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)

There may be other brand names for this medicine.


When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to tiotropium, ipratropium (Atrovent®), or atropine.

How to Use This Medicine

  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • 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.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
  • 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.
If a dose is missed:
  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

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 one blister at a time when you are ready to remove a capsule and put it into the HandiHaler® device. Once you have opened a blister, use the capsule right away.
  • 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 away from children and 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 are also using 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 are also using 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 a bronchospasm that has already started. Your doctor may prescribe another medicine for you to use in case of an acute attack.
  • This medicine may cause allergic reactions, including angioedema. Stop using the medicine and check with your doctor right away if you develop a skin rash, itching, or large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs after using this medicine.
  • This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Check with your doctor right away if you have coughing, difficulty breathing, shortness of breath, or wheezing 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 eye doctor.
  • If you use other medicines for your lung condition and they do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to 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.
  • Difficulty with breathing, shortness of breath, or wheezing.
  • Eye pain or redness and vision problems.
  • Fast heartbeat.
  • Problems with urination.
  • Swelling in your hands, ankles, or feet.
If you notice these less serious side effects, talk with your doctor:
  • Constipation, heartburn, stomach pain, or upset stomach.
  • Dry eyes, mildly blurred vision.
  • Dry mouth, sore throat.
  • Runny or stuffy nose, cough, or other cold symptoms.

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
Review Date: 2011-02-04 Reviewed By: Keywords: ,
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