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Tiotropium Coupon - Tiotropium 30 capsules of 18mcg per capsule inhaler

tiotropium

Generic Spiriva Handihaler
Used for COPD
Used for COPD

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.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on September 4, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Spiriva (tiotropium)?

What is Spiriva (tiotropium) used for?

  • Chronic obstructive pulmonary disease (COPD)

  • Asthma in people age 6 years and older - Spiriva Respimat only

How Spiriva (tiotropium) works

Spiriva (tiotropium) is an anticholinergic medication. It's also called a long-acting muscarinic antagonist (LAMA). It attaches to proteins called muscarinic receptors to block signals that cause the muscles in your airways to tighten. As a result, the medication relaxes the muscles in your airways to make it easier for you to breathe.

Are you looking for information on Stiolto Respimat (tiotropium / olodaterol) instead?
When does Spiriva (tiotropium) start working?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsSpiriva HandiHaler, Spiriva Respimat
Drug ClassLAMA
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only

More on Spiriva (tiotropium) essentials

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Do I Really Need Spiriva for My COPD?

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spiriva respimat: pharmacist grabbing medication for customer 1171965934

Three Ways to Save Money on Spiriva (Tiotropium)

Written by Ruth Guajardo, PharmD
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basics-icon

What are the side effects of Spiriva (tiotropium)?

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

Spiriva HandiHaler and genericSpiriva Respimat
  • Sore throat (12%)
  • Cough (6%)
  • Dry mouth (4%)
  • Sinus inflammation (3%)

Other Side Effects

  • Headache
  • Dizziness
  • Racing heart
  • Lower airway inflammation (bronchitis)
  • Runny, itchy, or stuffy nose
  • Indigestion
  • Diarrhea
  • Thrush (fungal infection in the mouth)

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 (tiotropium) possible side effects begin and end?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Dry mouth
Risk of upper respiratory infections
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

More on Spiriva (tiotropium) side effects

Health: spiriva-respimat: man using inhaler 826985536

What Are the Side Effects of Spiriva?

Written by Alex Brewer, PharmD, MBA

The following 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

nausea

sweating

trouble breathing

Less common

Cough

difficulty with swallowing

dizziness

hives, itching, or skin rash

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

chest pain

chills

congestion

cough

difficult, burning, or painful urination

dry mouth

dryness of the throat

ear congestion

fever

frequent urge to urinate

headache

heartburn

hoarseness

indigestion

loss of voice

lower back or side pain

pain or tenderness around the eyes and cheekbones

runny or stuffy nose

sneezing

sore throat

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

canker sores

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

muscle pain

nausea

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

Incidence not known

Bloating

change in vision

diarrhea

red skin

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.

pros-and-cons

Pros and cons of Spiriva (tiotropium)

thumbs-up

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)

thumbs-down

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

pharmacist-tips

Pharmacist tips for Spiriva (tiotropium)

pharmacist

  • Spiriva (tiotropium) doesn't work fast enough to treat a sudden COPD or asthma attack. Always have your rescue inhaler (like albuterol (Ventolin)) handy in case you have sudden difficulty breathing.

    • Continue to use Spiriva (tiotropium) even if you feel better. Each dose of Spiriva (tiotropium) helps keep your airways open for a full day. Keep in mind that it can take up to 2 months of daily use to see improvement in your breathing.

      Additional tips for Spiriva HandiHaler and generic:

      • Don't open or swallow the capsule since the medication won't work properly this way. Each capsule has enough powder for one dose, which is 2 puffs.

        • Rinse your HandiHaler device with warm water while you press the green button a few times to remove powder buildup. Let it air dry for 24 hours, and don't use a hair dryer to dry it faster. Never use your device when it's still wet because you might not get your full dose of medication.

          • Check with your provider whether Spiriva HandiHaler is right for you if you're allergic to milk or lactose. The capsules of Spiriva (tiotropium) contains a little bit of lactose.

            Additional tips for Spiriva Respimat:

            • Clean your inhaler with a damp cloth or tissue at least once a week.

              • Throw away your inhaler after 3 months of inserting the cartridge even if there's still medication left.

                faqs

                Frequently asked questions about Spiriva (tiotropium)

                Is Spiriva (tiotropium) a steroid?
                No, Spiriva (tiotropium) isn't a steroid. It belongs to a group of medications called anticholinergics, and it helps relax your airway muscles. Spiriva (tiotropium) works differently from steroids, which help to lower inflammation in the lungs.
                How do you use Spiriva HandiHaler?
                The Spiriva HandiHaler comes with capsules inside of a blister pack and a device that you'll use to inhale the powder that's in the capsule. To use Spiriva Handihaler, open the dust cap on the HandiHaler device by pressing the green button. Then, open the mouthpiece so that you can see the center chamber. Remove one capsule from the blister pack, and place it into the chamber of the HandiHaler device. Close the mouthpiece firmly until it clicks. With the device upright, press the green button once to make a hole in the capsule so the powder can come out when you inhale. Breathe out completely; then close your lips around the mouthpiece and breathe in fast and deep. Hold your breath for a few seconds and then breathe normally again. You'll need to inhale one more time to get the full dose. Check out this guide for more details on how to use Spiriva HandiHaler.
                How do you use Spiriva Respimat?
                Remove the clear base of the Spiriva Respimat inhaler and insert a new cartridge. Then, put the clear base back on and turn it in the direction of the arrows until it clicks (half a turn). Open the cap and point the inhaler toward the ground and press the button to release a dose. If you don't see any mist come out, close the cap, turn the clear base again, and spray a dose toward the ground. After you see four sprays, it's ready to use. Each time you're ready to take your dose, remember "TOP" (Turn, Open, Press). Start by keeping the cap closed and turning the clear base until it clicks. Then, open the cap and put you lips around the mouthpiece. Press the button to release your dose while slowly breathing in. Hold your breath for 10 seconds (or as long as possible). Repeat the "TOP" steps to take your second dose. Watch this video to learn more.
                When should you take Spiriva (tiotropium), morning or night?
                You can use Spiriva (tiotropium) at any time of day, so choose a time that's most convenient for you. The most important thing to remember is to take your dose around the same time every day. You can set up a reminder on your phone or pair it with something you do every day (like after brushing your teeth in the morning).
                Is Spiriva (tiotropium) a rescue inhaler?
                No, Spiriva (tiotropium) isn't considered a rescue inhaler. Rescue inhalers need to work quickly to help treat COPD or asthma attacks. But Spiriva (tiotropium) doesn't work fast enough to do that; the medication works over time to help with your breathing. In fact, it could take up to 4 to 8 weeks to see improvement in your breathing. Talk with your provider about what you should do if your breathing symptoms become worse or if you experience an asthma attack.
                Is Spiriva (tiotropium) a bronchodilator?
                Yes. Spiriva (tiotropium) is a bronchodilator, which means it opens up the air passages in your lungs. Keep in mind that there are many different bronchodilators. Some work faster or slower or for a shorter or longer period of time.
                Who should not take Spiriva (tiotropium)?
                While Spiriva (tiotropium) is generally safe to use, there are some precautions. If you have glaucoma or problems with urination, Spiriva (tiotropium) can make these conditions worse. Also, let your provider know if you have kidney problems, since more medication can build up in your body and cause more side effects if you do. Be sure to tell your provider all of your allergies so they can make sure Spiriva (tiotropium) is safe for you. People who've had an allergic reaction to tiotropium or ipratropium in the past shouldn't use this medication. Talk with your provider to see whether Spiriva (tiotropium) is safe for you to use.
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                What are the risks and warnings for Spiriva (tiotropium)?

                Spiriva (tiotropium) 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.

                risk-warning

                Not a rescue inhaler

                Spiriva (tiotropium) controls your symptoms over time. The medication won't help relieve sudden difficulty breathing. Make sure to always have your rescue inhaler with you to help in these situations.

                risk-warning

                Allergic reaction

                • Risk factors: History of allergic reaction to atropine, tiotropium, or ipratropium

                  In rare cases, people taking Spiriva (tiotropium) can have very serious, life-threatening allergic reactions. Get medical help right away if you have trouble breathing; feel swelling in your tongue, lips and face; or have severe itching and rash.

                  risk-warning

                  Sudden airway tightening (paradoxical bronchospasm)

                  Like all inhaled medications, Spiriva (tiotropium) can cause your airways to suddenly tighten (bronchospasm) right after you inhale the medication. If this happens, use your rescue inhaler and talk to your provider right away. You might have to switch to a different medication.

                  risk-warning

                  Worsening glaucoma

                  • Risk factors: History of narrow-angle glaucoma

                    Spiriva (tiotropium) can worsen an eye condition called narrow-angle glaucoma. Be careful using Spiriva (tiotropium) if you have this eye condition. Let your provider know right away if you notice new eye pain, blurry vision, or any other vision changes (like seeing halos or different colors) while you're taking Spiriva (tiotropium).

                    risk-warning

                    Urination problems

                    • Risk factors: History of urinary bladder blockage (urinary obstruction) | History of enlarged prostate

                      If you have problems with your prostate or with urination, Spiriva (tiotropium) can make your symptoms worse. Tell your provider right away if you notice any difficulty urinating or pain during urination while you're taking Spiriva (tiotropium).

                      risk-warning

                      Higher risk for side effects in people with kidney problems

                      • Risk factors: History of kidney problems

                        If you have kidney problems, Spiriva (tiotropium) can build up in your body and cause more side effects. These side effects can include dry mouth, blurry vision, fast heart rate, or constipation. Let your provider know if you notice these symptoms while you're taking Spiriva (tiotropium).

                        dosage

                        Spiriva (tiotropium) dosage forms

                        handihaler
                        Handihaler
                        DosageQuantityPrice as low asPrice per unit
                        30 capsules of 18mcg per capsule1 handihaler$337.69$337.69
                        90 capsules of 18mcg per capsule1 handihaler$976.50$976.50

                        Typical dosing for Spiriva (tiotropium)

                        Spiriva HandiHaler and generic

                        • This medication comes as capsules for dry powder inhalation for use with the HandiHaler device. Each capsule contains 18 mcg of tiotropium. The medication is inhaled through the mouth using the HandiHaler device.

                        • COPD: The typical dose is 2 inhalations of a single capsule (18 mcg total) once daily.

                        Spiriva Respimat

                        • This medication is available as a 2.5 mcg/puff and 1.25 mcg/puff metered-dose inhaler. The medication is inhaled through the mouth using the Respimat device.

                        • COPD: The typical dose is 2 inhalations of the 2.5 mcg inhaler (5 mcg total) once daily.

                        • Asthma in people age 6 years and older: The typical dose is 2 inhalations of the 1.25 mcg inhaler (2.5 mcg total) once daily.

                        interactions

                        Interactions between Spiriva (tiotropium) and other drugs

                        Spiriva (tiotropium) 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 (tiotropium). Please note that only the generic name of each medication is listed below.

                        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.

                        drug-cost

                        How much does Spiriva (tiotropium) cost?

                        To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
                        Spiriva Handihaler (brand)
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                        contraindications-icon

                        Spiriva (tiotropium) 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 (tiotropium) will not be safe for you to take.
                        alternatives

                        What are alternatives to Spiriva (tiotropium)?

                        There are a number of medications that your doctor can prescribe in place of Spiriva (tiotropium). Compare a few possible alternatives below.
                        Spiriva (tiotropium)
                        Used for:

                        • Chronic obstructive pulmonary disease (COPD)

                        • Asthma in people age 6 years and older - Spiriva Respimat only

                        $126.32 Lowest GoodRx priceView Prices
                        Incruse Ellipta (umeclidinium)
                        Used for:
                        $358.41 Lowest GoodRx priceView Prices
                        images

                        Spiriva (tiotropium) images

                        White Lu T18 - Tiotropium Bromide 18mcg Powder for Inhalation
                        This medicine is White Inhaler Imprinted With "Lu T18".White Lu T18 - Tiotropium Bromide 18mcg Powder for Inhalation

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                        References

                        Best studies we found

                        American College of Chest Physicians (CHEST). (n.d.). CHEST philanthropy.

                        Arany, S., et al. (2022). Anticholinergic medication: Related dry mouth and effects on the salivary glands.
                        Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology.

                        Boehringer Ingelheim Pharmaceuticals, Inc.  (2016). Starting Spiriva Respimat 2.5 mcg with ease.

                        View All References (6)

                        Boehringer Ingelheim Pharmaceuticals, Inc. (2017). Frequently asked questions.

                        Boehringer Ingelheim Pharmaceuticals, Inc. (2021). Welcome to your Respimat quick start guide.

                        Boehringer Ingelheim Pharmaceuticals, Inc. (2022). Spiriva Handihaler- tiotropium bromide capsule [package insert]. DailyMed.

                        Boehringer Ingelheim Pharmaceuticals, Inc. (2023). Spiriva Respimat- tiotropium bromide inhalation spray spray, metered [package insert]. DailyMed.

                        Buels, K. S., et al. (2012). Muscarinic receptor antagonists: Effects on pulmonary function. Handbook of Experimental Pharmacology.

                        Oba, Y., et al. (2008). Safety, tolerability and risk benefit analysis of tiotropium in COPD. International Journal of Chronic Obstructive Pulmonary Disease.

                        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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