If you have breathing problems, your doctor may suggest that you try to use the drug Spiriva.

Spiriva is a prescription drug that helps ease breathing difficulties caused by chronic obstructive pulmonary disease (COPD) or asthma. It comes in two forms, and which form your doctor prescribes depends on your age and condition:

  • Spiriva Respimat is used for COPD in adults and for asthma in adults and some children.
  • Spiriva HandiHaler is used for COPD in adults.

The active ingredient in Spiriva is tiotropium bromide. An active ingredient is what makes a drug work. Spiriva belongs to a class of medications known as anticholinergic drugs.

Both the liquid solution and the powder-filled capsule of the same name are available. Each includes an inhaler. You can take puffs of the drug with the provided inhaler.

This article describes the dosages of Spiriva, its strengths, and how to use it. To learn more about Spiriva, see this in-depth article.

Note: This chart highlights the basics of Spiriva’s dosages. Be sure to read on for more details.

Spiriva forms Spiriva strengths Usual dosage
Spiriva Respimat • The amount ofmcg per puff is 1.25.
• 2.5 mcg per puff.
two puffs once per day
Spiriva HandiHaler 18 mcg per powder-filled capsule two puffs (contents of one powder-filled
capsule) once per day

Please keep in mind that this article covers Spiriva’s standard dosage schedules, which are provided by the drugmaker. But always follow the dosing instructions your doctor prescribes.

Read on to find out more about the dosage.

What are the forms of Spiriva?

You use the liquid solution and the inhaler to take the drug.

The capsule is powder-filled. You can take puffs of the drug from the package.

What strengths does Spiriva come in?

The two strengths of the product are:

  • The amount ofmcg per puff is 1.25.
  • 2.5 mcg per puff.

The capsule is 18-mcg.

What are the usual dosages of Spiriva?

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Spiriva Respimat dosing for asthma

For asthma in adults, the recommended daily dose of Spiriva Respimat is 2.5 mcg. You’ll take this dose as two 1.25-mcg puffs once per day.

Spiriva Respimat dosing for COPD

For chronic obstructive pulmonary disease (COPD) in adults, the recommended daily dose of Spiriva Respimat is 5 mcg. You’ll take this dose as two 2.5-mcg puffs once per day.

Spiriva HandiHaler dosing for COPD

The contents of one capsule is what the recommended dosage of the COPD medication is. You will take two puffs per day to make sure you get the full dose.

What’s the dosage of Spiriva for children?

Asthma can cause breathing difficulties in children ages 6 years and older.

The usual daily dose is 2.5 mcg. A child would take this dose twice a day.

Children are not allowed to use the HandiHaler.

Is Spiriva used long term?

It is usually used as a long-term treatment. If you and your doctor agree that it is safe and effective for your condition, you will likely use it for a long time.

There are answers to some questions about the dosage.

Can I use Spiriva twice daily?

It is not recommended to use it more than once a day. Side effects or overdose can be caused by taking more than the recommended amount. The “What should be done in case of overdose?” section below contains more information about the latter.

If you are having breathing difficulties, talk to your doctor about the current dose of Spiriva. They may suggest other options or have you take another medication.

What is the maximum dose I can take for Spiriva?

The maximum dose of Spiriva Respimat for chronic obstructive pulmonary disease (COPD) is 5 micrograms (mcg) per day. The maximum dose of Spiriva Respimat for asthma is 2.5 mcg per day.

The maximum daily dose of HandiHaler is 18 mcg.

The instructions for using the HandiHaler form are dependent on whether you are prescribed the Respimat form. The steps for each form are below. Your doctor will give you instructions on how to use the inhalers. They give you instructions.

For information on the expiration, storage, and disposal of Spiriva, see this article.

Spiriva Respimat

The first time you use your inhaler, follow these steps.

  1. Remove the clear base from the inhaler by pressing the safety catch on it. The date should be written on the label.
  2. The narrow end of the cartridge is where you want to put the inhaler.
  3. Press down until the bottom of the inhaler clicks into place.
  4. The base should be put back on the inhaler and turned in the direction of the label arrows.
  5. Open the cap.
  6. Press the dose-release button when pointing the inhaler toward the ground. The cap needs to be closed.
  7. “If you don’t see a mist, repeat steps 4 through 6.”
  8. If a mist appears, repeat steps 4 through 6 three more times. Your inhaler is ready to use.

The dose can be taken using the Spiriva Resp inhaler.

  1. The base should be turned in the direction of the label arrows when the cap is closed.
  2. Open the cap.
  3. Slowly breathe out.
  4. Close your lips and point the inhaler at the back of your throat.
  5. Take a deep breath and press the button.
  6. Hold your breath for a while.
  7. You should repeat steps 1 through 6.
  8. The cap needs to be closed.

The drugmaker provides illustrated directions for using Spiriva Respimat, as well as a video. Your doctor or pharmacist can also show you how to use this product.

Spiriva HandiHaler

The steps to take your dose using the HandiHaler device are listed below.

  1. Press the green button to open the dust cap lid if you want to remove the inhaler from its pouch.
  2. The base has a dust cap lid.
  3. Pull up on the mouth piece.
  4. Remove the foil from the capsule to make it easier to remove it.
  5. The capsule should be placed in the center chamber of the inhaler.
  6. Close the mouth and you will hear a click.
  7. The green button is used to pierce a hole.
  8. Slowly breathe out.
  9. Close your lips when holding the inhaler.
  10. You can breathe through your mouth until your lungs are full.
  11. Hold your breath for a few seconds. Take the inhaler out of your mouth.
  12. The second dose is repeated in steps 8 through 11.

The drugmaker provides illustrated directions for using Spiriva HandiHaler. Your doctor or pharmacist can also show you how to use this product.

Accessible drug containers and labels

“If you can’t read the prescription label on your medication, you should tell your doctor or pharmacist. Some pharmacies have labels for medication.”

  • Large print or use of blind.
  • You can use a code on a phone to change the text to sound.

“If your current pharmacy doesn’t offer accessibility features, your doctor or pharmacist may be able to recommend a new pharmacy.”

If you miss a dose, take it as soon as you remember. If you missed the scheduled dose, take your next one. Do not take more than one dose in a day.

If you need help remembering to take your dose of Spiriva on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

If you use more of it than your doctor prescribes, you can end up with serious side effects.

Symptoms of overdose

Symptoms of overdose reported with Spiriva Respimat include dry mouth.

Symptoms of overdose reported with Spiriva HandiHaler include dry mouth and conjunctivitis (pink eye). After the HandiHaler form became available on the market, one person reported symptoms such as a change in mental status, tremors, belly pain, and constipation. But it’s unknown how likely such symptoms are to occur from taking too much Spiriva.

What to do in case you use too much Spiriva

Call your doctor right away if you think you’ve used too much Spiriva. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

The dosages provided by the drugmaker are described in the sections above. If your doctor recommends it, they will prescribe the right amount of the drug.

Remember, you should not change your dosage of Spiriva without your doctor’s recommendation. Only use Spiriva exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Some questions you may want to ask your doctor.

  • Will you prescribe a different dosage of Spiriva if I’m taking other medications for asthma or COPD?
  • “Will you change my dose if it isn’t working for me?”
  • Which form of Spiriva would be better for COPD?

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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.