Spiriva (tiotropium) is a prescription drug that’s used to treat asthma and COPD. This drug can interact with certain other medications. For example, Spiriva can interact with drugs used for an overactive bladder.

Spiriva is available in two inhaler devices:

Spiriva Respimat and Spiriva Handihaler both contain the active ingredient tiotropium. (An active ingredient is what makes a drug work.)

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Spiriva’s possible interactions. And for more information about Spiriva, including details about its uses, see this article.

Before you start taking Spiriva, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Spiriva interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Spiriva?” section below.)

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

The table below lists drugs that may interact with Spiriva. Keep in mind that this table does not include all drugs that may interact with Spiriva. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
other anticholinergics (the group of drugs Spiriva belongs to)• oxybutynin (Oxytrol, Gelnique)
trihexyphenidyl
• ipratropium (Atrovent HFA)
can increase the risk of side effects from Spiriva and anticholinergics

Certain health conditions or other factors could raise your risk of harm if you take Spiriva. In such cases, your doctor may not prescribe Spiriva for you. These are known as contraindications. Spiriva’s contraindication is described below.

If you’ve had an allergic reaction. If you have had an allergic reaction to Spiriva, any of its ingredients, or a similar drug called ipratropium (Atrovent HFA), your doctor likely won’t prescribe Spiriva. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Spiriva, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Spiriva is safe for you to take.

Spiriva is not known to interact with alcohol. But Spiriva and alcohol can cause some similar side effects, such as headache, dizziness, and blurry vision. So you may be more likely to experience these side effects if you drink alcohol during your Spiriva treatment.

If you have questions about consuming alcohol while using Spiriva, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Spiriva.

Interaction with other anticholinergics

Spiriva belongs to a group of drugs called anticholinergics. These drugs treat various health conditions, including urinary incontinence, Parkinson’s disease, and chronic obstructive pulmonary disorder (COPD).

Examples of anticholinergic drugs include:

What could happen

Anticholinergic drugs, including Spiriva, can all cause similar side effects. Taking Spiriva with other anticholinergic drugs can raise your risk of these side effects. Examples of these side effects include dry mouth, constipation, difficulty urinating, and acute narrow angle glaucoma (sudden increase in pressure in your eye).

If you have kidney problems or an enlarged prostate, you may have a higher risk of side effects if you take Spiriva with another anticholinergic drug.

What you can do

Your doctor will likely avoid prescribing Spiriva with other anticholinergic drugs.

If you do take Spiriva with another anticholinergic drug, your doctor may prescribe a lower dosage of Spiriva or the other anticholinergic drug for you. You should not take a higher dose of either medication than your doctor prescribes.

If you take Spiriva and another anticholinergic together, tell your doctor right away if you have constipation, difficulty urinating or pain while urinating, or symptoms of narrow angle glaucoma. These symptoms may include sudden pain and redness in your eye, blurry vision, or seeing halos around lights.

If you have questions about taking Spiriva with other anticholinergic drugs, talk with your doctor or pharmacist.

Spiriva may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Spiriva.

Does Spiriva interact with supplements?

Before you start taking Spiriva, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Spiriva and herbs

There are currently no reports of Spiriva interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Spiriva.

Spiriva and vitamins

There are currently no reports of Spiriva interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Spiriva.

Does Spiriva interact with food?

There are currently no reports of Spiriva interacting with food. If you have questions about eating certain foods during your treatment with Spiriva, talk with your doctor.

Does Spiriva interact with vaccines or lab tests?

There are currently no reports of Spiriva interacting with vaccines or lab tests. If you have questions about getting certain vaccines or lab tests during your Spiriva treatment, talk with your doctor.

Does Spiriva interact with cannabis or CBD?

There are currently no reports of Spiriva interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Spiriva.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Spiriva. Before taking Spiriva, talk with your doctor about your health history. They’ll determine whether Spiriva is right for you.

Health conditions or other factors that might interact with Spiriva include:

Kidney problems. Your kidneys help clear Spiriva from your body. If you have kidney problems, the drug could build up in your body. This could raise your risk of side effects from Spiriva, such as constipation, difficulty urinating, and closed-angle glaucoma (sudden raised pressure in your eye). If you have moderate or severe kidney problems, your doctor will likely monitor you for side effects during your Spiriva treatment.

Difficulty urinating. Spiriva may cause urinary retention (being unable to fully empty your bladder). If you have difficulty urinating, you may have a higher risk of this side effect. Conditions that may cause difficulty urinating include an enlarged prostate or a blockage at the exit of your bladder. Talk with your doctor about whether Spiriva is right for you.

Narrow angle glaucoma. In rare cases, Spiriva can cause acute narrow angle glaucoma, which is a medical emergency. If you already have long-term narrow angle glaucoma, you may have a higher risk of acute narrow angle glaucoma with Spiriva. Talk with your doctor about whether this drug is right for you.

Pregnancy. It’s not known whether Spiriva is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Spiriva.

Breastfeeding. It’s not known whether it’s safe to take Spiriva while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction. If you’ve had an allergic reaction to Spiriva, any of its ingredients, or a similar drug called ipratropium (Atrovent HFA), your doctor will likely not prescribe Spiriva for you. Ask your doctor about other treatment options that may be safer for you.

Common questionsabout Spiriva and interactions

Find answers to some frequently asked questions about Spiriva and possible interactions.

Is it safe to take Spiriva with a steroid?

Yes, it should be safe to take Spiriva with a steroid drug. There’s no known interaction between Spiriva and steroids. Taking them together doesn’t raise your risk of side effects.

Spiriva and steroids (also called corticosteroids) are both used to treat asthma and chronic obstructive pulmonary disease (COPD).

Steroids are also used to treat many other conditions that involve inflammation (swelling). It’s not uncommon for doctors to prescribe Spiriva and steroids together.

Examples of steroids include:

  • ciclesonide (Alvesco)
  • budesonide (Pulmicort)
  • fluticasone (Flovent HFA, Arnuity Ellipta)
  • prednisone (Rayos)

If you have other questions about taking Spiriva and steroids together, talk with your doctor or pharmacist.

Is there an interaction between Spiriva and Symbicort?

No. There’s no known interaction between Spiriva and Symbicort (budesonide/formoterol).

Spiriva is used to treat asthma in adults and certain children and COPD in adults. Symbicort is also prescribed for these uses. It’s not uncommon for doctors to prescribe these drugs together.

If you have other questions about taking Spiriva with Symbicort, talk with your doctor or pharmacist.

Taking certain steps can help you avoid interactions with Spiriva. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Spiriva treatment.

It’s also important to understand Spiriva’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Spiriva, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Spiriva exactly as prescribed can also help prevent interactions.

If you still have questions about Spiriva and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

  • Do other drugs that could treat my condition have similar interactions to Spiriva?
  • Do I need to tell you if I start taking another medication or supplement during my Spiriva treatment?
  • If I use other inhalers at the same time of day as Spiriva, does it matter in what order I take them?

To learn more about Spiriva, see these articles:

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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.