly different approved uses:

  • Spiriva HandiHaler, which is a capsule filled with powder
  • Spiriva Respimat, which is a liquid

Spiriva strengths

Spiriva is available in the following strengths:

Spiriva HandiHalerSpiriva Respimat
18 micrograms (mcg) per inhalation1.25 mcg and 2.5 mcg per inhalation

Typical dosages

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for asthma

Spiriva Respimat is approved to treat asthma in adults as well as children ages 6 years and older. The inhaler dosage for this condition is two inhalations (puffs) of the 1.25 mcg strength once per day. This is the maximum dose of Spiriva for asthma treatment.

Dosage for COPD

Both Spiriva HandiHaler and Spiriva Respimat are approved to treat chronic obstructive pulmonary disease (COPD). The dose frequency is the same for Spiriva HandiHaler and Spiriva Respimat: two inhalations, taken once per day. If you’re using Spiriva Respimat, you’ll use the 2.5 mcg strength for both puffs. This will provide a total of 5 mcg for your dose which is the maximum dose of Spiriva to treat COPD.

Children’s dosage

Spiriva Respimat can be used in children 6 years and older who have asthma. The children’s dosage is the same as that for adults: two inhalations of the 1.25 mcg strength once per day. This is the maximum dose of Spiriva for asthma treatment in children.

Long-term use

Spiriva is meant to be used as a long-term treatment. If you and your doctor determine that Spiriva is safe and effective for you, you’ll likely take it long term.

Below are answers to some frequently asked questions about Spiriva dosages.

Are Spiriva HandiHaler or Spiriva Respimat used twice daily?

No, Spiriva HandiHaler and Spiriva Respimat are not used twice daily. Both forms of the drug should be used once per day. But both the Spiriva HandiHaler and Spiriva Respimat will both require two inhalations taken once daily.

Certain other drugs used to treat asthma or chronic obstructive pulmonary disease (COPD) may be used twice daily, such as Advair Diskus (fluticasone propionate/salmeterol). To learn more about how Spiriva and Advair Diskus are alike and different, check out this article.

Does it matter which Spiriva form I use for my COPD?

Maybe. Both Spiriva HandiHaler and Spiriva Respimat are approved to treat chronic obstructive pulmonary disease (COPD). Both drugs are effective at improving breathing in adults with COPD.

One clinical trial compared Spiriva HandiHaler and Spiriva Respimat for improving breathing in adults with COPD. In this trial:

  • the 5 microgram (mcg) dose of Spiriva Respimat was as effective as the 5 mcg Spiriva HandiHaler dose
  • lower doses of Spiriva Respimat were slightly less effective compared with Spiriva HandiHaler

You can learn more about Spiriva’s clinical trials by checking out the prescribing information for Spiriva HandiHaler and Spiriva Respimat. Your doctor or pharmacist can also answer any questions you have about which form of Spiriva you should use for your COPD.

If you use more Spiriva than your doctor prescribes, you may develop serious side effects.

It’s important that you don’t use more Spiriva than your doctor prescribes. For some medications, taking more than the recommended amount may lead to side effects or overdose.

Symptoms of an overdose

Overdose symptoms of Spiriva can include:

If you take more than the recommended amount of Spiriva

Call your doctor right away if you believe you’ve taken too much of Spiriva. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

The Spiriva dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Spiriva to treat
  • the form of Spiriva you take

Other medical conditions you have can also affect your Spiriva dosage.

How you’ll use Spiriva depends on which form of the drug you use.

Spiriva HandiHaler. This form comes as a powder-filled capsule that you take using an inhaler. When you’re ready to take a dose, you’ll place a capsule into the center chamber of your inhaler. You’ll press a button to puncture (break open) the capsule. You’ll then breathe in the powder. To take your full dose, you’ll repeat these steps with another capsule, for a total of two capsules per dose.

Spiriva Respimat. This form comes as a liquid that you take using an inhaler. To use this form, you’ll first twist the base of your inhaler until you hear it click. Then, open the cap on the inhaler and close your lips around the mouthpiece. Begin inhaling and press the dose-release button to release the drug as you breathe in. You’ll repeat these steps again, for a total of two inhalations per dose.

When using either form of Spiriva, make sure to first breathe out slowly. Then when you inhale the medication, take a slow, deep breath and try to hold your breath for at least 10 seconds before exhaling.

To view complete instructions for use, check out the prescribing information for Spiriva HandiHaler and Spiriva Respimat.

If you miss a dose of Spiriva, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose. Then take your next dose at your regular scheduled time.

You should not take more than one dose to try and make up for the missed dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Spiriva for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.

As with any drug, never change your dosage of Spiriva without your doctor’s recommendation. If you have questions about the dosage that’s right for you, talk with your doctor.

Besides learning about dosage, you may want other information about Spiriva. These additional articles might be helpful to you:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.