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Tiotropium (as Bromide)

Chronic obstructive pulmonary disease is a condition which affects the respiratory system, inhibiting breathing and inducing a phlegmy cough.

  1. Mainly caused by smoking
  2. Treatable with bronchodilator medicine
  3. Often given as a daily inhaler powder or capsule

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PLEASE NOTE: This treatment is not available through our online pharmacy service. This page is for information only. If you are experiencing any of the symptoms related to the condition(s) this medication treats, we strongly recommend that you see your GP in person.

This content was reviewed by a clinician on

27 August 2020
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 27 August 2020
Product information

Spiriva is a treatment used in COPD. It is supplied as a capsule, which is taken through a device called a HandiHaler. The device pierces the capsule to release a powder, which is then inhaled by the user. Spiriva is manufactured by Boehringer Ingelheim and is only available to buy in the UK on prescription.

  1. Long-acting bronchodilator
  2. Simple to administer
  3. Relieves breathing difficulties

Chronic obstructive pulmonary disease is a term used to describe several conditions, including bronchitis, emphysema and chronic obstructive airways disease. It is largely caused by smoking, and is more prominent in those aged 35 and over; however it can occasionally be the result of repeated exposure to dust, fumes or pollutants. Such elements cause COPD by irritating the airways and leading to inflammation.

The most common symptoms of COPD are a phlegmy cough, wheeziness during periods of exertion and loss of breath. Often, these symptoms are mistaken for smoker’s cough, which is why only one third of the estimated 3 million people with COPD living in the UK are thought to have been given a diagnosis.

One of the first measures a doctor will take when treating the condition will be to advise the patient to eliminate the irritant causing it. COPD is a progressive condition, and continuing to expose the airways to irritants will exacerbate symptoms. To alleviate symptoms associated with the condition, a doctor may also issue a bronchodilator such as Spiriva, to facilitate easier breathing.

In this medication, the active ingredient is an antimuscarinic called tiotropium bromide monohydrate. This works by preventing the action of a chemical called acetylcholine, which can cause the muscles lining the airway to tense up and contract. Once the airways have been dilated, breathing becomes easier, and the symptoms of COPD become less severe.

We do not offer COPD treatments through our online service. See your GP to discuss suitable medication options, or renew your prescription.

Page last reviewed:  27/08/2020

It is crucial to read the instructions provided carefully prior to use, and to make sure that you follow the directions issued by your prescriber. This will help you to get the most benefit from your medicine and help to limit the risk of side effects.

  1. Take as directed.
  2. For COPD the recommended dose is one inhaled capsule per day.
  3. It is recommended that you do so at the same time each day, as the treatment provides relief for 24 hours.
  4. The capsules are to be used via the HandiHaler only. They should not be swallowed.
  5. Open the dust cap by pressing in the button and lifting the lid.
  6. Place one capsule in the compartment inside the HandiHaler.
  7. Close the mouthpiece over the compartment. You should hear a click.
  8. To puncture the capsule, press in the button and release.
  9. Breathe out fully.
  10. Place the mouthpiece in your mouth.
  11. Inhale slowly and deeply as far as you can, then hold your breath for as long as is comfortable. Remove the mouthpiece and commence breathing normally again.
  12. Once you have taken the dose, empty the HandiHaler and store with the dust cap secured.
  13. More detailed instructions and diagrams can be found in the leaflet.
  14. Do not take more than the prescribed amount.
  15. If you forget to take it, you can do so when you remember provided your next dose is not due. If your next dose is due, skip the one you have missed and take your next administration at the scheduled time.

The above is provided only as a guide. For more comprehensive instructions, please consult the leaflet supplied with the medicine.

Download PDF

Page last reviewed:  27/08/2020
Please read the patient information leaflet for this medicine fully before use:

Spiriva 18mcg

Spiriva 18 mcg with Handihaler

Side effects & Warnings

It is vital to be aware of the potential side effects this medication may cause, so that you can seek immediate medical advice if necessary. Contact your doctor or your nearest hospital as soon as possible if you notice any signs of: an allergic reaction, such as swelling of the face, lips, mouth or throat, or hives; worsening of COPD symptoms; or any other side effects which could be harmful or cause you concern.

Common (1 in 10 people or less):

Mild oral dryness.

Uncommon (1 in 100 people or less):

Dizziness, headache, unpleasant taste, blurred vision, irregular heartbeat, sore throat, hoarseness, cough, heartburn, constipation, urinary retention or pain, fungal infections of the mouth and throat, or a rash.

Rare (1 in 1,000 people or less):

Sleeping difficulty, sight problems, palpitations, tightness of the chest after inhalation, nosebleed, laryngitis, inflammation of the sinuses, blockage of the intestines, gingivitis, difficulty swallowing, feeling or being sick, itching, or urinary tract infections.

This is only a summary of the side effects associated with this product. For more detailed information, please refer to the leaflet provided with the medicine.

Taking it with other medicines

Let your doctor know if you are using other medicines, whether or not they are for similar conditions.

Conditions to look out for

Those who have or have ever had any of the following conditions may not be able to use this treatment, and should notify their doctor during consultation as appropriate: glaucoma; prostate problems difficulty passing urine; lactose intolerance; kidney problems; a myocardial infarction during the last six months; irregular heartbeat or severe heart failure.

Pregnancy and breastfeeding

Talk to your doctor before using this medication if you are pregnant, breastfeeding or trying to conceive.

Driving and using machinery

If you experience any side effects such as dizziness or blurred vision, do not drive or operate machines, and tell your doctor.

Lactose intolerance

If you are intolerant to any sugars, let your prescriber know. Spiriva contains lactose.

Page last reviewed:  27/08/2020
Please read the patient information leaflet for this medicine fully before use:

Spiriva 18mcg

Spiriva 18 mcg with Handihaler


Can I still drink alcohol?

Yes, alcohol is not thought to affect the way this treatment works.

Will I still be able to drive?

Yes, provided you experience no side effects which may cause your motor skills and judgment to become compromised. If you do, avoid driving and visit your doctor as soon as possible.

Can I take the medicine while pregnant?

If you are pregnant, breastfeeding or planning to become pregnant, discuss the use of this medicine with your doctor or family planning nurse prior to use.

How should I store it?

Keep in a safe place below 25°C and out of the reach of children.

Am I allergic to anything in the medicine?

This item contains: tiotropium (as bromide monohydrate) and lactose monohydrate.

Do not use it if you are allergic to any of these ingredients.

Is it available over-the-counter?

You will require a prescription to be able to buy Spiriva, which can be obtained from your doctor following a review of your condition.

Is it right for me?

The medicine you use for COPD will ultimately be decided on during consultation with your GP or respiratory nurse. Make an appointment with them to find out more about treatment options.

Page last reviewed:  27/08/2020 is rated 4.9 out of 5 by 3209 customers on TrustPilot!
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