All About Spiriva’s Dosage

If you have breathing problems due to certain lung conditions, your doctor might suggest Spiriva as a treatment option.

Spiriva is a prescription drug that helps ease breathing difficulties caused by chronic obstructive pulmonary disease (COPD) or asthma. It comes in two forms, and which form your doctor prescribes depends on your age and condition:

• Spiriva Respimat is used for COPD in adults and for asthma in adults and some children.
• Spiriva HandiHaler is used for COPD in adults.

The active ingredient in Spiriva is tiotropium bromide. An active ingredient is what makes a drug work. Spiriva belongs to a class of medications known as anticholinergic drugs.

Spiriva Respimat comes as a liquid solution, and Spiriva HandiHaler comes as a powder-filled capsule. Each includes an inhaler. You’ll use the provided inhaler to take puffs of (breathe in) the drug.

This article describes the dosages of Spiriva, its strengths, and how to use it. To learn more about Spiriva, see this in-depth article.

Note: This chart highlights the basics of Spiriva’s dosages. Be sure to read on for more details.

Please keep in mind that this article covers Spiriva’s standard dosage schedules, which are provided by the drugmaker. But always follow the dosing instructions your doctor prescribes.

Read on to find out more about Spiriva’s dosage.

What are the forms of Spiriva?

Spiriva Respimat comes as a liquid solution packaged together with an inhaler you use to take puffs of (breathe in) the drug.

Spiriva HandiHaler comes as a powder-filled capsule. It’s also packaged with an inhaler that you’ll use to take puffs of the drug.

What strengths does Spiriva come in?

Spiriva Respimat comes in two strengths:

• 1.25 micrograms (mcg) per puff
• 2.5 mcg per puff

Spiriva HandiHaler comes as an 18-mcg capsule.

What are the usual dosages of Spiriva?

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Spiriva Respimat dosing for asthma

For asthma in adults, the recommended daily dose of Spiriva Respimat is 2.5 mcg. You’ll take this dose as two 1.25-mcg puffs once per day.

Spiriva Respimat dosing for COPD

For chronic obstructive pulmonary disease (COPD) in adults, the recommended daily dose of Spiriva Respimat is 5 mcg. You’ll take this dose as two 2.5-mcg puffs once per day.

Spiriva HandiHaler dosing for COPD

The recommended dosage of Spiriva HandiHaler for COPD in adults is 18 mcg (the contents of one capsule). To make sure you receive the full dose, you’ll take two puffs once per day.

What’s the dosage of Spiriva for children?

Spiriva Respimat is used to ease breathing difficulty caused by asthma in children ages 6 years and older.

For this purpose, the usual daily dosage is 2.5 mcg. A child would take this dose as two 1.25-mcg puffs once per day.

Spiriva HandiHaler is not used in children.

Is Spiriva used long term?

Yes, Spiriva is usually used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely use it long term.

Below are answers to some commonly asked questions about Spiriva’s dosage.

Can I use Spiriva twice daily?

No, it’s not recommended to use Spiriva more than once per day. Taking more than the recommended amount could cause side effects or overdose. (For more information about the latter, see the “What should be done in case of overdose?” section below.)

If Spiriva isn’t working at your current dosage to ease your breathing difficulty, talk with your doctor. They may suggest other treatment options, or they may have you take another medication with Spiriva.

What is the maximum dose I can take for Spiriva?

The maximum dose of Spiriva Respimat for chronic obstructive pulmonary disease (COPD) is 5 micrograms (mcg) per day. The maximum dose of Spiriva Respimat for asthma is 2.5 mcg per day.

The maximum dose of Spiriva HandiHaler is 18 mcg (the contents of one capsule) per day.

The instructions for using Spiriva depend on whether you’re prescribed the Respimat or HandiHaler form. See the steps for each form below. Your doctor will give you detailed instructions on how to use the inhalers. Be sure to follow the instructions they give you.

For information on the expiration, storage, and disposal of Spiriva, see this article.

Spiriva Respimat

Follow these steps the first time you use your Spiriva Respimat inhaler:

1. With the cap closed, press the safety catch on the inhaler and remove the clear base. It’s recommended that you write the “discard by” date on the label.
2. Insert the narrow end of the cartridge into your inhaler.
3. With the inhaler upright and the cartridge bottom against a firm surface, press down until the cartridge clicks into place.
4. Put the clear base back on the inhaler, and turn the base in the direction of the label arrows until it clicks.
5. Open the cap.
6. While pointing the inhaler toward the ground, press the dose-release button. Close the cap.
7. If you do not see a mist, repeat steps 4 through 6 until a mist appears.
8. Once a mist appears, repeat steps 4 through 6 three more times. Your inhaler is now ready to use.

To take your dose using the Spiriva Respimat inhaler:

1. With the cap closed, turn the clear base in the direction of the label arrows until it clicks.
2. Open the cap.
3. Breathe out slowly.
4. Close your lips around the mouthpiece, pointing the inhaler toward the back of your throat.
5. Take a slow, deep breath while you press the dose-release button.
6. Hold your breath for about 10 seconds.
7. Repeat steps 1 through 6.
8. Close the cap.

The drugmaker provides illustrated directions for using Spiriva Respimat, as well as a video. Your doctor or pharmacist can also show you how to use this product.

Spiriva HandiHaler

To take your dose using the Spiriva HandiHaler device, follow these steps:

1. Remove the inhaler from its pouch and press the green button to open the dust cap lid.
2. Pull the dust cap lid away from the base.
3. Open the mouthpiece by pulling up on it.
4. Remove one Spiriva capsule from its blister pack by peeling back the foil.
5. Place the capsule in the center chamber of the inhaler.
6. Close the mouthpiece until you hear a click.
7. Press the green button to pierce a hole in the capsule.
8. Breathe out slowly.
9. Holding the inhaler horizontally, close your lips around the mouthpiece.
10. Breathe in deeply through your mouth until your lungs are full.
11. Hold your breath for a few seconds. Take the inhaler out of your mouth while you’re holding your breath.
12. Repeat steps 8 through 11 for the second dose.

The drugmaker provides illustrated directions for using Spiriva HandiHaler. Your doctor or pharmacist can also show you how to use this product.

Accessible drug containers and labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:

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

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you miss a dose of Spiriva, take it as soon as you remember. If it’s almost time for the next scheduled dose, skip the missed dose and take your next dose. Do not take more than one dose every 24 hours.

If you need help remembering to take your dose of Spiriva on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

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

Symptoms of overdose

Symptoms of overdose reported with Spiriva Respimat include dry mouth.

Symptoms of overdose reported with Spiriva HandiHaler include dry mouth and conjunctivitis (pink eye). After the HandiHaler form became available on the market, one person reported symptoms such as a change in mental status, tremors, belly pain, and constipation. But it’s unknown how likely such symptoms are to occur from taking too much Spiriva.

What to do in case you use too much Spiriva

Call your doctor right away 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.

The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Spiriva for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Spiriva without your doctor’s recommendation. Only use Spiriva exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

• Will you prescribe a different dosage of Spiriva if I’m taking other medications for asthma or COPD?
• Will you change my dosage if Spiriva isn’t working well enough for me?
• For COPD, which form of Spiriva would be a better treatment option for me?

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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.