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

Reviewed by: HU Medical Review Board | Last reviewed: December 2023

Spiriva® is a medicine that is approved to treat those with chronic obstructive pulmonary disease (COPD).1,2

People with COPD often struggle to breathe because their airways get narrow, making it harder to get enough air into their lungs. Spiriva works by widening these airways. This can make it easier to breathe.1-3

Spiriva comes in 2 forms:1,2

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

What are the ingredients in Spiriva?

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

How does Spiriva work?

COPD can cause symptoms such as:4

  • Mucus
  • Wheezing
  • Cough
  • Tightness in your chest
  • Shortness of breath

Spiriva is part of the LAMA class of drugs. LAMAs work by blocking the action of a chemical messenger called acetylcholine. This helps relax muscles in the airways, which reduces the symptoms of COPD.1,2

What are the possible side effects?

The most common side effects of Spiriva include:1,2

  • Dry mouth
  • Sore throat
  • Chest pain
  • Indigestion
  • Runny nose
  • Increased heart rate
  • Blurred vision

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

  • Allergic reactions like rash, hives, or breathing problems
  • Increased pressure in the eyes (glaucoma)
  • Urinary retention, which could be severe

Call 9-1-1 if your breathing suddenly worsens after taking Spiriva.1,2
These are not all the possible side effects of Spiriva. Talk to your doctor about what to expect when taking Spiriva. You also should call your doctor if you have any changes that concern you when taking Spiriva.

Other things to know

Spiriva is a once-daily medicine for the treatment of COPD. It is not a rescue inhaler. If you have trouble breathing, Spiriva will not work right away. Talk to your doctor about rescue inhalers for quick relief of trouble breathing.1,2

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

Do not swallow the capsules in the Spiriva HandiHaler. These should only be inhaled using the delivery device.1

Spiriva Respimat uses a special inhaler that delivers a slow-moving mist to help people inhale the medicine more easily. The amount of drug the patient takes does not depend on how fast they can 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 is safe to take while pregnant or breastfeeding. Before taking these drugs, tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. They can help you decide if Spiriva is right for you.1,2

Taking too much Spiriva can lead to severe or life-threatening effects. Take Spiriva as directed. Do not take more than you are prescribed.1,2

Spiriva may interact with other medicines. Before beginning treatment for COPD, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.1,2

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

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