Treating COPD with Spiriva

What you need to know about side effects and drug interactions

Photo courtesy of Daniel More,

Patients with chronic obstructive pulmonary disease, or COPD, often need daily maintenance medicines that reduce airway swelling, relax the muscles in the airways and help the lungs work better. Spiriva, a long-acting, anticholinergic bronchodilator, is a maintenance medication that can help you manage your COPD symptoms.

First approved by the FDA as safe and effective for daily use in 2004, Spiriva is a brand name formulation of tiotropium bromide.

The medication comes in two different formulations — Spiriva Handihaler, a powder, and Spiriva Respimat, a spray. Both are delivered via oral inhalation as a once-daily maintenance treatment. The standard dose for patients with COPD is 2.5 mcg, although a lower dose is available and approved for use in controlling asthma.

There are numerous possible side effects of using Spiriva that you should be aware of ranging from common to more severe. Side effects for both Spiriva Handihaler and Spiriva Respimat are generally similar, although some patients who have unpleasant side effects with one formulation experience less difficulty with the other.

Contrary to earlier studies, Spiriva does not increase the risk of stroke or other cardiovascular events. The following is a list of possible drug interactions and side effects, although additional unreported problems may be associated with use. Be sure to talk with your health care provider if you take these, or any other medications, before taking Spiriva, or if you experience additional side effects that are not mentioned here.

Here's what you need to know.

Common Spiriva Side Effects

Common side effects from Spiriva generally don't require medical attention and include:

  • Constipation
  • Cough
  • Dry mouth
  • Headache
  • Muscle pain
  • Sore throat
  • Upset stomach

More Severe Spiriva Side Effects

Some more serious side effects that have been reported after using Spiriva.

Contact your health care provider immediately if you experience:

  • Any type of allergic reaction such as skin rash, hives, or swelling of the face, lips or tongue
  • Difficulty breathing
  • Changes in vision
  • Chest pain
  • Rapid heartbeat or heart palpitations
  • Infection or flu-like symptoms
  • Trouble passing urine or change in the amount of urine that you pass

Spiriva Interactions

Spiriva is an anticholinergic bronchodilator and should not be taken with other anticholinergic medicines. Spiriva may interact with the following medications. If you take these, or any other medications, be sure to talk to your doctor:

  • Atropine
  • Hyoscyamine
  • Ipratropium
  • Related medicines called antimuscarinics (drugs that block bladder contractions) or anticholinergics


Highlights of Prescribing Information: Spiriva Handihaler. Boerhinger-Ingelheim website. Revised January 2016.

Highlights of Prescribing Information: Spiriva Respimat. Boerhinger-Ingelheim website. Revised January 2016. 

Chronic Obstructive Pulmonary Disease — Control Drugs. U.S. National Library of Medicine website. Revised April 26, 2104. 

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