Proper Use

Drug information provided by: IBM Micromedex

Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. Also, do not stop using this medicine or any asthma medicine without telling your doctor. To do so may increase the chance of having breathing problems.

This medicine usually comes with patient instructions. Read them carefully before using the medicine. If you do not understand the instructions or have questions about using the inhaler, talk to your doctor.

Use this medicine at the same time each day.

Spiriva® capsules should only be used with the HandiHaler® device. Do not swallow the capsule. Spiriva® capsules should only be inhaled through your mouth (oral inhalation). Do not use the HandiHaler® device with any other medicine.

Do not allow the powder from the capsules to get in your eyes. If the powder does get in your eyes, it may cause blurred vision and pupil dilation (increased pupil size). If this happens, call your doctor right away.

To use the Spiriva® HandiHaler®:

  • Open the HandiHaler® device and the blister containing the capsule.
  • Put one capsule into the HandiHaler® device.
  • Press and then release the green piercing button on the side of the HandiHaler® device. Do not press the green button more than once.
  • Breathe out fully. Do not breathe into the mouthpiece of the HandiHaler® device.
  • Hold the HandiHaler® base, put the mouthpiece between your lips, and close your lips around the mouthpiece.
  • Breathe in slowly and deeply through your mouth as you can hear or feel the Spiriva® capsule vibrate. Do not breathe through your nose.
  • Hold your breath and remove the mouthpiece from your mouth. Then, breathe normally again.
  • After you are finished, open the mouthpiece and remove the used Spiriva® capsule and throw it away. Do not store any used or unused capsule in the HandiHaler® device.
  • Rinse the HandiHaler® device with warm water and keep it dry.

To use the Spiriva® Respimat® inhaler:

  • Take the inhaler and cartridge out of the carton before you use it for the first time.
  • Do not use the inhaler for this medicine with any other medicine.
  • Push the narrow end of the cartridge into the inhaler. About 1/8 of an inch will remain visible when the cartridge is correctly inserted.
  • Do not turn the clear base before inserting the cartridge.
  • Do not remove the cartridge once it has been inserted in the inhaler.
  • Flip the aqua cap until it snaps fully open. Turn the clear base in the direction of the black arrows on the label until it clicks (half a turn).
  • When you use the inhaler for the first time, or if you have not used it for 3 days or longer, it may not deliver the right amount of medicine with the first puff. Before using the inhaler, prime it by spraying the medicine 3 times into the air away from the face.
  • To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece fully into your mouth and close your lips around it. Do not block the mouthpiece with your teeth or tongue.
  • While pressing down firmly and fully on the dose release button of the inhaler, breathe in through your mouth as deeply as you can until you have taken a full deep breath.
  • Repeat these steps for the next puff.
  • Close the aqua cap after taking your medicine.
  • The inhaler has a window that shows the number of doses that are left. The counter will turn red when the inhaler has few doses left. This will remind you to refill your prescription.
  • Clean the inhaler mouthpiece daily with a damp cloth or tissue only, at least once a week.
  • Throw away the inhaler after 3 months from its first use.


The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For asthma:
    • For oral inhalation dosage form (spray):
      • Adults and children 6 years of age and older—2 puffs once a day. Each puff contains 1.25 microgram (mcg) of tiotropium. Do not take more than 2 puffs in 24 hours.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
  • For bronchospasm caused by COPD:
    • For oral inhalation dosage form (capsules):
      • Adults—2 puffs of the powder from one Spiriva® capsule (18 micrograms [mcg]) inhaled through the HandiHaler® device once a day.
      • Children—Use and dose must be determined by your doctor.
    • For oral inhalation dosage form (spray):
      • Adults—2 puffs once a day. Each puff contains 2.5 microgram (mcg) of tiotropium.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Do not use this medicine more than once every 24 hours.


Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Leave the capsules in the blister pack until you are ready to use the medicine. Only open one blister at a time when you are ready to remove a capsule and put it in the HandiHaler® device. Once you have opened a blister, use the capsule right away. After using the first capsule, the 2 remaining capsules should be used over the next 2 consecutive days. Capsules that are accidently exposed to air and not intended for immediate use should be discarded.