A Guide to COPD Inhalers
COPD inhalers may contain short- or long-acting medication, and there are a variety of devices on the market. Compare the best COPD inhalers with this guide.
tiotropium
Used for COPD
Used for COPD
Spiriva HandiHaler (tiotropium) is a long-acting muscarinic antagonist (LAMA). It helps control chronic obstructive pulmonary disease (COPD) in adults. It comes as an inhaler that uses capsules filled with the medication. The usual dose is two inhalations from the same capsule once a day. Side effects can include dry mouth and upper respiratory tract infections.
What is Spiriva HandiHaler?
What is Spiriva HandiHaler used for?
- Maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults
How Spiriva HandiHaler works
Spiriva HandiHaler (tiotropium) is an anticholinergic medication. It's also called a long-acting muscarinic antagonist (LAMA).
It works by blocking proteins called muscarinic receptors in your lungs. This relaxes the muscles around your airways so you can breathe more easily.
When does Spiriva HandiHaler start working?Time passed since treatment started:
Drug facts
| Common Brands | Spiriva HandiHaler |
|---|---|
| Drug Class | LAMA |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Spiriva HandiHaler essentials
Side effects of Spiriva HandiHaler
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Upper respiratory tract infection (41%)
- Dry mouth (16%)
- Sinus inflammation (11%)
- Sore throat (9%)
- Urinary tract infection (7%)
- Chest pain (7%)
- Indigestion (6%)
- Runny, itchy, or stuffy nose (6%)
Spiriva HandiHaler serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reaction: hives, itching, swelling of the face or throat, trouble breathing
- Worsening breathing symptoms
When do Spiriva HandiHaler possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Dry mouth
More on Spiriva HandiHaler side effects
The following Spiriva HandiHaler side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Arm, back, or jaw pain
chest pain or discomfort
chest tightness or heaviness
fast or irregular heartbeat
sweating
trouble breathing
Less common
difficulty with swallowing
dizziness
painful blisters on the trunk of body
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
tightness in the chest
unusual tiredness or weakness
Rare
Fainting
fast, pounding, or irregular heartbeat or pulse
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
belching
bladder pain
bloody or cloudy urine
body aches or pain
chills
congestion
difficult, burning, or painful urination
dryness of the throat
ear congestion
frequent urge to urinate
headache
hoarseness
indigestion
loss of voice
lower back or side pain
pain or tenderness around the eyes and cheekbones
runny or stuffy nose
stomach discomfort, upset, or pain
tender, swollen glands in the neck
voice changes
Less common
Bloody nose
blurred vision
bone pain
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
difficulty having a bowel movement (stool)
discouragement
feeling sad or empty
flushed, dry skin
fruit-like breath odor
increased hunger
increased thirst
increased urination
irritability
lack of appetite
leg pain
loss of interest or pleasure
painful or difficult urination
sore mouth or tongue
sores, ulcers, or white spots on the lips or tongue or inside the mouth
sweating
swelling or inflammation of the mouth
tiredness
trouble concentrating
trouble sleeping
unexplained weight loss
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$362.29
GoodRx discount
$76.57
Pros and cons of Spiriva HandiHaler
Pros
- Helps prevent COPD flare-ups
- Used once daily
- Most side effects are mild
- Doesn't contain steroids
Cons
- Not used as a rescue inhaler for attacks
- Can be hard for some people to use
- Can cause dry mouth as a side effect
- Not approved for asthma
Pharmacist tips for Spiriva HandiHaler
- Read the Instructions for Use before using Spiriva HandiHaler for the first time. If you're not sure how to use it, ask your pharmacist or prescriber.
- Never open or swallow the Spiriva capsules. They're only meant to be placed in the HandiHaler device. Then, you use the HandiHaler to breathe in the medication inside the capsule.
- Always keep your rescue inhaler, such as albuterol (Ventolin), with you in case you have sudden trouble breathing. Spiriva HandiHaler doesn't work fast enough to treat a sudden COPD attack.
- Keep using Spiriva HandiHaler every day, even if you feel better. Each dose helps keep your airways open for a full day. Using Spiriva HandiHaler every day helps prevent COPD flare-ups over time.
- If you get dry mouth from Spiriva HandiHaler, drinking sips of water throughout the day can help. You can also suck on ice chips or try over-the-counter saliva substitutes like Biotene. If dry mouth bothers you, talk to your prescriber for more options.
- Tell your care team about all the medications and supplements you take. This helps them check for drug interactions with Spiriva HandiHaler. For example, using it with other anticholinergic medications can raise your risk of certain side effects. Your care team can make sure all your medications are safe to use together.
How to use Spiriva HandiHaler:
- Each Spiriva capsule contains one full dose of medication. To get the full dose, breathe in the medication twice from the same capsule.
- When you're ready, open the Spiriva HandiHaler dust cap and pull the mouthpiece open. Take 1 capsule out of the blister pack and place it into the center chamber. Close the mouthpiece until it clicks.
- Hold the Spiriva HandiHaler upright and press the green button all the way in once to pierce the capsule.
- Breathe out completely away from the HandiHaler device. Then, place your lips around the mouthpiece and take a slow, deep breath until you hear or feel the capsule rattle. Hold your breath for a few seconds, then breathe out slowly away from the device. Repeat these steps for a second inhalation from the same capsule. Don't press the green button again.
- Remove the used capsule and throw it away in the trash.
How to clean your Spiriva HandiHaler device:
- Open the HandiHaler device and lift the green button to open the base. Tap out any capsule pieces or powder from the center chamber.
- Then, rinse the HandiHaler device with warm water while pressing the green button a few times. This helps wash away any leftover powder.
- Let the HandiHaler device air dry completely with all the parts open. This takes about 24 hours. Never use the device until it's completely dry, or you might not get your full dose of medication.
Risks and warnings for Spiriva HandiHaler
Spiriva HandiHaler can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not a rescue inhaler
Spiriva HandiHaler helps control your COPD symptoms over time. The medication doesn't work fast enough to treat sudden trouble breathing. Always carry your rescue inhaler in case you need it for these situations.
Serious allergic reactions
- Risk factors: History of allergic reaction to atropine, tiotropium, or ipratropium | Allergic to milk proteins
Although rare, some people can have serious allergic reactions to Spiriva HandiHaler. Symptoms can include hives, rash, itching, trouble breathing, or swelling of your face, lips, tongue, or throat. Get emergency medical help right away if this happens.
Tell your prescriber if you've ever had an allergic reaction to atropine or ipratropium. These medications are similar to Spiriva HandiHaler, so you might also react to it. Tell your prescriber if you have a milk protein allergy before using Spiriva HandiHaler. The capsules contain a small amount of lactose that might contain milk proteins.
Sudden airway tightening (bronchospasm)
Like all inhaled medications, Spiriva HandiHaler can sometimes make your airways suddenly tighten (bronchospasm) after you use it. If this happens, use your rescue inhaler and call your prescriber right away. You might need to switch to a different medication.
Worsening glaucoma
- Risk factors: History of narrow-angle glaucoma
Let your prescriber know if you have narrow-angle glaucoma before using Spiriva HandiHaler. This medication can make this eye condition worse. Your prescriber can make sure it's safe for you. Call your prescriber or optometrist right away if you have new eye pain, blurry vision, or see halos around lights while using Spiriva HandiHaler.
Trouble urinating
- Risk factors: History of having a blockage in your urinary tract that makes it hard to empty your bladder | History of enlarged prostate
Spiriva HandiHaler can make it harder to urinate. This might be worse if you also have an enlarged prostate or another condition that make it hard to empty your bladder. Tell your prescriber right away if you have trouble urinating or pain when you urinate while using Spiriva HandiHaler.
Higher risk of side effects with kidney problems
- Risk factors: History of moderate or severe kidney problems
If you have kidney problems, Spiriva HandiHaler can build up in your body and raise your risk of side effects. You might have more side effects, like dry mouth, blurry vision, a fast heart rate, or constipation. Tell your prescriber if you notice any of these symptoms.
Spiriva HandiHaler dosage
The average cost for 1 inhaler of 30 capsules of 18mcg per capsule of Spiriva HandiHaler is $76.57 with a free GoodRx coupon. This is 78.86% off the average retail price of $362.29. 
Inhaler
Inhaler| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30 capsules of 18mcg per capsule | 1 inhaler | $76.57 | $76.57 |
Interactions between Spiriva HandiHaler and other drugs
Spiriva HandiHaler may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Spiriva HandiHaler. Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aclidinium
- Amifampridine
- Amitriptyline
- Amoxapine
- Atropine
- Belladonna
- Benztropine
- Biperiden
- Brompheniramine
- Carbinoxamine
- Carisoprodol
- Chlorpheniramine
- Chlorpromazine
- Clemastine
- Clidinium
- Clomipramine
- Clozapine
- Cyclobenzaprine
- Cyclopentolate
- Cyproheptadine
- Darifenacin
- Desipramine
- Dicyclomine
- Dimenhydrinate
- Diphenhydramine
- Donepezil
- Doxepin
- Fesoterodine
- Flavoxate
- Fluphenazine
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Homatropine
- Hydroxyzine
- Hyoscyamine
- Imipramine
- Ipratropium
- Loxapine
- Meclizine
- Mepenzolate
- Methacholine
- Nortriptyline
- Olanzapine
- Orphenadrine
- Oxitropium Bromide
- Oxybutynin
- Paroxetine
- Perphenazine
- Pimozide
- Pipenzolate Bromide
- Pirenzepine
- Prochlorperazine
- Procyclidine
- Promethazine
- Propantheline
- Propiverine
- Protriptyline
- Quetiapine
- Revefenacin
- Scopolamine
- Solifenacin
- Stramonium
- Terodiline
- Thioridazine
- Thiothixene
- Tiotropium
- Tizanidine
- Tolterodine
- Trifluoperazine
- Trihexyphenidyl
- Trimipramine
- Tropicamide
- Trospium
- Umeclidinium
How much does Spiriva HandiHaler cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Spiriva HandiHaler contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Spiriva HandiHaler will not be safe for you to take.
- Allergy to tiotropium or ipratropium
What are alternatives to Spiriva HandiHaler?
There are a number of medications that your doctor can prescribe in place of Spiriva HandiHaler. Compare a few possible alternatives below.
News about Spiriva HandiHaler
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Do I Really Need Spiriva for My COPD?
What is Spiriva (tiotropium), and how does it help chronic obstructive pulmonary disease (COPD)? Spiriva is a daily inhaler medication that reduces COPD symptoms without the help of a steroid. Learn how the Spiriva HandiHaler and Spiriva Respimat Inhaler compare to each other and other treatments.
Spiriva HandiHaler images
