Spiriva (tiotropium) is a prescription drug used to treat certain lung conditions. Spiriva can cause side effects that range from mild to serious. Examples include cough and dry mouth.

Spiriva Respimat and Spiriva Handihaler treat chronic obstructive pulmonary disease (COPD) in adults. Spiriva Respimat is also used to treat asthma in adults and certain children.

Spiriva is not a rescue inhaler. You should not use it to treat sudden breathing problems from your condition.

The active ingredient in Spiriva is tiotropium. (An active ingredient is what makes a drug work.)

The drug comes in two forms:

  • Spiriva Respimat comes with a device (the Respimat) and a cartridge. The cartridge contains the liquid form of Spiriva. You’ll use the Respimat to inhale Spiriva mist into your lungs.
  • Spiriva Handihaler comes with a device (the Handihaler) and Spiriva powder capsules. The Handihaler pierces the capsules to release Spiriva powder which you breathe in through your mouth using the Handihaler.

Keep reading to learn about the common, mild, and serious side effects Spiriva can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during their Spiriva treatment. Below are a few of the more common side effects reported by people using Spiriva Respimat in studies. These side effects can vary depending on the condition you are using the drug to treat.

Common side effects in people using Spiriva Respimat for asthma include:

Common side effects in people using Spiriva Respimat for COPD include:

Common side effects reported in studies of people using Spiriva Handihaler for COPD include:

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Spiriva and can vary depending on the condition you’re using the drug to treat. Mild side effects of Spiriva include:

Usually, these side effects are temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Spiriva unless your doctor recommends it.

Spiriva may cause mild side effects other than those listed above. See the prescribing information for Spiriva Respimat and Spiriva Handihaler for details.

* To learn more about this side effect, see the “Side effects explained” section below.

Serious side effects have been reported with Spiriva and can vary depending on the condition you’re using the drug to treat. Serious side effects include:

If you develop serious side effects while using Spiriva, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Spiriva, visit MedWatch.

Get answers to some frequently asked questions about Spiriva’s side effects.

Can Spiriva Respimat cause different side effects than Spiriva Handihaler?

This is unlikely. Both forms of Spiriva (Respimat and Handihaler) contain the same active ingredient, tiotropium bromide. (The active ingredient is what makes the drug work.)

The two forms of Spiriva have several common side effects, including:

Note that side effects you may experience depend on several factors, such as:

  • the condition you’re using the drug to treat
  • your age
  • other medications you take
  • other health conditions you may have

If you have questions about the side effects of the different forms of Spiriva, ask your doctor for more information. If you plan to use Spiriva to treat chronic obstructive pulmonary disease (COPD), they can recommend the best form for you. (Only Spiriva Respimat is used to treat asthma.)

* To learn more about this side effect, see the “Side effects explained” section below.

Is weight gain a side effect of Spiriva?

No, people using Spiriva Respimat or Spiriva Handihaler in studies did not report weight gain as a side effect. But it may be caused by other conditions you have or other medications you take.

If you’re concerned about weight gain during Spiriva treatment, talk with your doctor. They can recommend ways to help you reach or maintain a moderate weight.

Does Spiriva cause anxiety?

No, people using Spiriva Respimat or Spiriva Handihaler in studies did not report anxiety. But it is a symptom of breathing conditions such as asthma and COPD. And some serious side effects of Spiriva, such as bronchospasm (sudden airway tightening), can make breathing difficult. This may cause you to have anxiety.

If you experience anxiety during Spiriva treatment, talk with your doctor. They can discuss possible causes with you and suggest ways to help you manage this symptom.

Learn more about some of the side effects Spiriva may cause.

Urinary tract infection

Spiriva can increase your risk of a urinary tract infection (UTI). This was a mild side effect in Spiriva Respimat and Spiriva Handihaler studies. Symptoms of a UTI may include:

What might help

If you have symptoms of a UTI, call your doctor. They’ll diagnose your condition and treat it if needed.

Tell your doctor if you’re prone to frequent UTIs. If they prescribe Spiriva for you, they may monitor you for signs of UTI. In some cases, they may recommend a different treatment for your condition.

Upper respiratory tract infection

Spiriva can cause an upper respiratory infection, such as the common cold. This was a common but mild side effect in studies of the drug. Symptoms may include:

What might help

Tell your doctor if you have an infection before starting Spiriva. They’ll likely treat the infection before you begin using Spiriva.

If you develop an upper respiratory infection while using Spiriva, call your doctor. They’ll diagnose you based on your symptoms and suggest treatment options. They may have you temporarily stop using Spiriva until your infection clears up.

Ask your doctor if you have questions about your risk of an upper respiratory infection.

Pharyngitis

Spiriva can cause pharyngitis (sore throat). This was a common but mild side effect in Spiriva Respimat and Spiriva Handihaler studies.

What might help

Pharyngitis is a mild side effect that usually goes away after a few days to weeks of Spiriva treatment. But if you have a bothersome sore throat that doesn’t go away, tell your doctor. Sometimes, pharyngitis may be a sign of an upper respiratory infection. In this case, your doctor will diagnose your condition and treat the infection if necessary.

Sinusitis

Spiriva use can cause sinusitis (swelling in your sinuses). This was a common but mild side effect of the drug. Symptoms of sinusitis can include:

Sometimes, sinusitis may be due to an upper respiratory infection or a sinus infection.

What might help

Sinusitis is a mild side effect of Spiriva that’s usually temporary. But if you have symptoms that are serious, ongoing, or bothersome, talk with your doctor. They can diagnose the cause and suggest ways to ease your symptoms.

The following tips might help you manage mild symptoms at home:

  • Use a humidifier in your bedroom.
  • Apply a warm, damp cloth to your forehead and sinus areas.
  • Use nasal saline to rinse mucus from your nostrils and sinuses.

If you have an upper respiratory or sinus infection, you may need a prescription medication to treat the infection.

Allergic reaction

Like most drugs, Spiriva can cause an allergic reaction in some people. This side effect rarely happened in studies of Spiriva Respihaler and Spiriva Handihaler. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

If your doctor confirms you’ve had a mild allergic reaction to Spiriva, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Spiriva, they may have you switch to a different treatment.

Keeping track of side effects

During your Spiriva treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start treatment with a new drug or drug combination.

Your side effect notes can include things such as:

  • what dose of the drug you were using when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Taking notes and sharing them with your doctor will help them learn more about how Spiriva affects you. They can then use this information to adjust your treatment plan if needed.

Spiriva may not be right for you if you have certain medical 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 starting this drug. Factors to consider include those described below.

Worsening of urinary retention. Spiriva can cause urinary retention (not being able to empty your bladder fully). Tell your doctor if you have an enlarged prostate or urinary retention problems. Spiriva could worsen your condition. Your doctor will determine whether Spiriva is safe for you to use.

Kidney problems. If you have moderate to severe kidney disease, you may have a higher risk of developing side effects from Spiriva. Tell your doctor about any kidney problems you have. They’ll decide whether Spiriva is safe for you based on the severity of your condition. If they do prescribe Spiriva for you, they’ll monitor you for serious side effects during your treatment.

Allergic reaction. If you’ve had an allergic reaction to Spiriva or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Worsening of closed-angle glaucoma. If you have closed-angle glaucoma, Spiriva may worsen your condition. Tell your doctor about any eye health problems you may have. They’ll decide whether this medication is safe for you.

If they do prescribe Spiriva, they’ll monitor your eye condition carefully to make sure it’s not getting worse. Call your doctor if you have symptoms such as:

These symptoms may mean that Spiriva is worsening your glaucoma.

Alcohol and Spiriva

There are no known interactions between alcohol and Spiriva. If you plan to drink while using Spiriva, talk with your doctor. They can discuss your risks and a safe amount to drink during treatment.

Pregnancy and breastfeeding with Spiriva

The effects of using Spiriva during pregnancy or while breastfeeding are unknown. If you’re pregnant or planning to become pregnant, talk with your doctor about the safety of Spiriva use.

If you’re breastfeeding or planning to breastfeed your child while using Spiriva, talk with your doctor. They can discuss with you the risks and benefits of Spiriva treatment during this time. They may recommend feeding your baby a different way if you plan to use this medication.

Spiriva can cause mild side effects. These are usually temporary and go away with continued use of the drug. But, as with most medications, Spiriva has some serious side effects. These are rare but may require immediate medical attention. If you have questions about side effects Spiriva can cause, talk with your doctor.

Examples of questions to help get you started include:

  • Do I have a higher risk of side effects if I’m taking other medications for my condition?
  • Does my risk of side effects with Spiriva depend on my dosage?
  • How do the side effects of Spiriva and Incruse Ellipta compare?

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.