If you have breathing problems caused by certain lung conditions, your doctor may prescribe Spiriva for you. Spiriva is a prescription drug that comes in two forms. The form your doctor prescribes depends on the lung condition you have.

You’ll use Spiriva every day to relax your airways and keep them open. It’s important to note that this drug is not a rescue inhaler. It won’t work to relieve sudden breathing problems caused by asthma or COPD.

Spiriva basics

Spiriva contains the active ingredient tiotropium. (An active ingredient is what makes a drug work.) Spiriva belongs to a group of drugs called anticholinergics.

Spiriva Respimat comes with a cartridge containing a liquid form of Spiriva and an inhaler device called the Respimat. The Respimat delivers the Spiriva liquid as a fine mist that you breathe in.

Spiriva Handihaler comes with capsules containing Spiriva powder and an inhaler device called the Handihaler. The Handihaler pierces the capsule allowing you to breathe in the Spiriva powder.

At this time, generic versions of Spiriva are not available.

Your doctor will recommend the dosage of Spiriva that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Forms and strengths

Spiriva is available in the following forms and strengths:

  • Spiriva Respimat. This comes with an inhaler device called the Respimat and a cartridge containing a liquid form of Spiriva. The Respimat delivers the Spiriva liquid as a fine mist that you breathe in. Two strengths are available: 1.25 micrograms (mcg) per puff and 2.5 mcg per puff.
  • Spiriva Handihaler. This comes with an inhaler device called the Handihaler and capsules containing Spiriva powder. The Handihaler pierces the capsule so that you can breathe in the Spiriva powder. Each capsule contains 18 mcg of Spiriva.

Recommended dosages

See below for details on Spiriva’s dosage for asthma and COPD. And for more information about the drug’s dosage, see this article.

Dosage for asthma

The Spiriva Respimat is used to treat asthma. The recommended dosage for adults and children ages 6 years and older is two puffs of 1.25 mcg once per day.

Dosage for COPD

Both the Spiriva Handihaler and Spiriva Respimat are used to treat COPD.

  • For the Spiriva Respimat, the recommended dosage for adults is two puffs of 2.5 mcg once per day.
  • For the Spiriva Handihaler, the recommended dosage for adults is two puffs from one 18 mcg capsule once per day.

If you have questions about which form of Spiriva is right for your COPD, talk with your doctor.

Questions about Spiriva’s dosing

Below are some common questions about Spiriva’s dosing.

  • What if I miss a dose of Spiriva? If you miss a dose of Spiriva, take it as soon as possible. But if it’s almost time for your next dose, skip the missed dose and take your next dose as scheduled. You should not take two doses at once to make up for a missed dose. This can raise your risk of side effects.
  • Will I need to use Spiriva long term? Yes, 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 use it long term.
  • How long does Spiriva take to work? Spiriva starts working to open your airways about 1 hour after you first take a dose. But it may take a few weeks before your symptoms are noticeably improved. If you have questions about what to expect from Spiriva treatment, talk with your doctor.

Like most drugs, Spiriva may cause mild or serious side effects. The lists below describe some of the more common side effects that Spiriva may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Spiriva. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Spiriva can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the prescribing information for Spiriva Respimat or Spiriva HandiHaler.

Mild side effects that people using Spiriva have reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Spiriva can occur, but they aren’t common. If you have serious side effects from Spiriva, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects that people using Spiriva have reported include:

  • new or worsened urinary retention (not being able to completely empty your bladder)
  • paradoxical bronchospasm (sudden tightening of your airways after taking a dose of Spiriva)
  • severe allergic reaction*

* To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

Some people may have an allergic reaction to Spiriva. But in studies, allergic reaction was reported rarely.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Spiriva. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will explain how you should use Spiriva. They’ll also explain how much to use and how often. Be sure to follow your doctor’s instructions.

You’ll use Spiriva by breathing the medication into your lungs from the inhaler device.

It’s important to note that Spiriva is not a rescue inhaler. Do not use it to relieve sudden breathing problems caused by asthma or COPD, as it is not meant for that purpose. Instead, use Spiriva every day to keep your airways open and help prevent breathing problems. And continue using your rescue inhaler as directed by your doctor if you have sudden breathing problems or worsened asthma or COPD symptoms.

How to use Spiriva Respimat

Spiriva Respimat comes with a cartridge containing a liquid form of Spiriva and an inhaler device called the Respimat. The Respimat delivers the Spiriva liquid as a fine mist that you breathe in.

You’ll receive instructions for preparing and using Spiriva Respimat with your medication. The manufacturer also provides instructions for use, including an instruction video on its website.

To learn more about how to use Spiriva Respimat, see this article.

How to use Spiriva HandiHaler

Spiriva Handihaler comes with capsules containing Spiriva powder and an inhaler device called the Handihaler. Each time you take a dose, you should place one capsule in the chamber of the Handihaler. Each capsule delivers one dose (two puffs) of Spiriva. The Handihaler pierces the capsule so that you can breathe in the Spiriva powder.

You should not swallow, crush, split, chew, or open the Spiriva capsules.

You’ll receive instructions for preparing and using Spiriva Handihaler with your medication. The manufacturer also provides instructions for use on its website.

To learn more about how to use Spiriva Handihaler, see this article.

Accessible medication containers and labels

If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

  • have large print
  • use braille
  • contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.

Taking Spiriva with other drugs

Your doctor may prescribe Spiriva with other drugs to treat your asthma or COPD.

For example, they’ll typically prescribe a rescue inhaler, such as albuterol (Ventolin HFA, Proventil-HFA, Proair, or others) to use with Spiriva.

Rescue inhalers quickly open up your airways. You use them to relieve sudden breathing problems, such as asthma attacks or sudden worsening of COPD symptoms. Your doctor might also recommend using your rescue inhaler before exercising.

Depending on how severe your breathing problems are, your doctor may also prescribe other maintenance treatments with Spiriva. Maintenance treatments are medications you take every day to help prevent sudden breathing problems.

Spiriva is a maintenance treatment. But you may take it with other maintenance treatments, such as budesonide/formoterol (Symbicort).

Is there a best time of day to take Spiriva?

You can take your dose of Spiriva at any time of day but try to take it at the same time each day. This helps keep a steady level of the drug in your body, which makes it as effective as possible.

Questions for your doctor

You may have questions about Spiriva and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Spiriva affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Find answers to some commonly asked questions about Spiriva.

What are some alternative medications for the conditions Spiriva treats?

Spiriva treats asthma and chronic obstructive pulmonary disease (COPD). Spiriva belongs to a group of drugs called anticholinergics. These drugs treat asthma and COPD by keeping your airways open.

Other anticholinergic drugs used for COPD include ipratropium (Atrovent HFA) and revefenacin (Yupelri). Other kinds of drugs used for COPD include long-acting beta-agonists, such as olodaterol (Striverdi Respimat). These drugs also help keep your airways open.

Medications containing a combination of ingredients are also available. Examples include tiotropium/olodaterol (Stiolto Respimat), umeclidinium/vilanterol (Anoro Ellipta), and fluticasone/umeclidinium/vilanterol (Trelegy Ellipta).

Other medications used for asthma include corticosteroids such as ciclesonide (Alvesco). These drugs help reduce swelling in your airways. Drugs containing a combination of corticosteroids and long-acting beta-agonists are also commonly prescribed for asthma. Examples include budesonide/formoterol (Symbicort) and fluticasone/vilanterol (Breo Ellipta).

Although both asthma and COPD cause breathing problems, not all drugs used for asthma are suitable for COPD, and vice versa. Your doctor can tell you more about alternatives to Spiriva for your condition.

Will stopping Spiriva treatment abruptly cause withdrawal symptoms?

No, stopping Spiriva suddenly won’t cause withdrawal symptoms. (Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.) But suddenly stopping treatment could worsen your breathing problems because you won’t be treating your condition anymore.

If you want to stop using Spiriva, talk with your doctor. They can determine whether it’s safe to do so. They’ll also let you know if you need to start using a different drug for your condition when you stop your Spiriva treatment.

What is Spiriva’s mechanism of action (how does it work)?

With asthma and COPD, your airways become narrowed. This leads to symptoms such as wheezing and shortness of breath.

Spiriva works by relaxing the muscles in the walls of your airways. This helps keep your airways open. As a result, air can flow more easily in and out of your lungs. This makes breathing easier and helps relieve symptoms of asthma and COPD.

If you have other questions about how Spiriva works to treat your condition, talk with your doctor or pharmacist.

Can Spiriva cause weight gain or high blood pressure?

Spiriva is not known to cause weight gain. This side effect wasn’t reported in studies of Spiriva Respimat or Spiriva Handihaler.

Spiriva may cause high blood pressure, but you’re unlikely to have this side effect. In studies, high blood pressure was a rare side effect reported in people who took Spiriva Respimat for asthma. But this side effect wasn’t reported in people who took either form of Spiriva for COPD.

If you’re concerned about weight gain or high blood pressure with Spiriva, talk with your doctor.

Spiriva is used to treat asthma and chronic obstructive pulmonary disease (COPD). The medication comes in two forms: Spiriva Respimat and Spiriva Handihaler. The form your doctor prescribes depends on the condition you’re using it to treat.

Spiriva for asthma

Spiriva Respimat is prescribed to treat asthma in adults and in children ages 6 years and older. Spiriva Handihaler is not used to treat asthma. (The Handihaler is used to treat COPD only.)

With asthma, you have inflammation (swelling) and narrowing of your airways. This can cause wheezing, cough, chest tightness, and shortness of breath. Certain triggers may make your symptoms suddenly get worse. This is called an asthma attack.

For asthma, you’ll take Spiriva every day to relax your airways and help keep them open. This can make breathing easier and help relieve your symptoms. And it can help prevent asthma attacks.

It’s important to note that Spiriva is not a rescue inhaler. It won’t work to relieve an asthma attack. While using Spiriva, continue using your rescue inhaler as directed by your doctor if you have sudden breathing problems or worsened asthma symptoms.

Spiriva for chronic obstructive pulmonary disease (COPD)

Spiriva Respimat and Spiriva Handihaler are both used to treat COPD in adults.

COPD is a chronic (long term) lung condition that gradually worsens over time. With COPD, you typically have a mixture of emphysema and chronic bronchitis.

With emphysema, you have damaged air sacs in your lungs. With chronic bronchitis, your airways are inflamed (swollen or damaged), narrowed, and contain large amounts of mucus. These issues cause wheezing, cough, chest tightness, and shortness of breath.

For COPD, you’ll take Spiriva every day to relax your airways and keep them open. This can make breathing easier and help relieve your symptoms.

It’s important to note that Spiriva is not a rescue inhaler. It won’t work to relieve sudden breathing problems caused by COPD. While using Spiriva, continue using your rescue inhaler as directed by your doctor if you have sudden breathing problems or worsened COPD symptoms.

Before taking Spiriva, you should talk with your doctor about your overall health, any medical conditions you may have, and other medications you take. All these factors can affect whether Spiriva is a good option for you.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Spiriva, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Spiriva.

For information about drug-condition interactions, see the “Warnings” section below.

Interactions with drugs or supplements

Spiriva is a kind of drug called an anticholinergic. It can interact with several types of drugs, including other anticholinergics. Examples of these drugs include:

This list does not contain all types of drugs that may interact with Spiriva. Your doctor or pharmacist can tell you more about these interactions and any others that may occur when using Spiriva.

Warnings

Spiriva can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Spiriva is a good treatment option for you.

Talk with your doctor about your health history before you take Spiriva. Factors to consider include the following:

Closed-angle glaucoma. In rare cases, Spiriva can cause acute closed-angle glaucoma if you already have long-term closed-angle glaucoma. Acute closed-angle glaucoma is an emergency that requires immediate treatment. Because of this risk, doctors may not prescribe Spiriva if you have long-term closed-angle glaucoma. Talk with your doctor about whether Spiriva is right for you.

Trouble urinating. Spiriva can sometimes cause urinary retention (not being able to completely empty your bladder). If you have one of these issues, Spiriva could make it worse. Other conditions, such as an enlarged prostate or a bladder obstruction, could also cause trouble urinating. If you have one of these conditions, talk with your doctor about whether Spiriva is right for you.

Kidney problems. If you have a moderate or severe kidney problem, you may have a higher risk of side effects with Spiriva. Examples of these side effects include constipation and trouble urinating. Talk with your doctor about whether Spiriva is right for you.

Your doctor may order tests to determine the severity of your kidney problem and whether Spiriva is safe to prescribe for you. They may monitor you closely for side effects if they prescribe Spiriva to you.

Allergic reaction. If you’ve had an allergic reaction to Spiriva, any of its ingredients, or the related drug ipratropium (Atrovent), your doctor will likely not prescribe Spiriva. Ask them what other medications are better options for you.

Spiriva and alcohol

Spiriva is not known to interact with alcohol. If you drink alcohol, talk with your doctor about how much may be safe to drink during your Spiriva treatment. While alcohol doesn’t interact with Spiriva, drinking too much alcohol could cause damage to your lungs. This may worsen your asthma or COPD symptoms.

Pregnancy and breastfeeding

It’s unknown whether Spiriva is safe to use while pregnant or breastfeeding. If you’re pregnant or breastfeeding or planning to become pregnant or to breastfeed, talk with your doctor about the risks and benefits of using Spiriva.

Spiriva and Advair are drugs used to treat asthma and chronic obstructive pulmonary disease (COPD).

Spiriva and Advair are daily medications that you use to manage your asthma or COPD and help prevent sudden breathing problems. But they work in different ways and can cause different side effects.

To find out more about how Spiriva compares with Advair, see this article.

Spiriva and Incruse Ellipta both treat chronic obstructive pulmonary disease (COPD). Spiriva is also used to treat asthma, but Incruse Ellipta does not treat this condition.

Both these medications belong to a group of drugs called anticholinergics. But they contain different active ingredients. (An active ingredient is what makes a drug work.) Spiriva contains tiotropium, while Incruse Ellipta contains umeclidinium. These drugs have some similar side effects and others that differ.

To find out more about how Spiriva compares with Incruse Ellipta, see this article.

Costs of prescription drugs can vary depending on many factors. These factors may include your insurance coverage (if you have it) and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. If you’re using Spiriva Respimat, you may qualify for a Spiriva Respimat Savings Card.

You can also check out this article to learn more about saving money on prescriptions.

Do not use more Spiriva than your doctor prescribes. Using more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you use too much Spiriva

Call your doctor if you think you’ve used too much Spiriva. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

If you have questions about taking Spiriva, talk with your doctor or pharmacist. Questions you may want to ask include:

  • Are Spiriva inhalers hard to use with arthritis?
  • Can Spiriva affect eye conditions other than closed-angle glaucoma?
  • How effective is Spiriva?
  • Would a combination inhaler be better for my condition?
  • Does Spiriva have any long-term side effects?

To learn more about Spiriva, see this article about the drug’s dosage. You may also find the following articles about asthma and COPD treatments helpful:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

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 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.

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