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Atrovent 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 bromide

 

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Spiriva

(tiotropium)

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Summary for Atrovent

Prescription only

Ipratropium bromide is an inhaled medication used to help people with chronic obstructive pulmonary disease (COPD). It's an inhaled anticholinergic that works by opening up your airways so you can breathe easier. The medication is administered through a nebulizer machine and inhaled through the mouth 3 to 4 times a day. Common side effects include headache and cough.

Indications for Atrovent

Pros and Cons for Atrovent

Pros

  • Works well as a maintenance treatment for COPD
  • Doesn't really affect your heart rate
  • Can mix with albuterol if ipratropium bromide doesn't fully control your symptoms
  • Available as a lower-cost generic

Cons

  • Takes about 5 to 15 minutes to receive the whole dose
  • Need to use with a nebulizer machine, which isn't ideal for someone who's on the go
  • Might need to be used multiple times per day because effects don't last long
  • Not a rescue medication

Common Side Effects for Atrovent

Warnings for Atrovent

  • Severe allergic reactions
  • Narrowing of your airways (bronchospasm)
  • Risk of eye and vision problems
  • Trouble urinating

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 Atrovent vs. Spiriva Handihaler

Price Card Drug Icon
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$369.84
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