Spiriva (tiotropium bromide)

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

Spiriva® (tiotropium bromide) is approved for long-term treatment of asthma in people 6 years and older. It is sometimes added on to treatment for people who are not responding to their rescue inhaler (b-agonist/Albuterol). It is also approved for long-term treatment of chronic obstructive pulmonary disease (COPD).1,2

Spiriva comes as a dry powder inhaler (Spiriva HandiHaler) and an inhalation spray (Spiriva Respimat). Spiriva Respimat is the version used to treat asthma.1,2

Do not use Spiriva to treat an asthma attack. Use a rescue inhaler instead.1,2

What are the ingredients in Spiriva?

The active ingredient in Spiriva is tiotropium bromide.1,2

How does Spiriva work?

Spiriva is an anticholinergic drug. This means it blocks a chemical in your body called acetylcholine. Acetylcholine sends messages between your cells to affect functions like airway muscle movement.1,2

Spiriva stops acetylcholine from binding to proteins on your cells called muscarinic receptors. This prevents airway muscles from tightening and causes the airway to open (bronchodilation). The effects of a dose of Spiriva last for about 24 hours.1,2

What are the possible side effects?

Possible side effects of Spiriva include:1,2

  • Sore throat
  • Headache
  • Bronchitis
  • Dry mouth
  • Sinus infection

Spiriva may cause your airway to tighten suddenly (bronchospasm). If this happens, use your rescue inhaler. Stop Spiriva and call your doctor. They will suggest a different asthma treatment.1,2

Spiriva can increase pressure in your eyes (narrow-angle glaucoma). Talk to your doctor if you notice symptoms of narrow-angle glaucoma, such as:1,2

  • Eye pain
  • Blurred vision
  • Seeing halos or colored images

Spiriva may make it harder to urinate (urinary retention). Talk to your doctor if you notice symptoms of urinary retention, such as:1,2

  • Difficulty passing urine
  • Painful urination

Some people may have allergic reactions to Spiriva. Talk to your doctor if you experience an allergic reaction. They will suggest a different asthma treatment. If the allergic reaction causes difficulty breathing, get emergency help. Symptoms of an allergic reaction may include:1,2

  • Raised, red patches on your skin (hives)
  • Itching
  • Rash
  • Swelling of the face, lips, tongue, and throat
  • Low blood pressure
  • Difficulty breathing
  • Lightheadedness

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

Other things to know

Take Spiriva exactly as your doctor describes. Your doctor will teach you how to use, store, and clean your inhaler.1,2

You may not feel the full benefits of Spiriva for 4 to 8 weeks. Do not change your dose or how often you use Spiriva without talking to your doctor. Do not take more than 1 dose per day.1,2

Do not take Spiriva if you are:1,2

  • Allergic to tiotropium
  • Allergic to any other ingredients in Spiriva
  • Taking other anticholinergic drugs

Spiriva may worsen other conditions or interfere with other medicines. Tell your doctor if you:1,2

  • Have had any problems with your kidneys, eyes, bladder, or prostate
  • Have had problems urinating
  • If you are pregnant or breastfeeding

Before beginning treatment for asthma, tell your doctor about 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.

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