Spiriva Respimat (tiotropium bromide inhalation spray) and Spiriva HandiHaler (tiotropium bromide inhalation powder)

Reviewed by: HU Medical Review Board | Last reviewed: February 2022 | Last updated: March 2022

Spiriva is a long-term maintenance treatment of bronchospasms associated with chronic obstructive pulmonary disease (COPD). It is not a rescue medicine and should not be used for treating sudden breathing problems.1,2

Spiriva is available in 2 forms:1,2

  • Spiriva Respimat (tiotropium bromide inhalation spray)
  • Spiriva HandiHaler (tiotropium bromide inhalation powder)

What are the ingredients in Spiriva HandiHaler and Spiriva Respimat?

The active ingredient in Spiriva Respimat and Spiriva HandiHaler is tiotropium. This is a long-acting muscarinic agent (LAMA), or anticholinergic.1,2

How do Spiriva HandiHaler and Spiriva Respimat work?

Spiriva works by relaxing the muscles that surround the airways. For people living with COPD, the muscles lining the airways can tighten. This causes the airways to become too narrow, making breathing difficult (bronchospasm).1,2

What are the possible side effects of Spiriva HandiHaler and Spiriva Respimat?

The most common side effects of Spiriva HandiHaler include:1

  • Upper respiratory tract infection
  • Dry mouth
  • Sinusitis
  • Sore throat
  • Chest pain
  • Urinary tract infection
  • Indigestion
  • Runny nose
  • Constipation
  • Increased heart rate
  • Blurred vision

The most common side effects of Spiriva Respimat include:2

  • Sore throat
  • Cough
  • Dry mouth
  • Sinusitis

Spiriva may also cause serious side effects, including:1,2

  • Allergic reactions like rash, hives, or breathing problems
  • New or worsening eye problems like
  • Difficult or painful urination

If your breathing problems quickly worsen after taking Spiriva HandiHaler or Spiriva Respimat, contact 9-1-1 right away.

These are not all the possible side effects of Spiriva HandiHaler or Spiriva Respimat. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with HandiHaler or Spiriva Respimat.

Things to know about Spiriva HandiHaler and Spiriva Respimat

Do not use Spiriva HandiHaler and Spiriva Respimat if you are allergic to milk proteins or any of the ingredients in these drugs.1,2

Spiriva HandiHaler and Spiriva Respimat should not be used with other anticholinergic drugs.1,2

The medicine in Spiriva HandiHaler comes in a dry powder contained in a capsule that is put into a special inhaler. The Spiriva capsules should not be swallowed. They should only be used with the HandiHaler device and inhaled through the mouth.1

Spiriva Respimat uses a different kind of special inhaler. It delivers a slow-moving mist to help people inhale the medicine easier. The amount of medicine the patient takes in does not depend on how fast they are able to inhale.2

Before starting Spiriva, tell your doctor if you have:1,2

  • Kidney problems
  • Eye problems, including glaucoma
  • Bladder or prostate problems

There is not enough data to know if Spiriva HandiHaler or Spiriva Respimat is safe to take while pregnant or breastfeeding. Before taking these drugs, tell your doctor if you are pregnant, plan to become pregnant, or breastfeeding.1,2

Spiriva Handihaler and Spiriva Respimat may interact with other medicines. Before beginning treatment for COPD, tell your doctor all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Spiriva HandiHaler and Spiriva Respimat.

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