Tiotropium (Spiriva): Uses, Side Effects, and How to Take It
Tiotropium is a long-acting bronchodilator that opens airways and is used to help prevent wheezing and breathing problems in COPD. Depending on the product, it may also be used as an add-on treatment for asthma that is not well controlled. It is not a rescue medicine for sudden breathing attacks.
Use tiotropium exactly as prescribed, usually once daily, and do not rely on it for sudden breathing trouble. Ask a doctor or pharmacist if you have glaucoma, urinary problems, or take other medicines that also open the airways.
Key facts at a glance
- ATC
- R03BB04
- Generic
- Tiotropium
- Class
- anticholinergic
- Brands
- Spiriva
- Availability
- rx
- Pregnancy
- C
- Lactation
- caution
- Half-life (h)
- 200
- Onset (min)
- 30
- Duration (h)
- 24
- Routes
- inhaled
- Forms
- inhaler
- Regions
- CN, US, EU, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
first trimesteravoid if possible
use only if benefits outweigh risks to the fetus
regular prenatal monitoring
Use with caution and monitor for adverse effects.
pregnancy
second third trimesteravoid if possible
continue only if benefits outweigh risks
regular fetal monitoring and uterine activity assessment
Use with caution and monitor for adverse effects.
lactation
n/adiscontinue breastfeeding or avoid
not recommended during breastfeeding due to unknown excretion in milk
monitor infant for anticholinergic effects
geriatric
age 65 and olderno specific adjustment required
use with caution due to anticholinergic effects, assess cognitive function and urinary retention risk
monitor for cognitive changes, urinary retention, and constipation
Use with caution and monitor for adverse effects.
pediatric_age
under 18 yearsnot applicable
do not use in patients under 18 years of age
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
severe crcl below 50reduce dose to once daily
use 5 mcg once daily instead of 5 mcg twice daily, monitor renal function
regular monitoring of renal function and serum creatinine
Use with caution and monitor for adverse effects.
renal_impairment
moderate mild crcl above 50no adjustment needed
standard dosing may be used
periodic renal function monitoring
hepatic_impairment
any severityno adjustment required
standard dosing recommended, limited data but hepatic metabolism minimal
standard clinical monitoring
Statistics and clinical data
FDA approval year
First FDA approval for Spiriva
Drug class
Long-acting muscarinic antagonist
Primary indications
Main therapeutic indications
Mechanism of action
Pharmacological mechanism
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 22, 2026. · Read our editorial policy