Sounds like 'tee-oh-tro-pee-um'

Easy-to-read medicine information about tiotropium – what it is, how to take tiotropium safely and possible side effects.

Type of medicineAlso called
  • Bronchodilator (opens the airways)
  • Anticholinergic inhaler
  • Spiriva®
  • Spiriva Respimat®

What is tiotropium?

  • Tiotropium is used to treat the symptoms of  chronic obstructive pulmonary disease (COPD).
  • It works by relaxing and opening up the air passages and this makes breathing easier —  relieves shortness of breath, chest tightness and wheezing.
  • Tiotropium is not used to treat sudden breathing problems. Always have a rescue inhaler or quick-acting inhaler with you to treat sudden symptoms.
  • Tiotropium is available as inhalation capsules (called Spiriva) to be used with the Handihaler inhaler device or as a metered dose mist inhaler called Spiriva Respimat®.


  • The dose of tiotropium is different depending on which inhaler device you are using.
  • Dry powder inhaler (Spiriva Handihaler®):
    • The dose is 1 tiotropium capsule inhaled once a day.
    • Inhale the powder in the capsules using the Handihaler device. Do not swallow the capsules.
  • Metered dose mist inhaler (Spiriva Respimat®):
    • The dose is 2 puffs inhaled once a day.
  • Tiotropium is a long-acting medication which means that its effects lasts for 24 hours.
  • Follow your doctor's instructions carefully. The pharmacy label on your medicine will tell you how much to use, how often to use it and any special instructions.

How to use tiotropium

Special instructions

  • Use your tiotropium inhaler once a day.
  • Try using it at about the same time each day.
  • Tiotropium starts working within a few hours, but it may take longer to feel the full effects.
  • Discard the Spiriva® blister pack 9 days after opening.
  • Discard the Spiriva Respimat® inhaler 90 days after first use.
  • If you miss a dose, take it as soon as you remember.
  • However, if it is nearly time for your next dose, take the next dose at the usual time. Do not take double the dose.
  • Keep using tiotropium every day, even if you feel better. This will help to keep you free of symptoms throughout the day and night.

Possible side effects

Like all medicines tiotropium can cause unwanted side effects, although not everyone gets them. Often unwanted side effects improve as your body adjusts to the new medicine.

Side effectsWhat should I do?
  • Dry mouth
  • A change in voice (hoarse voice)
  • A different taste in your mouth
  • After using your handihaler or inhaler device, rinse your mouth to prevent dry mouth and throat irritation
  • Tell your doctor if troublesome.
  • Headache
  • Difficulty urinating (peeing)
  • Tell your doctor if troublesome
  • Changes in your heartbeat (fast or irregular)
  • Tell your doctor immediately or ring Healthline on 0800 611 116
  • Difficulty breathing or worsening of your breathing problem.
  • Tell your doctor immediately or ring Healthline on 0800 611 116

Learn more

Medsafe Consumer Information Sheets:

Spiriva Respimat

Credits: Sandra Ponen, Pharmacist. Reviewed By: Carolyn Woolerton, Pharmacist, MedWise, August 2016