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Generic Name:

tiotropium, Inhalation powder

Generic Name:
Spiriva HandiHaler

tiotropium, Inhalation powder

All Brands

  • Spiriva HandiHaler
SECTION 1 of 5

Highlights for tiotropium

Inhalation powder
1

Tiotropium is an inhaled anticholinergic drug. It is used to treat breathing problems, such as chronic obstructive pulmonary disease (COPD) and asthma. It is available as a powder that you inhale and a solution that you inhale.

2

Tiotropium is a long-term drug. It should not be used as immediate treatment for shortness of breath or other breathing problems.

3

If you use the powder form of tiotropium, it comes in a capsule. Do not swallow the capsule. You place the capsule in a special inhaling device that allows you to inhale the powder through your mouth.

4

Do not use tiotropium if you are allergic to ipratropium. Use with extreme caution if you have an allergy to atropine or milk proteins. The powder for inhalation contains lactose, which may contain milk proteins.

5

Keep the tiotropium powder or spray out of your eyes. This can cause blurred vision and pupil changes.

IMPORTANT INFORMATION

Worsened shortness of breath

Inhaled medicines like this drug can unexpectedly worsen shortness of breath. It can also lead to new breathing problems. Contact your doctor and do not use any more of this drug if this happens to you.

Eye damage

This drug can cause damage to your eyes. Contact your doctor if you have any of the following eye problems while taking this drug:

  • eye pain or discomfort
  • blurred vision
  • halos
  • colored images due to red eyes

Urine retention

This drug can cause you to retain urine (your urine cannot come out). Contact your doctor if you have trouble passing urine or pain when you urinate while you take this drug.

Dizziness and blurred vision

This drug can cause dizziness and blurred vision. Use extreme caution when driving a vehicle or operating machinery if you take this drug.

What is tiotropium?

This drug is a prescription drug. It is not available as a generic drug. It comes as an inhalation powder in a capsule that is used in a special device called a HandiHaler. It is also available as a solution that you inhale through a metered dose inhaler.

This drug may be used as part of combination therapy. This means you my need to take it with other drugs.

Why it's used

This drug is a long-term treatment of breathing problems, such as chronic obstructive pulmonary disease (COPD) and asthma. It is used to reduce disease flare-ups.

How it works

This drug belongs to a class of drugs called inhaled anticholinergic medications. A class of drugs is a group of medications that work in a similar way.

More Details

How it works

This drug belongs to a class of drugs called inhaled anticholinergic medications. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug relaxes the muscles of your lungs. This helps to decrease and prevent shortness of breath.

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SECTION 2 of 5

tiotropium Side Effects

Inhalation powder

More Common Side Effects

Some of the more common side effects that can occur with use of tiotropium include:

  • dry mouth

  • sore throat

  • cough

  • sinus problems

  • constipation

  • fast heart rate

  • blurred vision or vision changes

  • pain with urination

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

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Sudden shortness of breath that may be life-threatening

  • Eye damage. Symptoms can include:

    • eye pain or discomfort
    • blurred vision
    • halos
    • red eyes
    • seeing colored images
  • Urine problems. Symptoms can include:

    • pain or difficulty urinating
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug does not make you tired. However, it can make you dizzy.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

tiotropium May Interact with Other Medications

Inhalation powder

Tiotropium can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Other anticholinergic drugs

The risk of side effects may be increased when tiotropium is used with other anticholinergic medications. Do not use tiotropium with other anticholinergic drugs.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
kidney disease
People with kidney disease

If you have kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects.

pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

call doctor
When to call the doctor

Call your doctor if you notice that your shortness of breath does not improve after using this drug.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • itching
  • swelling of the lips, tongue, or throat
  • rash
  • trouble breathing

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death). Also, do not take this drug if you have had an allergic reaction to ipratropium. Use extreme caution if you have had an allergic reaction to atropine or milk proteins. The powder for inhalation contains lactose, which may contain milk proteins.

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How to Take tiotropium (Dosage)

Inhalation powder

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Chronic obstructive pulmonary disease

Brand: Spiriva

Form: Capsules with powder for oral inhalation, to be used with the HandiHaler device
Strengths: Each capsule contains 18 micrograms of Spiriva.

Brand: Spiriva Respimat

Form: Solution in a metered dose inhaler (Respimat device)
Strengths:
  • Metered dose inhaler that delivers 1.25 micrograms of Spiriva per inhalation
  • Metered dose inhaler that delivers 2.5 micrograms of Spiriva per inhalation
Adult dosage (ages 18 years and older)
  • Tiotropium capsule with powder for oral inhalation through the HandiHaler device:
    • Inhale the powder contents of one capsule, taking two inhalations, once per day.
    • Do not take more than two inhalations in 24 hours.
  • Tiotropium metered dose inhaler (Respimat) that administers 2.5 micrograms per inhalation:
    • Take two inhalations, once per day.
    • Do not take more than two inhalations in 24 hours.
Child dosage (ages 0–17 years)

It has not been confirmed that tiotropium is safe and effective for use in people younger than 18 years. 

Asthma

Brand: Spiriva

Form: Capsules with powder for oral inhalation, to be used with the HandiHaler device
Strengths: Each capsule contains 18 micrograms of Spiriva.

Brand: Spiriva Respimat

Form: Solution in a metered dose inhaler (Respimat device)
Strengths:
  • Metered dose inhaler that delivers 1.25 micrograms of tiotropium per inhalation
  • Metered dose inhaler that delivers 2.5 micrograms of tiotropium per inhalation
Adult dosage (ages 18 years and older)
  • Tiotropium capsule with powder for oral inhalation through the HandiHaler device is not used to treat asthma.
  • Tiotropium metered dose inhaler (Respimat) that administers 1.25 micrograms per inhalation:
    • Take two inhalations, once per day.
    • It may take up to 2 months of use before your lungs get the full benefit of this drug.
Child dosage (ages 12–17 years)
  • Tiotropium capsule with powder for oral inhalation through the HandiHaler device is not used to treat asthma.
  • Spiriva metered dose inhaler (Respimat) that administers 1.25 micrograms per inhalation:
    • Take two inhalations, once per day.
    • It may take up to 2 months of use before your lungs get the full benefit of this drug.
Child dosage (ages 0–11 years)

It has not been confirmed that tiotropium is safe and effective.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

You may have worsened shortness of breath or other breathing problems.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Call your local poison control center or go to the nearest emergency room.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You may have less shortness of breath or other breathing problems.

This drug is used for long-term treatment. It should not be used as immediate treatment for shortness of breath or other breathing problems.

Do not cut, crush, or open the capsule

It can only be used with the HandiHaler device.

Keep it away from high temperatures

Store the capsules with powder or solution at 77°F (25°C). Both forms can be in temperatures of 59–86°F (15–30°C) for very short periods.

Do not store this medication in moist or damp areas, such as bathrooms. The capsules with powder for oral inhalation should be stored in the blister and removed just prior to use. Do not store the capsules with powder for oral inhalation inside the HandiHaler device. Avoid freezing the metered dose inhaler.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor will show you how to use your inhaler. Read the patient information and instructions for use that come with your prescription so that you know how to use your device.

Clinical monitoring

Your doctor will periodically ask you about your shortness of breath and ability to tolerate exercise and other physical activities of your daily life.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does tiotropium Cost?

Inhalation powder

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These prices represent the lowest priced national pharmacies for tiotropium on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 6, 2015

Disclaimer: Healthline 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.
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