Tiotropium: uses, dosing, side effects & brands
Tiotropium is an anticholinergic sold in the U.S. under 2 brand and generic names, for pulmonary emphysema and chronic bronchitis. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Anticholinergic
- Treats (across its forms)
- Pulmonary Emphysema and Chronic Bronchitis
- Available as
- Spray/Inhaler, metered · Capsule
- Sold as
- 2 products — Spiriva Respimat and Spiriva
- Prescription?
- Prescription only
- Generic available?
- Not in our catalog
- What the pharmacy pays
- about $354 for a 30-count supply — not your price
How Spiriva Respimat is dosed
From the FDA label for Spiriva Respimat (application NDA021936). Other tiotropium products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
To receive the full dosage of medication, SPIRIVA RESPIMAT must be administered as two inhalations once-daily. Do not take more than one dose (2 inhalations) in 24 hours. Prior to first use, the SPIRIVA RESPIMAT cartridge is inserted into the SPIRIVA RESPIMAT inhaler and the unit is primed. When using the unit for the first time, patients are to actuate the inhaler toward the ground until an aerosol cloud is visible and then repeat the process three more times. The unit is then considered primed and ready for use. If not used for more than 3 days, patients are to actuate the inhaler once to prepare the inhaler for use. If not used for more than 21 days, patients are to actuate the inhaler until an aerosol cloud is visible and then repeat the process three more times to prepare the inhaler for use [see Patient Counseling Information (17) ]. For oral inhalation only. To receive the full dose of medication, SPIRIVA RESPIMAT must be administered as two inhalations once-daily. Treatment of COPD: 2 inhalations of SPIRIVA RESPIMAT 2.5 mcg once-daily. ( 2 ) Treatment of asthma patients 6 years and older: 2 inhalations of SPIRIVA RESPIMAT 1.25 mcg once-daily. ( 2 ) 2.1 Chronic Obstructive Pulmonary Disease The recommended dosage for patients with COPD is 2 inhalations of SPIRIVA RESPIMAT 2.5 mcg per actuation once-daily; total dose equals 5 mcg of SPIRIVA RESPIMAT. 2.2 Asthma The…
Everything below is the FDA label for Spiriva Respimat (spray/inhaler, metered). Tiotropium is also sold as capsule, and those are different medicines to take — follow the label for the one you were prescribed.
Spiriva Respimat side effects
The following adverse reactions are described, or described in greater detail, in other sections: Immediate hypersensitivity reactions [see Warnings and Precautions (5.2) ] Paradoxical bronchospasm [see Warnings and Precautions (5.3) ] Worsening of narrow-angle glaucoma [see Warnings and Precautions (5.4) ] Worsening of urinary retention [see Warnings and Precautions (5.5) ] Because clinical trials are conducted under widely varying conditions, the incidence of adverse reactions observed in the clinical trials of a drug cannot be directly compared to the incidences in the clinical trials of another drug and may not reflect the incidences observed in practice. Since the same active ingredient (tiotropium bromide) is administered to COPD and asthma patients, prescribers and patients should take into account that the observed adverse reactions could be relevant for both patient populations independent of dosage strength. The most common adverse reactions in: COPD: (>3% incidence in the placebo-controlled trials with treatment durations of between 4 and 48 weeks) were pharyngitis, cough, dry mouth, and sinusitis. ( 6.1 ). Asthma: (>2% incidence in the placebo-controlled trials with treatment durations of between 12 and 52 weeks) were pharyngitis, headache, bronchitis, and sinusitis in adults. ( 6.2 ). To report SUSPECTED ADVERSE REACTIONS, contact Boehringer Ingelheim…
Who shouldn’t take Spiriva Respimat
SPIRIVA RESPIMAT is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, or any component of this product [see Warnings and Precautions (5.2) ] . In clinical trials with SPIRIVA RESPIMAT, immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported [see Warnings and Precautions (5.2) ] . Hypersensitivity to tiotropium, ipratropium, or any component of this product. ( 4 )
Spiriva Respimat drug interactions
Anticholinergics: May interact additively with concomitantly used anticholinergic medications. Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. ( 7.2 ) 7.1 Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. 7.2 Anticholinergics There is potential for an additive interaction with concomitantly used anticholinergic medications. Therefore, avoid coadministration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs as this may lead to an increase in anticholinergic adverse effects [see Warnings and Precautions (5.4 , 5.5) and Adverse Reactions (6) ].
Every tiotropium product we track (2)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 72/100 | Prescription | Spray/Inhaler | Generic | $354 | View → | |
| 2 | 70/100 | Prescription | Capsule | Generic | $354 | View → |
What tiotropium pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
Can you crush or split tiotropium?
At least one tiotropiumproduct is labelled to be swallowed whole — crushing an extended-release tablet releases the whole day’s dose at once. Which applies depends on the form you were given.
What each tiotropium label says about crushing, splitting and chewingHow long tiotropium keeps
No tiotropium label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does tiotropium expire? The in-use limits and storage rules from its labelsTiotropium and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for tiotropium: levels in milk, effects in breastfed infants, and the drugs it would consider insteadAlthough no published data exist on the use of tiotropium, its use produces negligible maternal serum levels and any drug in breastmilk would not be absorbed by the infant. The risk to the breastfed infant of maternal tiotropium inhalation is small. International guidelines agree that breastfeeding can continue during tiotropium therapy.
National Institute of Child Health and Human Development, record revised July 15, 2024. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about tiotropium
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 12,232 reports naming tiotropium, and the FDA flagged 91% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- dyspnoea3,302 reports
- asthma2,989 reports
- wheezing2,280 reports
- therapeutic product effect incomplete1,594 reports
- loss of personal independence in daily activities1,496 reports
- cough1,422 reports
- sleep disorder due to a general medical condition1,309 reports
- pneumonia1,126 reports
Read these as a signal, not a rate. A report does not mean tiotropium caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved August 26, 2026.
Related calculators
Frequently asked questions
What is Spiriva Respimat?
Spiriva Respimat (Tiotropium Bromide) is an anticholinergic used to treat Pulmonary Emphysema, Chronic Bronchitis.
What kind of drug is tiotropium?
The FDA classifies tiotropium as an anticholinergic. Anticholinergic drugs block acetylcholine, the chemical messenger of the body's "rest and digest" nervous system, by occupying its muscarinic receptors. This eases muscle spasms, dries up secretions, relaxes the bladder and airways, and speeds the heart, depending on the tissue. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take tiotropium with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run tiotropium against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is tiotropium sold under?
We track 2 tiotropium-containing products in the U.S.: Spiriva Respimat and Spiriva. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does tiotropium come in?
Across the brands we track, tiotropium is currently marketed as spray/inhaler, metered and capsule, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic tiotropium?
We do not currently list a generic-labelled tiotropium product. That does not always mean none exists — it means none appears under a generic name in the FDA data we track. Ask your pharmacist.
Cite this page
- APA
- pharmaranks. (2026, July 24). Tiotropium: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/tiotropium
- MLA
- “Tiotropium: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/tiotropium.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for tiotropium on DailyMed (NIH) ↗.