Key takeaways

  • Spiriva (tiotropium), available as Respimat and Handihaler, is prescribed to treat COPD and asthma but should not be used as a rescue inhaler for sudden breathing issues.
  • Common side effects of Spiriva include cough and dry mouth, while serious side effects can include allergic reaction and worsening of glaucoma.
  • It’s important to discuss any existing conditions, such as kidney problems or glaucoma, with your doctor before using Spiriva, and to report any side effects experienced during treatment.

Spiriva Respimat and Spiriva HandiHaler treat chronic obstructive pulmonary disease (COPD) in adults. Spiriva Respimat is also used to treat asthma in adults and certain children. Both forms of the drug contain the active ingredient tiotropium.

  • Spiriva Respimat comes with a device (the Respimat) and a cartridge. The cartridge contains the liquid form of Spiriva. You’ll use the Respimat to inhale Spiriva mist into your lungs.
  • Spiriva HandiHaler comes with a device (the HandiHaler) and Spiriva powder capsules. The HandiHaler pierces the capsules to release Spiriva powder which you breathe in through your mouth using the HandiHaler.

Spiriva is not a rescue inhaler. You should not use it to treat sudden breathing problems from your condition.

Keep reading to learn about the common, mild, and serious side effects Spiriva can cause.

Some people may experience mild to serious side effects during Spiriva treatment.

The following are a few of the more common side effects reported by people using Spiriva Respimat in studies. These side effects can vary depending on the condition you’re using the drug to treat.

Common side effects in people using Spiriva Respimat for asthma include:

Common side effects in people using Spiriva Respimat for COPD include:

Common side effects reported in studies of people using Spiriva HandiHaler for COPD include:

To learn more about some of these side effects, see the “Side effects explained” section.

Mild side effects have been reported with Spiriva and can vary depending on the condition you’re using the drug to treat. Mild side effects of Spiriva include:

Usually, these side effects are temporary — and some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop using Spiriva unless your doctor recommends it.

To learn more about some of these side effects, see the “Side effects explained” section.

Spiriva may cause mild side effects other than those listed here. See the prescribing information for Spiriva Respimat and Spiriva HandiHaler for details.

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Serious side effects have been reported with Spiriva and can vary depending on the condition you’re using the drug to treat. Serious side effects include:

To learn more about some of these side effects, see the “Side effects explained” section.

If you develop serious side effects while using Spiriva, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect from using Spiriva and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Get answers to some frequently asked questions about Spiriva’s side effects.

It’s unlikely. Both forms of Spiriva (Respimat and HandiHaler) contain the same active ingredient, tiotropium bromide. And they both have several common side effects, including dry mouth, pharyngitis, and sinusitis.

However, side effects you may experience depend on several factors, such as:

• the condition you’re using the drug to treat
• your age
• other medications you take
• other health conditions you may have

If you have questions about side effects of the different forms of Spiriva, ask your doctor or pharmacist for more information. If you plan to use Spiriva to treat COPD, they can recommend the best form for you. (Only Spiriva Respimat is used to treat asthma.)

No, people using Spiriva Respimat or Spiriva HandiHaler in studies did not report weight gain as a side effect. But it may be caused by other conditions you have or other medications you take.

If you’re concerned about weight gain during Spiriva treatment, talk with your doctor. They can recommend ways to help you reach or maintain a moderate weight.

No, people using Spiriva Respimat or Spiriva HandiHaler in studies did not report anxiety. But it is a symptom of breathing conditions such as asthma and COPD. And some serious side effects of Spiriva, such as bronchospasm (sudden airway tightening), can make breathing difficult. This may cause you to have anxiety.

If you experience anxiety during Spiriva treatment, talk with your doctor. They can discuss possible causes with you and suggest ways to help you manage this symptom.

Learn more about some of the side effects Spiriva may cause.

Urinary tract infection (UTI)

Spiriva can increase your risk of a UTI. This was a mild side effect in Spiriva Respimat and Spiriva HandiHaler studies. Symptoms of a UTI may include:

What might help

If you have symptoms of a UTI, call your doctor. They’ll diagnose your condition and treat it if needed.

Tell your doctor if you’re prone to frequent UTIs. If they prescribe Spiriva for you, they may monitor you for signs of UTI. In some cases, they may recommend a different treatment for your condition.

Upper respiratory tract infection

Spiriva can increase your risk of getting an upper respiratory infection, such as the common cold. This was a common but mild side effect in studies of the drug. Symptoms may include:

What might help

Tell your doctor if you have an infection before starting Spiriva. They’ll likely treat the infection before you begin using Spiriva.

If you develop an upper respiratory infection while using Spiriva, call your doctor. They’ll diagnose you based on your symptoms and suggest treatment options. They may have you temporarily stop using Spiriva until your infection clears up.

Ask your doctor if you have questions about your risk of an upper respiratory infection.

Pharyngitis

Spiriva can increase your risk of pharyngitis (sore throat). This was a common but mild side effect in Spiriva Respimat and Spiriva HandiHaler studies.

What might help

Pharyngitis is a mild side effect that usually goes away after a few days to weeks of Spiriva treatment. But if you have a bothersome sore throat that doesn’t go away, tell your doctor. Sometimes, pharyngitis may be a sign of an upper respiratory infection. In this case, your doctor will diagnose your condition and treat the infection if necessary.

Sinusitis

Spiriva can increase your risk of sinusitis (swelling in your sinuses). This was a common but mild side effect of the drug. Symptoms of sinusitis can include:

Sometimes, sinusitis may be due to an upper respiratory infection or a sinus infection.

What might help

Sinusitis is a mild side effect of Spiriva that’s usually temporary. But if you have symptoms that are serious, ongoing, or bothersome, talk with your doctor. They can diagnose the cause and suggest ways to ease your symptoms.

The following tips might help you manage mild symptoms at home:

  • Use a humidifier in your bedroom.
  • Apply a warm, damp cloth to your forehead and sinus areas.
  • Use nasal saline to rinse mucus from your nostrils and sinuses.

If you have an upper respiratory or sinus infection, you may need a prescription medication to treat the infection.

Allergic reaction

Like most drugs, Spiriva can cause an allergic reaction in some people. This side effect rarely happened in studies of Spiriva Respimat and Spiriva HandiHaler. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

If your doctor confirms you’ve had a mild allergic reaction to Spiriva, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Spiriva, they may have you switch to a different treatment.

Spiriva may not be right for you if you have certain medical conditions. This is known as a drug-condition interaction. Other factors may also affect whether Spiriva is a good treatment option for you. Talk with your doctor about your health history before starting this drug. Factors to consider include those described here.

Alcohol and Spiriva

There are no known interactions between alcohol and Spiriva. If you plan to drink while using Spiriva, talk with your doctor. They can discuss your risks and a safe amount for you to drink during treatment.

Pregnancy and breastfeeding with Spiriva

The effects of Spiriva use during pregnancy or while breastfeeding are unknown.

If you’re pregnant or planning to become pregnant, talk with your doctor about the safety of Spiriva use.

If you’re breastfeeding or planning to breastfeed a child while using Spiriva, talk with your doctor. They can discuss with you the risks and benefits of Spiriva treatment during this time. They may recommend feeding your baby a different way if you plan to use this medication.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.