Description and Brand Names

Drug information provided by: Micromedex

US Brand Name

  1. Spiriva


Tiotropium is used to treat bronchospasm or wheezing caused by chronic obstructive pulmonary disease (COPD). COPD is a lung disease that also includes chronic bronchitis (swelling of the tubes leading to the lungs) and emphysema (damage to the air sacs in the lungs).

Tiotropium belongs to the family of medicines known as bronchodilators. Bronchodilators are breathed in through the mouth to help open up the bronchial tubes (air passages) in the lungs. It is taken by inhalation (an inhaler) and will increase the flow of air to the lungs.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Capsule

Before Using





Appropriate studies have not been performed on the relationship of age to the effects of inhaled tiotropium in the pediatric population. Safety and efficacy have not been established.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of inhaled tiotropium in the elderly.


Information about this tiotropium-inhalation-route
Pregnancy Category Explanation



Drug Interactions


Other Interactions


Other Medical Problems


  • Allergy to milk proteins or
  • Difficult urination or
  • Enlarged prostate or
  • Glaucoma, narrow angle or

Proper Use


Spiriva® capsules should only be used with the HandiHaler® device. Do not swallow the capsule. Spiriva® capsules should only be inhaled through your mouth (oral inhalation). Do not use the HandiHaler® device with any other medicine.

This medicine usually comes with patient instructions. Read them carefully before using the medicine. If you do not understand the instructions or have questions about using the inhaler, talk to your doctor.

Do not allow the powder from the capsules to get in your eyes. If the powder does get in your eyes, it may cause blurred vision and pupil dilation (increased pupil size). If this happens, call your doctor right away.

To use:

  • Open the HandiHaler® device and the blister containing the capsule.
  • Put one capsule into the HandiHaler® device.
  • Press and then release the green piercing button on the side of the HandiHaler® device. Do not press the green button more than once.
  • Breathe out fully. Do not breathe into the mouthpiece of the HandiHaler® device.
  • Hold the HandiHaler® base, put the mouthpiece between your lips, and close your lips around the mouthpiece.
  • Breathe in slowly and deeply through your mouth as you can hear or feel the Spiriva® capsule vibrate. Do not breathe through your nose.
  • Hold your breath and remove the mouthpiece from your mouth. Then, breathe normally again.
  • After you are finished, open the mouthpiece and remove the used Spiriva® capsule and throw it away. Do not store any used or unused capsule in the HandiHaler® device.
  • Rinse the HandiHaler® device with warm water and keep it dry.




  • For oral inhalation dosage form (capsules):
    • For bronchospasm caused by COPD:
      • Adults—Two puffs of the powder from one Spiriva® capsule (18 micrograms [mcg]) inhaled through the HandiHaler® device once a day.

Missed Dose


Do not use this medicine more than once every 24 hours.


Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.



Leave the capsules in the blister pack until you are ready to use the medicine. Only open one blister at a time when you are ready to remove a capsule and put it in the HandiHaler® device. Once you have opened a blister, use the capsule right away. After using the first capsule, the 2 remaining capsules should be used over the next 2 consecutive days. Capsules that are accidently exposed to air and not intended for immediate use should be discarded.



This medicine will not stop bronchospasm that has already started. Your doctor will give you another medicine to use in case of an acute attack.

Tiotropium may cause allergic reactions, including anaphylaxis and angioedema. Stop using the medicine and check with your doctor right away if you develop a skin rash, itching, shortness of breath, or large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs after using this medicine.


Check with your doctor right away if you have any changes to your eyes, such as eye pain, eye discomfort, blurred vision, visual halos, or colored images with red eyes while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may cause dizziness or blurred vision. Avoid driving, using machines, or doing anything else that could be dangerous if you are dizzy or not able to see well.


Side Effects



More common

  1. Arm, back, or jaw pain
  2. chest pain or discomfort
  3. chest tightness or heaviness
  4. fast or irregular heartbeat
  5. nausea
  6. shortness of breath
  7. sweating

Less common

  1. Cough
  2. difficulty with swallowing
  3. dizziness
  4. hives
  5. itching
  6. painful blisters on the trunk of body
  8. skin rash
  9. tightness in the chest
  10. unusual tiredness or weakness
  11. wheezing


  1. Fainting
  3. palpitations
  4. pounding, or irregular heartbeat or pulse


More common

  1. Acid or sour stomach
  2. belching
  3. bladder pain
  4. bloody or cloudy urine
  5. body aches or pain
  6. chest pain
  7. chills
  8. congestion
  9. cough
  10. difficult, burning, or painful urination
  11. difficulty with breathing
  12. dry mouth
  13. dryness of the throat
  14. ear congestion
  15. fever
  16. frequent urge to urinate
  17. headache
  18. heartburn
  19. hoarseness
  20. indigestion
  21. loss of voice
  22. lower back or side pain
  23. pain or tenderness around the eyes and cheekbones
  24. runny or stuffy nose
  25. sneezing
  26. sore throat
  27. stomach discomfort, upset, or pain
  28. tender, swollen glands in the neck
  29. trouble with swallowing
  30. troubled breathing
  31. unusual tiredness or weakness
  32. voice changes

Less common

  1. Abdominal or stomach pain
  2. bloody nose
  3. blurred vision
  5. canker sores
  6. difficulty having a bowel movement (stool)
  7. discouragement
  8. feeling sad or empty
  9. flushed, dry skin
  10. fruit-like breath odor
  11. increased hunger
  12. increased thirst
  13. increased urination
  14. irritability
  15. lack of appetite
  16. large amount of cholesterol in the blood
  17. leg pain
  18. loss of interest or pleasure
  19. muscle pain
  20. nausea
  21. painful or difficult urination
  22. skeletal pain
  23. sore mouth or tongue
  25. sweating
  26. swelling
  27. swelling or inflammation of the mouth
  28. tiredness
  29. trouble concentrating
  30. trouble sleeping
  31. troubled breathing
  32. unexplained weight loss
  33. vomiting
  34. white patches in the mouth and/or on the tongue

Incidence not known

  1. Bloating
  2. change in vision
  3. constipation
  4. diarrhea
  5. itching or red skin

