Spiriva is a brand-name prescription drug that’s used long term to improve breathing in people with certain respiratory conditions. It’s available in these two forms, which each have different FDA-approved uses:

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

With either COPD or asthma, you may have shortness of breath, cough, or wheezing. Both conditions cause your airways to become swollen and narrowed, making it hard for you to breathe.

Spiriva contains the drug tiotropium bromide, which belongs to a class of drugs called anticholinergic agents. Over time, Spiriva works to relax and open up your airways. Whether you have asthma or COPD, this drug can make it easier for you to breathe.

However, it’s important to note that Spiriva isn’t meant to be used as a rescue inhaler for sudden breathing problems.

Instead, it’s used as a maintenance treatment. That means it’s used consistently each day to help control breathing problems. You’ll still need to use your rescue inhaler, as directed by your doctor, even if you’re using Spiriva.

Spiriva HandiHaler capsules come in one strength: 18 mcg. Spiriva Respimat liquid solution comes in two strengths: 1.25 mcg and 2.5 mcg.

Effectiveness

Spiriva HandiHaler and Spiriva Respimat have each been found effective in improving lung function in people using the drugs. For information on the effectiveness of these drugs in clinical studies, see the “Spiriva uses” section below.

Spiriva is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of a brand-name medication.) Generics tend to cost less than brand-name drugs.

Spiriva contains the active drug tiotropium bromide.

Spiriva can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Spiriva. These lists don’t include all possible side effects. Your side effects may vary from those listed below, depending on whether you’re using Spiriva HandiHaler or Spiriva Respimat.

For more information on the possible side effects of Spiriva, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they’ve approved. If you would like to report to the FDA a side effect you’ve had with Spiriva, you can do so through MedWatch.

More common side effects

The more common side effects of Spiriva can include:

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Spiriva aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Paradoxical bronchospasm (sudden tightening of your airway that’s unexpected because the drug is meant to relax your airway). Symptoms can include:
    • sudden trouble breathing
    • wheezing
  • Acute narrow-angle glaucoma (increased pressure in your eye). Symptoms can include:
    • sudden eye pain
    • blurry vision
    • seeing halos or colored images
    • redness in your eye
  • Inability to pass urine. Symptoms can include:
    • painful urination
    • being unable to completely empty your bladder
  • Severe allergic reaction, which is explained below in “Side effect details.”

Side effects in children

Spiriva Respimat is used to improve lung function in children with asthma who are ages 6 years and older. This drug is used as a maintenance treatment to control asthma symptoms over time.

In clinical studies, there were no differences in the common side effects seen in children and teenagers using Spiriva Respimat compared to adults using the drug.

Spiriva HandiHaler isn’t approved for use in children.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Spiriva. But it’s not known for sure how many people have had allergic reactions to the drug.

Symptoms of a mild allergic reaction can include:

  • skin rash or raised red patches on the skin
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Spiriva. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Heart effects

Although it’s very rare, some people taking Spiriva have had heart effects while using the drug. In fact, some people have had chest pain while using Spiriva. General chest soreness can sometimes happen just from inhaling the drug into your lungs. For some people, this type of pain is confused with having a problem with their heart.

Also, some people using Spiriva have had changes in the electrical signaling in their heart.

In a clinical study, 16% to 20% of people using Spiriva HandiHaler had a slightly lengthened QT interval. In comparison, 1% to 12% of people taking a placebo (no active drug) had the same result. (QT interval is a measurement recorded on an EKG.) In some cases, this side effect can lead to a condition called long QT syndrome. However, long QT syndrome hasn’t been reported in anyone taking Spiriva.

If you have questions about how Spiriva may affect your heart, talk with your doctor. And if you have any symptoms that concern you, such as chest pain or irregular heart rate, call your doctor right away. If you feel that your symptoms are life threatening, call 911.

Oral thrush

Oral thrush (yeast infection in your mouth) is a possible side effect of Spiriva, but it doesn’t occur very often. With oral thrush, a fungus called Candida albicans overgrows inside your mouth. This condition usually makes the inside of your mouth look white or chalky. It can also make your mouth feel sore.

In clinical studies, oral thrush occurred in about 1% to 3% of people using Spiriva. The side effect occurred in fewer people using a placebo (no active drug).

Oral thrush is more likely to happen if you’re also using an inhaled corticosteroid with Spiriva. Examples of inhaled corticosteroids include:

  • beclomethasone diproprionate (QVAR)
  • budesonide (Pulmicort)
  • fluticasone (Flovent HFA)
  • mometasone furoate (Asmanex)

If you have symptoms of oral thrush, tell your doctor. They can recommend treatment for the condition, and they can also suggest ways to help prevent this side effect.

Eye effects, including glaucoma and blurry vision

Spiriva has caused glaucoma (increased pressure in your eye) and blurry vision in some people using the drug. But it’s not known for sure how many people have had these side effects.

If you have a history of glaucoma, talk with your doctor before starting Spiriva. This drug should be used with caution in people who’ve had glaucoma in the past because Spiriva may worsen the condition.

Symptoms of glaucoma and other eye issues can include:

  • pain or discomfort in your eye
  • blurry vision
  • seeing halos
  • redness in your eye

If you have any of these symptoms while you’re using Spiriva, call your doctor right away. They can check to see what’s causing your symptoms, and they’ll recommend whether you need any medical treatment.

Weight gain (not a side effect)

There aren’t any reports of Spiriva causing weight gain in people using the drug to treat either asthma or chronic obstructive pulmonary disease (COPD). If you have concerns about gaining weight while you’re using Spiriva, talk with your doctor.

High blood pressure (not a side effect)

Very rarely, Spiriva has been related to increased blood pressure in people taking the drug for asthma treatment. In fact, in clinical studies of people with asthma, increased blood pressure occurred in 1% to 2% of people taking the drug. But it’s not known for sure whether these people had high blood pressure before they started taking Spiriva.

If you have questions about how Spiriva may affect your blood pressure, talk with your doctor. And if you already have high blood pressure, talk with your doctor about whether it’s safe for you to use Spiriva.

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
  • your age
  • the form of Spiriva you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

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.

Drug forms and strengths

Spiriva contains the active drug tiotropium bromide. It comes in two forms that are available in the following strengths:

  • Spiriva HandiHaler. This form of Spiriva comes as powder-filled capsules that are taken using an inhaler. Spiriva HandiHaler capsules come in one strength: 18 mcg.
  • Spiriva Respimat. This form of Spiriva comes as a liquid solution inside an inhaler. Spiriva Respimat liquid solution comes in two strengths: 1.25 mcg and 2.5 mcg.

Dosage for COPD

Both Spiriva HandiHaler and Spiriva Respimat can be used to treat chronic obstructive pulmonary disease (COPD). The typical doses and frequency for using each form of Spiriva are as follows:

  • Spiriva HandiHaler should be taken as two inhalations (puffs), using just one powder capsule for both puffs, once each day.
  • Spiriva Respimat should be taken as two inhalations (puffs) once each day. For this condition, the 2.5 mcg strength of Spiriva Respimat is prescribed.

Dosage for asthma

The typical dosage of Spiriva Respimat for asthma is two inhalations (puffs) taken once each day. For this condition, the 1.25 mcg strength of Spiriva Respimat is prescribed.

Pediatric dosage

Spiriva Respimat can be used in children with asthma who are ages 6 years and older. The typical dosage for children is the same as it is for adults.

The recommended dosage of Spiriva Respimat is two inhalations (puffs) taken once each day.

What if I miss a dose?

If you miss a dose of Spiriva, take it as soon as you remember. But if it’s almost time for your next dose, just skip the missed dose and take your next dose at the usual time. Don’t take more than one dose of Spiriva at a time. Doing so may increase your risk for side effects from the drug.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Yes, you might. 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.

Other drugs are available that can treat either asthma or chronic obstructive pulmonary disease (COPD). Some may be a better fit for you than others. If you’re interested in finding an alternative to Spiriva, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for COPD

Examples of other drugs that may be used to treat COPD include:

  • long-acting beta agonist (LABA) inhalers, such as:
    • salmeterol (Serevent)
    • olodaterol (Striverdi Respimat)
    • indacaterol (Arcapta Neohaler)
    • formoterol (Foradil, Perforomist)
  • long-acting anticholinergic inhalers, such as:
    • ipratropium (Atrovent)
    • aclidinium (Tudorza Pressair)
    • umeclidinium (Incruse Ellipta)
    • glycopyrronium (Seebri Neohaler)
    • revefenacin (Yupelri)
  • certain inhaled corticosteroids, such as:
    • fluticasone (Flovent)
    • mometasone (Asmanex)
    • ciclesonide (Alvesco)
    • budesonide (Pulmicort)
  • combination inhalers that contain both a steroid and a LABA, such as:
    • budesonide/ formoterol (Symbicort)
    • fluticasone/ salmeterol (Advair)
    • formoterol/ mometasone (Dulera)
  • combination inhalers that contain other types of medications, such as:
    • indacaterol/ glycopyrrolate (Utibron Neohaler)
    • fluticasone/ umeclidinium/ vilanterol (Trelegy Ellipta)

Alternatives for asthma

Examples of other drugs that may be used to treat asthma include:

  • combination inhalers that contain a steroid and a long-acting beta agonist (LABA), such as:
    • formoterol and mometasone (Dulera)
    • fluticasone and vilanterol (Breo Ellipta)
  • certain inhaled corticosteroids, such as:
    • ciclesonide (Alvesco)
    • flunisolide (Aerobid)
  • certain drugs that are taken (swallowed) by mouth, such as:
    • theophylline

You may wonder how Spiriva compares with other medications that are prescribed for similar uses. Here we look at how Spiriva and Incruse Ellipta are alike and different.

Ingredients

Spiriva HandiHaler and Spiriva Respimat both contain the drug tiotropium bromide, while Incruse Ellipta contains the drug umeclidinium. Spiriva HandiHaler, Spiriva Respimat, and Incruse Ellipta all belong to a class of drugs called anticholinergic agents.

Uses

Spiriva HandiHaler, Spiriva Respimat, and Incruse Ellipta are all used for long-term treatment of chronic obstructive pulmonary disease (COPD) in adults.

In addition to treating COPD, Spiriva Respimat is also used to treat asthma in adults and children ages 6 years and older.

Over time, Spiriva HandiHaler, Spiriva Respimat, and Incruse Ellipta each work to make it easier for you to breathe.

However, these drugs aren’t meant to be used as rescue inhalers for sudden breathing problems. Instead, they’re meant to be used consistently to control breathing problems over time. You’ll still need to use your rescue inhaler, as directed by your doctor, even if you’re using Spiriva or Incruse Ellipta.

Drug forms and administration

Spiriva comes in two forms that are taken as follows:

  • Spiriva HandiHaler. This form of Spiriva comes as powder-filled capsules that are taken using an inhaler. It should be taken as two inhalations (puffs), using just one powder capsule for both puffs, once each day.
  • Spiriva Respimat. This form of Spiriva comes as a liquid solution inside an inhaler. The strength of Spiriva Respimat that you’re given depends on whether you’re taking it for asthma or COPD. This drug should be taken as two inhalations (puffs) once each day.

Incruse Ellipta comes as an inhaler that contains a powder. It should be taken as one inhalation (puff) once each day.

Side effects and risks

Spiriva and Incruse Ellipta both contain drugs that belong to a class of medications called anticholinergic agents. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with either form of Spiriva, with Incruse Ellipta, or with any of the drugs (when taken individually).

  • Can occur with Spiriva:
    • dry mouth
    • sinus infections
    • chest soreness
    • constipation
  • Can occur with Incruse Ellipta:
    • stuffy nose
    • cough
    • mouth pain
    • joint pain
    • changes in taste
    • muscle pain
    • tooth pain
    • stomach pain
    • bruising or having dark areas on your skin
    • palpitations (feeling your heart flutter or skip a beat)
  • Can occur with both Spiriva and Incruse Ellipta:
    • upper respiratory tract infection, such as the common cold
    • runny nose
    • sore throat
    • blurry vision

Serious side effects

This list contains examples of serious side effects that can occur with both Spiriva (HandiHaler or Respimat) and Incruse Ellipta (when taken individually):

  • severe allergic reaction
  • paradoxical bronchospasm (tightening of your airway that’s unexpected because the drug is meant to relax your airway)
  • acute narrow-angle glaucoma (increased pressure in your eye)
  • being unable to pass urine

Effectiveness

Spiriva and Incruse Ellipta have different approved uses, but they’re both used to treat COPD in adults.

The use of Spiriva HandiHaler and Incruse Ellipta in treating COPD has been directly compared in a clinical study.

In this study, a measurement called FEV1 was recorded to see how well treatment improved people’s lung function.

FEV1 (forced expiratory volume in 1 second) is the maximum amount of air that you can forcefully blow out of your lungs in 1 second. Higher FEV1s show better lung function, while lower FEV1s show poorer lung function.

People in the study were given either Incruse Ellipta or Spiriva HandiHaler. After 12 weeks of treatment, people who took Incruse Ellipta had a larger increase in their FEV1 than people who took Spiriva.

There haven’t been any studies done to compare treatment of Spiriva Respimat to that of Incruse Ellipta.

Costs

Spiriva and Incruse Ellipta are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Spiriva generally costs more than Incruse Ellipta costs. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You may wonder how Spiriva compares with other medications that are prescribed for similar uses. Here we look at how Spiriva and Advair Diskus are alike and different.

Note: Advair is also available in a form called Advair Respules. However, Advair Respules aren’t used to treat COPD. Instead, they’re only used to treat asthma. In this article, we’re only comparing Advair Diskus with Spiriva.

Ingredients

Spiriva contains the active drug tiotropium bromide, which belongs to a class called anticholinergic agents.

Advair Diskus contains two active drugs: fluticasone propionate and salmeterol. Fluticasone belongs to a class of drugs called corticosteroids, while salmeterol belongs to a class of drugs called long-acting beta2-agonists (LABAs).

Uses

Spiriva HandiHaler, Spiriva Respimat, and Advair Diskus are each used to treat chronic obstructive pulmonary disease (COPD) in adults.

Spiriva Respimat and Advair Diskus are also used to treat asthma in adults and children. For asthma, Spiriva Respimat can be used in children ages 6 years and older. But Advair Diskus can be used in children ages 4 years and older.

Over time, Spiriva HandiHaler, Spiriva Respimat, and Advair Diskus all work to make it easier for you to breathe.

However, these drugs aren’t meant to be used as rescue inhalers for sudden breathing problems. Instead, they’re meant to be used consistently to control breathing problems. You’ll still need to use your rescue inhaler, as directed by your doctor, even if you’re using Spiriva or Advair Diskus.

Drug forms and administration

Spiriva comes in two forms that are taken as follows:

  • Spiriva HandiHaler. This form of Spiriva comes as powder-filled capsules that are taken using an inhaler. It should be taken as two inhalations (puffs), using just one powder capsule for both puffs, once each day.
  • Spiriva Respimat. This form of Spiriva comes as a liquid solution inside an inhaler. The strength of Spiriva Respimat that you’re given will depend on whether you’re taking it for asthma or COPD. This drug should be taken as two inhalations (puffs) once each day.

Advair Diskus comes as a powder inside an inhaler. It should be taken as one inhalation (puff) twice each day. After taking Advair Diskus, you should rinse out your mouth with water. (Doing this helps you to avoid getting oral thrush, which is a fungal infection in your mouth.)

Side effects and risks

Spiriva and Advair Diskus both contain drugs that are inhaled through your mouth. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with either form of Spiriva, with Advair Diskus, or with any of the drugs (when taken individually).

  • Can occur with Spiriva:
    • dry mouth
    • sinus infections
    • chest soreness
    • runny nose
    • constipation
    • blurry vision
  • Can occur with Advair Diskus:
    • hoarseness in your voice
    • oral thrush (a fungal infection in your mouth or throat)
    • bronchitis (inflammation in the airways leading to your lungs)
    • cough
    • headache
    • nausea
    • vomiting muscle pain
    • bone pain
    • nervousness
    • tremors
  • Can occur with both Spiriva and Advair Diskus:
    • sore throat
    • upper respiratory tract infection, such as the common cold

Serious side effects

These lists contain examples of serious side effects that can occur with either form of Spiriva, with Advair Diskus, or with any of the drugs (when taken individually).

  • Can occur with Spiriva:
    • being unable to pass urine
  • Can occur with Advair Diskus:
    • changes in blood pressure general chest pain
    • loss of energy caused by reduced function of your adrenal glands increased blood sugar level
    • lowered blood potassium level
    • changes in your levels of white blood cells
    • reduced bone mineral density (weakened bones)
    • eye problems, such as cataracts (cloudiness in the lens of your eye)
    • slowed growth in children using the drug
    • pneumonia
  • Can occur with both Spiriva and Advair Diskus:
    • severe allergic reaction
    • paradoxical bronchospasm (tightening of your airway that’s unexpected because the drug is meant to relax your airway)
    • acute narrow-angle glaucoma (increased pressure in your eye)

Effectiveness

Spiriva and Advair Diskus are both approved to treat COPD and asthma. The effectiveness of each drug in treating these conditions is described below.

Effectiveness for COPD

For COPD treatment, the use of Spiriva HandiHaler and Advair Diskus has been directly compared in a clinical study.

In this study, people were given either Advair Diskus or Spiriva HandiHaler. After 2 years of treatment, there were no differences in the number of COPD flare-ups seen between the two groups of people.

However, after treatment, people who took Advair Diskus had better overall health. Clinical results also showed fewer deaths among people who took Advair Diskus compared to people who took Spiriva.

Effectiveness for asthma

For asthma treatment, the use of Spiriva and Advair Diskus hasn’t been directly compared in clinical studies. But separate studies have found both Spiriva Respimat and Advair Diskus to be effective in treating asthma.

Costs

Spiriva and Advair Diskus are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Spiriva generally costs much more than Advair Diskus. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You should take Spiriva according to your healthcare provider’s instructions.

How to use Spiriva HandiHaler

Spiriva HandiHaler comes as powder-filled capsules that are taken using an inhaler. This drug should be taken as two inhalations (puffs) once each day. To take these two puffs, you’ll use only one Spiriva HandiHaler capsule inside your inhaler.

The instructions that you receive with your Spiriva HandiHaler show you how to prepare the inhaler for use. When you’re ready to take a dose, start by placing one Spiriva HandiHaler capsule into the center chamber of your inhaler device. Then press the green piercing button on the side of the HandiHaler. This allows the device to break open the capsule.

Once the inhaler is ready, first breathe out slowly and fully. Then hold the inhaler to your mouth and close your lips around the mouthpiece.

Be careful to avoid covering the air vents on the sides of the inhaler. When you inhale through the HandiHaler device, you’ll be breathing in the powder from the capsule.

Make sure to take a slow, deep breath through your mouth while inhaling the drug. This will draw the medication into your lungs. Try to keep holding your breath for at least 10 seconds, or for as long as you’re able to comfortably do so.

You’ll take two inhalations (puffs) of Spiriva HandiHaler once each day to get your full dose of the drug.

How to use Spiriva Respimat

Spiriva Respimat comes as a liquid solution inside an inhaler. It should be taken as two inhalations (puffs) once each day.

The instructions that you receive with your Spiriva Respimat inhaler show you how to prepare the inhaler for use.

Once the inhaler is ready, first breathe out slowly and fully. Then hold the inhaler to your mouth and close your lips around the mouthpiece. Be careful to avoid covering the air vents on the sides of the inhaler.

Then, while you’re pressing the dose-release button on the inhaler, take a slow, deep breath through your mouth. This will draw the medication into your lungs. Try to keep holding your breath for at least 10 seconds, or for as long as you’re able to comfortably do so.

You’ll take two inhalations (puffs) of Spiriva Respimat once each day to get your full dose of the drug.

When to take

Spiriva should be taken once each day. It can be taken at any time of day, as long as it’s around the same time every day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Do I need to take Spiriva in the morning or at night?

You can take Spiriva either in the morning or at night. But try to take it at around the same time each day.

Is it safe to abruptly stop using Spiriva?

No, it might not be safe for you to suddenly stop using Spiriva. This is because doing so could worsen your breathing symptoms. If you’d like to stop taking Spiriva, talk with your doctor. They can recommend whether it’s safe for you to stop using the drug, and they’ll discuss other ways to treat your breathing condition.

The Food and Drug Administration (FDA) approves prescription drugs such as Spiriva to treat certain conditions. Spiriva is sometimes also used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Spiriva for COPD

Spiriva HandiHaler and Spiriva Respimat are both FDA-approved to treat chronic obstructive pulmonary disease (COPD) in adults. COPD is a condition that includes several lung diseases that get worse over time. These diseases include emphysema and chronic bronchitis.

With COPD you may have shortness of breath, cough, or wheezing. These symptoms are caused by narrowing inside your airways.

Spiriva contains the drug tiotropium bromide. Over time, it works to open up and relax your airways. This helps air to flow through them more easily as you breathe.

You’ll use Spiriva once a day as a maintenance (long-term) treatment for your COPD.

Spiriva isn’t meant to be used as a rescue inhaler for sudden breathing problems. Instead, it’s meant to be used consistently each day to help manage breathing problems. You’ll still need to use your rescue inhaler, as directed by your doctor, even if you’re using Spiriva.

Effectiveness for COPD

Clinical studies have shown that both Spiriva HandiHaler and Spiriva Respimat are effective to treat COPD. In the studies, a measurement called FEV1 was recorded to see how well treatment improved people’s lung function.

FEV1 (forced expiratory volume in 1 second) is the maximum amount of air that you can forcefully blow out of your lungs in 1 second. Higher FEV1s show better lung function, while lower FEV1s show poorer lung function.

Clinical studies compared COPD treatment with Spiriva HandiHaler versus a placebo over either 6 months or 1 year. Some of the results of these studies are reviewed below.

  • In the 1-year studies: Thirty minutes after their dose, people taking Spiriva HandiHaler had their FEV1 increased by 0.13 liters (L). Twelve hours after their dose, the increase in FEV1 was significantly higher in people taking Spiriva HandiHaler compared to people taking a placebo (no active drug). This increase was maintained for 1 year.
  • In the 6-month studies: The FEV1 measured 12 hours after their dose was significantly higher in people taking Spiriva HandiHaler than in people taking a placebo. This was seen both on the first day of treatment and at 6 months after starting the medication.

Some clinical studies compared COPD treatment with Spiriva HandiHaler to that of ipratropium bromide (Atrovent) over a period of 1 year.

People taking Spiriva HandiHaler had a significantly higher FEV1 6 hours after taking their dose compared to people taking Atrovent. This was seen on the first day of treatment and 91 days after starting treatment.

Spiriva for asthma

Spiriva Respimat is FDA-approved to treat asthma in adults and children ages 6 years and older. Asthma is a condition that causes swelling and narrowing of your airways.

With asthma, you may have wheezing, tightness in your chest, shortness of breath, and cough. For some people, these symptoms are worse during allergy season, which is typically in spring and summer.

Spiriva contains the drug tiotropium bromide. Over time, it works to open up and relax your airways. This helps air to flow through them more easily as you breathe.

You’ll use Spiriva once a day as a maintenance (long-term) treatment for your asthma.

Spiriva isn’t meant to be used as a rescue inhaler for sudden breathing problems. Instead, it’s meant to be used consistently each day to manage breathing problems. You’ll still need to use your rescue inhaler, as directed by your doctor, even if you’re using Spiriva.

Effectiveness for asthma

Clinical studies have shown that Spiriva is effective to treat asthma. In the studies, a measurement called FEV1 was recorded to see how well treatment improved people’s lung function.

FEV1 (forced expiratory volume in 1 second) is the maximum amount of air that you can forcefully blow out of your lungs in 1 second. Higher FEV1s show better lung function, while lower FEV1s show poorer lung function.

Several clinical studies looked at using Spiriva Respimat to treat asthma in adults over a period of 12 to 48 weeks.

In these studies, some people were given Spiriva Respimat, while other people were given a placebo (no active drug). Everyone in the studies also took their usual asthma medication, which included salmeterol (Serevent) and certain inhaled corticosteroids (such as QVAR, Pulmicort, Flovent HFA, and Asmanex).

After 12 to 24 weeks of treatment, peak (maximum) FEV1 was increased by 0.16 to 0.24 L more in people taking Spiriva Respimat than in people taking the placebo. In one study, after 24 weeks of treatment, people’s FEV1 24 hours after their dose of Spiriva Respimat was significantly higher than it was in people taking the placebo.

Spiriva and children

Spiriva Respimat is FDA-approved to treat asthma in children ages 6 years and older. Spiriva Respimat shouldn’t be used in children younger than 6 years of age.

Spiriva HandiHaler is not FDA-approved for use in children of any age.

Spiriva is meant to be used consistently as a maintenance (long-term) treatment for asthma and chronic obstructive pulmonary disease (COPD). This drug isn’t meant to be used as a rescue medication, which is taken to treat sudden breathing problems.

You’ll likely use other medications in combination with Spiriva to manage your COPD or asthma symptoms. The number of treatments you’ll use depends on the severity of your breathing symptoms and how often you have symptoms.

Below, we describe some treatments that may be used with Spiriva to treat either COPD or asthma.

Rescue inhalers

Rescue inhalers are drugs that work quickly to relax your airways, which allows you to breathe easier.

These drugs are typically used as needed when you’re having sudden breathing problems, such as cough or shortness of breath. And sometimes rescue inhalers are used before exercise to prevent breathing problems.

Examples of rescue inhalers include:

Other medications that may be used with Spiriva

Depending on how severe your asthma or COPD symptoms are, your doctor may recommend that you use other medications that also work over time.

Like Spiriva, certain other medications can be used consistently each day to help manage breathing symptoms over time. These types of drugs are called maintenance medications.

Examples of maintenance medications include:

  • fluticasone/salmeterol (Advair)
  • budesonide/formoterol (Symbicort)
  • fluticasone (Flovent HFA)
  • budesonide (Pulmicort, Uceris)

There aren’t any known interactions between Spiriva and alcohol. Talk with your doctor about whether it’s safe for you to drink alcohol while you’re using Spiriva.

Spiriva can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Spiriva and other medications

Below are lists of medications that can interact with Spiriva. These lists don’t contain all the drugs that may interact with Spiriva.

Before taking Spiriva, talk with your doctor or pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Spiriva and other anticholinergic medications

Spiriva belongs to a class of drugs called anticholinergic agents. Spiriva shouldn’t be used with other medications that also belong to this class of drugs.

Taking Spiriva with other anticholinergic agents can increase your risk of side effects from the drugs. These side effects include having trouble urinating and acute narrow-angle glaucoma (increased pressure in your eye).

Examples of other drugs that contain anticholinergic agents and are taken by inhalation include:

  • umeclidinium (Incruse Ellipta)
  • ipratropium bromide/albuterol sulfate (Combivent)
  • ipratropium (Atrovent)
  • tiotropium bromide/olodaterol (Stiolto Respimat)
  • vilanterol/umeclidinium/and fluticasone (Trelegy)
  • umeclidinium/vilanterol (Anoro Ellipta)
  • revefenacin (Yupelri)

This list doesn’t include all the anticholinergic medications that are available. For example, several other anticholinergic agents that are taken by mouth aren’t listed above.

Before starting Spiriva or any other medications, check with your doctor or pharmacist. They’ll review all the medications you’re taking and let you know if it’s safe for you to take Spiriva.

Spiriva and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Spiriva. However, you should still check with your doctor or pharmacist before using any of these products while taking Spiriva.

Here are answers to some frequently asked questions about Spiriva.

If I stop taking Spiriva, will I have withdrawal symptoms?

No, if you suddenly stop taking Spiriva, you shouldn’t have any withdrawal symptoms. However, your breathing symptoms will likely get worse if you stop treatment.

If you’d like to stop taking Spiriva, talk with your doctor. They can recommend whether it’s safe for you to stop using the drug. And they’ll discuss other ways to treat your breathing condition.

If I accidently swallow Spiriva, will I have any side effects?

If you accidentally swallow a Spiriva HandiHaler capsule, you probably won’t have any side effects other than mild stomach discomfort. However, because the drug won’t reach your lungs, it won’t be able to work properly to treat your breathing condition.

By using the Spiriva HandiHaler device correctly, the drug inside the Spiriva capsules will be inhaled through your mouth into your lungs.

If you happen to swallow a Spiriva HandiHaler capsule, call your doctor or pharmacist. They can recommend whether you need to be seen by a healthcare provider.

Does Spiriva contain steroids?

No, Spiriva doesn’t contain steroids. Instead, Spiriva contains the drug tiotropium bromide, which belongs to a class of drugs called anticholinergic agents.

These drugs work differently in your body than steroids work. But both steroids and anticholinergic agents can be used to help improve breathing symptoms in people with either asthma or chronic obstructive pulmonary disease (COPD).

Can inhalers like Spiriva cause dementia?

It’s not known for sure if using drugs similar to Spiriva can increase your risk for dementia.

One study looked at 58,769 people diagnosed with dementia who had taken anticholinergic agents earlier in their life. (Spiriva belongs to the class of drugs called anticholinergic agents.)

This study didn’t determine whether the anticholinergic drugs caused the people’s dementia. However, the use of anticholinergics was associated with higher risk for dementia, especially in middle-aged and older adults.

More research is needed to know whether using anticholinergic drugs, such as Spiriva, can increase the risk for dementia later in life.

Can I take Spiriva for sudden breathing problems?

No, you shouldn’t take Spiriva to treat sudden breathing problems. Over time, Spiriva works to open up your airways and improve your ability to breathe. But for sudden breathing problems, you should use a rescue inhaler.

Rescue inhalers work quickly to relax your airways, which allows you to breathe easier. These drugs are typically used if you’re having sudden breathing problems, such as cough or shortness of breath.

Examples of rescue inhalers include:

If you have questions about using a rescue inhaler with Spiriva, talk with your doctor.

If I have arthritis in my hands, will I be able to use the Spiriva inhaler?

Yes, you’ll probably be able to. In fact, if you have arthritis, talk with your doctor about using the Spiriva Respimat inhaler.

While Spiriva comes as either the HandiHaler or Respimat inhaler, the Respimat inhaler is certified by the Arthritis Foundation as being easy to use for people who have arthritis in their hands.

If you’d like to know more about the ease of using Spiriva, talk with your doctor.

Spiriva is approved to treat chronic obstructive pulmonary disease (COPD) and asthma. With either of these conditions, your airways become narrowed, making it hard for you to breathe.

Spiriva contains the active drug tiotropium bromide. It belongs to a class of drugs called anticholinergic agents.

Over time, Spiriva works to relax and open up your airways. It does this by binding to certain receptors (attachment sites) in your airways. Once your airways are opened, air can flow more easily through them, making it easier for you to breathe.

How long does it take to work?

In people with either asthma or COPD, Spiriva starts to relax and open up their airways in as little as 1 hour after it’s been taken.

For people with asthma, it takes about 4 to 8 weeks to see the most improvement in their symptoms.

When you get Spiriva from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Storing Spiriva HandiHaler

Spiriva HandiHaler capsules come in an aluminum foil blister pack. They should always be stored in the aluminum foil blister pack until you’re ready to use them. Keep the capsules stored at room temperature (77°F/25°C) and away from moisture.

Spiriva HandiHaler capsules can be stored until their expiration date. (This length of time is sometimes called “shelf-life.”) After the expiration date, you should dispose of the drug.

Storing Spiriva Respimat

Unopened Spiriva Respimat inhalers should also be stored at room temperature (77°F/25°C). They should never be put into the freezer.

Once you assemble the Spiriva Respimat inhaler and begin to use it, the shelf-life of the medication is one of the following, whichever comes first:

  • 3 months after the first use
  • whenever the locking mechanism becomes engaged (the inhaler becomes locked once you’ve used the number of doses that are marked on the label)
  • when the drug expires

After the shelf-life has passed, you should dispose of Spiriva Respimat.

Disposal

If you no longer need to take Spiriva and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

As with all medications, the cost of Spiriva can vary. To find current prices for Spiriva in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before they approve coverage for Spiriva. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Spiriva.

If you’re not sure if you’ll need to get prior authorization for Spiriva, contact your insurance plan.

Financial and insurance assistance

If you need financial support to pay for Spiriva, or if you need help understanding your insurance coverage, help is available.

Boehringer Ingelheim Pharmaceuticals, Inc., the manufacturer of Spiriva, offers a cost savings program for Spiriva Respimat. For more information and to find out if you’re eligible for support, call 855-772-7223. Or you can also find more information online about cost savings programs.

If you’re taking Spiriva Respimat for COPD, visit this program website. If you’re taking Spiriva Respimat for asthma, visit this program website.

For information on cost assistance for Spiriva HandiHaler, visit the Medicine Assistance Tool website. This website lists programs that may help lower the cost of your prescription.

It’s not known if Spiriva is safe to use during pregnancy. Animal studies have shown that some pregnant females who were given Spiriva had either pregnancy loss or offspring with low birth weights. But keep in mind that animal studies don’t always predict what’ll happen in humans.

If you’re pregnant, or may become pregnant, talk with your doctor about whether it’s safe for you to use Spiriva.

It’s not known if Spiriva is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Spiriva.

It’s not known if Spiriva is safe to take while you’re breastfeeding. It’s also not known if Spiriva passes into the breast milk of lactating women. Some animal studies have shown that Spiriva does pass into the breast milk of lactating rats. However, animal studies don’t always predict what’ll happen in people.

If you’re breastfeeding, or planning to breastfeed, talk with your doctor about whether it’s safe for you to use Spiriva.

Before taking Spiriva, talk with your doctor about your health history. Spiriva may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Glaucoma. If you’ve ever had glaucoma (increased pressure in your eye), you may have a higher risk of developing acute narrow-angle glaucoma while using Spiriva. This rare side effect occurs when you have a sudden increase in pressure inside your eye. If you have eye pain, blurry vision, redness in your eye, or you begin seeing halos or colors, call your doctor right away. Before starting Spiriva, talk with your doctor about any history of eye problems.
  • Problems urinating. If you’ve had trouble passing urine in the past, you may have a higher risk for this side effect while using Spiriva. Conditions that may affect your ability to pass urine include having an enlarged prostate or a bladder-neck obstruction. If you have these conditions, or you’ve had trouble urinating in the past, talk with your doctor before starting Spiriva. If you have trouble urinating or painful urination while you’re taking Spiriva, call your doctor right away.
  • Allergies. If you’re allergic to tiotropium (the active drug in Spiriva), ipratropium, or any inactive ingredients in Spiriva, you should avoid taking this medication. If you’re not sure if you have allergies to medications, talk with your doctor.
  • Pregnancy. It’s not known if Spiriva is safe to use during pregnancy. For more information, please see the “Spiriva and pregnancy” section above.
  • Breastfeeding. It’s not known if Spiriva is safe to take while breastfeeding. For more information, please see the “Spiriva and breastfeeding” section above.

Note: For more information about the potential negative effects of Spiriva, see the “Spiriva side effects” section above.

Using more than the recommended dosage of Spiriva can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

The following information is provided for clinicians and other healthcare professionals.

Indications

Both Spiriva HandiHaler and Spiriva Respimat are indicated for long-term maintenance treatment of chronic obstructive pulmonary embolism (COPD) in adults.

Spiriva Respimat is also indicated for long-term maintenance treatment of asthma in adults and children ages 6 years and older.

Mechanism of action

Spiriva contains the active drug tiotropium, which is a long-acting anticholinergic agent. It binds to the M3 muscarinic receptors on the smooth muscles of the airway. By inhibition of the M3 receptors, it enables bronchodilation of the smooth muscles.

Pharmacokinetics and metabolism

Following inhalation of Spiriva, maximum plasma concentrations were seen at 5 to 7 minutes in people with either COPD or asthma.

The drug is primarily excreted via urine and is unchanged. The terminal half-life of Spiriva in people with COPD is 25 hours. In people with asthma, it’s 44 hours.

Contraindications

Spiriva is contraindicated in people who have a hypersensitivity to tiotropium, ipratropium, or any components of Spiriva.

Storage

Spiriva HandiHaler capsules come in an aluminum foil blister pack. They should always be stored in the aluminum foil blister pack. Store Spiriva HandiHaler capsules at room temperature (77°F/25°C) and away from moisture. Discard Spiriva HandiHaler capsules once their expiration date has been reached.

Unopened Spiriva Respimat inhalers should be stored at room temperature (77°F/25°C). They should never be frozen. Once assembled, the shelf life of Spiriva Respimat is either 3 months later, the marked expiration date, or once the inhaler’s locking mechanism becomes engaged, whichever comes first.

Temperature excursions for Spiriva are permitted from 59°F to 86°F (15°C to 30°C).

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 other 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.