Spiriva (tiotropium bromide)

Spiriva® (tiotropium bromide) has been approved by the U.S. Food and Drug Administration (FDA) to treat asthma for patients ages 6 and over. Spiriva is also approved for the long-term treatment and reducing flare-ups from COPD (chronic obstructive pulmonary disease).1,2

Spiriva is made by Boehringer Ingelheim. It comes as a dry powder inhaler (Spiriva HandiHaler®), which is used as a treatment for COPD (chronic obstructive pulmonary disease) and a slow-moving mist inhaler (Spiriva Respimat®), which is used as a treatment for asthma.1,2

How does Spiriva work?

Spiriva is an “anticholingeric” medication. It is a type of bronchodilator, or medication that opens the airways.1 It prevents the muscles around the large airways from tightening.3 Tiotropium is a long-acting medication that can work for up to 24 hours.3

How is Spiriva taken?

Ask your health care provider or respiratory therapist to demonstrate how to use your inhaler.

There are directions for using Spiriva Respimat to treat asthma (Table).1 The inhaler has to be assembled and primed before the first use. The instructions come with your inhaler.

Table. Using the Spiriva Respimat inhaler

The steps for using your Spiriva Respimat inhaler are:

  1. Hold the inhaler with the cap closed.
  2. Turn the base in the direction of the black arrows at the bottom until it clicks.
  3. Flip the cap open.
  4. Breathe out until your lungs are empty.
  5. Put the mouthpiece in your mouth and close your lips around it. Be sure that the inhaler is pointing to the back of your throat.
  6. Begin to breathe in deeply and slowly through your mouth. Press the dose release button to release a “puff.” Continue to breathe in slowly for as long as you can.
  7. Hold your breath for 10 seconds, or as long as comfortably possible.
  8. Repeat steps 1-7 a second time to get the full dose of medication.1


  • Read the Patient Information that comes with your inhaler for complete instructions.

What are the recommendations for storing, cleaning, and discarding the Spiriva Respimat inhaler?

The package for Spiriva Respimat contains a cartridge and inhaler. Do not use the Spiriva cartridge with any other Respimat inhaler. Keep the Spiriva Respimat at room temperature (77˚F). Do not let it freeze. Use a damp cloth to wipe the inside and outside of the mouthpiece once a week. Throw out the Respimat inhaler and cartridge three months after first use or after it locks itself, whichever comes first.1

What are the possible side effects of taking Spiriva?

Taking Spiriva could cause your airways to tighten suddenly (“bronchospasm”).1 Discontinue Spiriva, use a rescue inhaler, and call your health care provider.1,2

Common side effects of Spiriva Respimat are sore throat, headache, bronchitis, dry mouth, and sinus infection.1,2 This is not an exhaustive list of side effects of Spiriva and other side effects may occur. Please make sure to discuss this with your doctor.

Spiriva can increase the pressure in your eyes. This is called narrow-angle glaucoma. Symptoms are eye pain, blurred vision, seeing halos or colored images, and redness of the eyes. Be careful about driving or operating machinery.1,2

Spiriva can make it more difficult to urinate. Symptoms include pain or difficulty with urination.1,2

Are there people who should not take Spiriva Respimat?

Do not take Spiriva Respimat to treat sudden breathing symptoms.1 If your health care provider has given you medications to take for sudden breathing symptoms, take that instead.

Tell your health care provider if you have had problems with your kidneys, eyes, bladder, or prostate.1 Mention if you have had problems with passing urine. Taking Spiriva can make these problems worse.

Tell your health care provider about any prescription medications, particularly anticholinergic medications or eye drops.1 Also let your health care provider know about any over-the-counter medications or supplements that you take.

Spiriva has not been well studied in pregnant or breastfeeding women.1 Little is known about whether this medication passes into breast milk. Talk to your doctor about if you become pregnant or wish to breastfeed while taking Spiriva.

If you are allergic to any ingredient in Spiriva Respimat, you should not take this medication. Symptoms of an allergy are hives, itching, rash, and swelling in the mouth.1

Is there a generic alternative to Spiriva?

There is no generic alternative to Spiriva.

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Written by: Sarah O'Brien | Last Reviewed: April 2021.