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Ipratropium vs. Spiriva Handihaler

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Ipratropium (Atrovent) and tiotropium (Spiriva) are both inhaled medications used to treat chronic obstructive pulmonary disease (COPD). They belong to the anticholinergic class of medications, but they differ in their specific subtypes and uses. Ipratropium is a short-acting muscarinic antagonist (SAMA), while tiotropium is a long-acting muscarinic antagonist (LAMA). Ipratropium is typically used 3 to 4 times a day through a nebulizer, whereas tiotropium is used once daily with either the Spiriva HandiHaler or Spiriva Respimat inhalers. Tiotropium is also approved for treating asthma in people aged 6 years and older, but only with the Spiriva Respimat inhaler. Ipratropium is available as a generic, while only the Spiriva HandiHaler has a generic version. Common side effects of ipratropium include headache and cough, while tiotropium may cause dry mouth and upper respiratory tract infections. Both medications can cause serious allergic reactions and should not be used as rescue inhalers.

ipratropium nasal spray

 

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Spiriva

(tiotropium)

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Summary for Ipratropium

Prescription only

Ipratropium nasal spray is a prescription nasal spray used to treat runny nose from allergies and from the common cold. Depending on the strength, it can be used in people ages 5 or 6 years and older. It's only available as a generic medication since the brand name, Atrovent, has been discontinued. Dosing for ipratropium nasal spray typically ranges from 2 sprays in each nostril, 2 to 4 times daily. Although most people experience few to no side effects while using ipratropium nasal spray, some people might have headache or nosebleeds during treatment.

Indications for Ipratropium

  • Runny nose due to year-round allergies, seasonal allergies, and the common cold

Pros and Cons for Ipratropium

Pros

  • Starts to work in as quickly as 15 minutes
  • Available as a lower-cost generic medication
  • Safe to use for children 5 or 6 years of age and older

Cons

  • Not sure if safe or works well in people with kidney or liver conditions
  • Needs to be used multiple times a day
  • Might worsen certain medical conditions, such as glaucoma or prostate problems

Common Side Effects for Ipratropium

Ipratropium 0.06% nasal spray

Ipratropium 0.03% nasal spray

  • Headache (10%)
  • Cough, runny nose, and other symptoms of respiratory infections (10%)
  • Nosebleed (9%)
  • Sore throat (8%)
  • Dry nose (5%)

Warnings for Ipratropium

  • Allergic reactions
  • Vision and eye problems
  • Worsening of certain medical conditions

Summary for Spiriva Handihaler

Prescription only

Spiriva (tiotropium) is a medication used to help control chronic obstructive pulmonary disease (COPD) and asthma. There are two different Spiriva inhalers: Spiriva Respimat is a metered-dose inhaler, and Spiriva HandiHaler is a device that you place a capsule of medication into before you take the medication. The typical dosage for Spiriva (tiotropium) is two inhalations once a day, but the dose depends on the reason you're using it. Side effects include dry mouth, cough, and upper respiratory tract infections. Only Spiriva HandiHaler is also available as a generic version.

Indications for Spiriva Handihaler

  • Chronic obstructive pulmonary disease (COPD)
  • Asthma in people age 6 years and older - Spiriva Respimat only

Pros and Cons for Spiriva Handihaler

Pros

  • Helps prevent attacks or flare-ups
  • Has few side effects
  • Used once daily
  • Doesn't commonly cause a fast heart rate like some other bronchodilators
  • Available as a lower-cost generic (Spiriva HandiHaler only)

Cons

  • Doesn't work fast enough to be used as a rescue inhaler for attacks
  • Can be difficult for some people to use
  • Can cause dry mouth as a side effect
  • Only Spiriva Respimat can be used for asthma in children 6 years and older
  • Spiriva Respimat is currently only available as brand name

Common Side Effects for Spiriva Handihaler

Spiriva HandiHaler and generic

Spiriva Respimat

  • Sore throat (12%)
  • Cough (6%)
  • Dry mouth (4%)
  • Sinus inflammation (3%)

Warnings for Spiriva Handihaler

  • Not a rescue inhaler
  • Allergic reaction
  • Sudden airway tightening (paradoxical bronchospasm)
  • Worsening glaucoma
  • Urination problems
  • Higher risk for side effects in people with kidney problems

Prices with our coupons for Ipratropium vs. Spiriva Handihaler

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Ipratropium1 nasal spray / 15ml of 0.06%
$26.45$81.42
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Tiotropium1 inhaler / 30 capsules of 18mcg per capsule
$76.57$366.94
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