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Terms Of Use


Brand Name(s) : Spiriva
Side Effects


Tiotropium should be used with caution in:

It should not be used in:

  • patients who are allergic to tiotropium, atropine (or similar drugs such as ipratropium or oxitropium) or to any other ingredients in the medicine or allergic to lactose or milk protein, children and adolescents aged under 18 years

Also see list of precautions and interactions


Do not store above 25ºC and do not freeze.
The tiotropium inhaler (Spiriva Respimat) should be discardedat the latest 3 months after first use.

The HandiHaler device can be used for up to 1 year to take your medicine. The tiotropium capsule blister pack should be discarded 9 days after opening.


Tiotropium is used to open up the airways making it easier to get air in and out of the lungs.

It is an antimuscarinic, sometimes known as a long-acting bronchodilator.

It is used to treat chronic obstructive pulmonary disease (COPD) which is a long term chronic lung disease associated with shortness of breath and coughing.

In general this drug is used to treat the chronic lung disease called chronic obstructive pulmonary disease (COPD) which may be associated with the lung conditions chronic bronchitis and emphysema.

It is a maintenance treatment, which means that it should be taken every day and not only when you experience breathing problems or other COPD symptoms

Benefits of being on this drug can include being able to breathe more easily because tiotropium makes it easier to get air into and out of your lungs, feeling more able to get on with every day life and being active for longer. Tiotropium can also help to stop sudden short-term worsening of your COPD symptoms which may last for a number of days.

Listed below are the typical uses of tiotropium:

On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Such conditions are listed below.

  • None known.


How often do I take it?

  • Tiotropium is available as powder capsules for inhalation which are used with the HandiHaler device or as an inhaler (Respimat inhaler).
  • Powder capsules: The contents of one tiotropium capsule should be inhaled using the HandiHaler device once a day, at the same time each day. Do not swallow the capsules. The HandiHaler that you put the tiotropium capsules into makes holes in the capsules, allowing you to breathe in the powder.
  • Inhaler: Inhale two puffs once a day at the same time each day.
  • Make sure that you know exactly how to use the titotropium inhaler and powder capsules. If you are unsure consult your doctor, nurse or pharmacist for more details. Make sure that you do not get any tiotropium powder into you eyes. If it does get into your eyes you should wash your eyes with warm water immediately and contact your doctor immediately. It is important that you do not use tiotropium to treat a sudden attack of breathlessness and wheezing.
  • Use this medication regularly in order to get the most benefit from it.
  • Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Tiotropium may cause dizziness, blurred eyesight or headache. If you develop any of these symptoms then do not drive or operate any machinery. Consult your doctor or pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.


Further information about other side effects can be found on the patient information leaflet.
If any of these persist or you consider them severe then inform your doctor or pharmacist.

Tell your doctor immediately and stop taking your medicine if you develop any of the following symptoms:

  • Rash, swelling, itching, wheezing or breathlessness (this may be an allergic reaction to tiotropium)
  • Tightness of the chest, coughing, wheezing and breathlessness
  • Eye pain or discomfort including blurred vision, seeing halos around lights or coloured images in association with red eyes (headache, nausea and vomiting may also occur).
  • Worsening of breathing

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.


Before taking tiotropium, tell your doctor or pharmacist if you are allergic to it; or to other anticholinergic drugs; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: are allergic to tiotropium, atropine (or similar drugs such as ipratropium or oxitropium) or to any other ingredients in the medicine or allergic to lactose or milk protein, are pregnant or breastfeeding

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: the eye condition called narrow-angle glaucoma, prostate problems or difficulty passing water (urine), kidney problems, or you are taking other medicines containing ipratropium or oxitropium.

Dry mouth a side effect often observed with anticholinergic medicines may in the long-term be associated with dental carries, so oral hygiene is important.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Alcohol intake is not known to affect tiotropium.

The elderly: tiotropium can be used in the elderly.

Pregnancy and breastfeeding - please ensure you read the detailed information below


The safety of tiotropium has not been established during pregnancy. Ask your doctor or pharmacist if you have any doubts or questions about this.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.


It is not known whether tiotropium passes into breast milk. The manufacturer therefore states that it should not be taken if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.


Before using this medicine, tell your prescriber of all the medicines you are taking including prescription medicines and medicines you have bought over the counter without a prescription. Tell your prescriber if you are taking vitamins or complementary remedies such as herbal products, as these can also interact with medicines.

If you are taking more than one medicine, these may interact with each other. Your prescriber may decide to use medicines which interact with each other if the benefit outweighs the risks. In these cases, the dose of your medicines may need to be adjusted or you may be monitored more closely.

The following medicines may interact with tiotropium:

  • Other anticholinergic drugs such as ipratropium
  • Oxitropium

This information does not contain all possible interactions. Therefore, tell your prescriber of all the products you are using before taking this medicine.

If you have a question or want to discuss anything about your medicine, speak to your local pharmacist.


Speak to your doctor immediately if you take more tiotropium than you should. You may be at a greater risk of side effects such as dry mouth, constipation, difficulty passing water (urine), increased heart rate and blurred eyesight.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of tiotropium or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.


If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up and do not take two doses on the same day.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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