Tiotropium (By breathing)


Tiotropium (tye-oh-TROE-pee-um)

Prevents the symptoms of bronchospasm caused by emphysema, chronic bronchitis, or COPD (chronic obstructive pulmonary disease). This medicine is a bronchodilator.

Brand Name(s)


When This Medicine Should Not Be Used

How to Use This Medicine


  • Take your medicine as directed.
  • Spiriva® capsules should be used only with the HandiHaler® device. Do not swallow the capsule. Do not use the HandiHaler® device with any other medicine.
  • Each capsule contains powder that is released from the HandiHaler® device when you use it. Do not let the medicine powder get into your eyes.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
  • To use:
    • Open the HandiHaler® device and the blister pack containing the capsule.
    • Put 1 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. You should 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.
    • Once again, breathe out fully, place the mouthpiece between your lips, and breath in slowly to get the full dose of medicine. Do not press the green piercing button 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. Let it air dry completely.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. Do not use this medicine more than 1 time every 24 hours.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Leave the capsules in their blister pack until you are ready to use the medicine. Open only 1 blister pack at a time when you are ready to remove a capsule and put it into the HandiHaler® device. Use the capsule right away once you have opened a blister pack.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you also use medicine for incontinence, stomach cramps, ulcers, or muscle spasms, or to prevent nausea, vomiting, and motion sickness. This would include Anaspaz®, Bentyl®, Cystospaz®, Detrol®, Norflex®, Robinul®, Transderm-Scop®, and others.
  • Tell your doctor if you also use ipratropium (Atrovent®).

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding or if you have kidney disease, liver disease, narrow-angle glaucoma, prostate problems, or urination problems. Tell your doctor if you have had an allergic reaction to milk proteins.
  • This medicine will not stop bronchospasm that has already started. Your doctor may prescribe another medicine for you to use in case of an acute attack.
  • Stop using the medicine and check with your doctor right away if you develop a skin rash, itching, or swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs after you use this medicine. These may be signs of an allergic reaction.
  • This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. This can be life-threatening. Stop using this medicine and check with your doctor right away if you have coughing, trouble breathing, or wheezing after you use this medicine.
  • Check with your doctor right away if you have any changes to your eyes, such as eye pain, blurred vision, or vision changes, while you are using this medicine.
  • This medicine may cause dizziness or blurred vision. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
  • Call your doctor right away if you use other medicines for your lung condition and they do not seem to be working as well as usual. Do not change your doses or stop using your medicines before you talk to your doctor.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Bloody or cloudy urine
  • Change in how much or how often you urinate
  • Chest pain
  • Eye pain or redness and vision problems
  • Fast heartbeat
  • Painful or difficult urination
  • Red or itching skin rash
  • Swelling in your face, hands, ankles, or feet
  • Trouble breathing or wheezing

If you notice these less serious side effects, talk with your doctor:

  • Dry eyes or mildly blurred vision
  • Dry mouth
  • Heartburn, stomach pain, or upset stomach
  • Runny or stuffy nose, cough, fever, sore throat, or body aches

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last reviewed on 8/4/2014

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch)

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2013 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.