Tiotropium Inhalers

What are tiotropium inhalers?

Tiotropium is a long-acting bronchodilator used in inhalers to help manage chronic lung conditions. It works by relaxing the muscles around the airways, making it easier to breathe. Tiotropium is not a rescue inhaler, but a maintenance treatment used regularly to prevent symptoms. You can only get it on prescription and common brand names in the UK include Braltus, Spiriva, and Spiriva Respimat[1]. 

What are tiotropium inhalers used for?

Tiotropium inhalers are prescribed to manage the symptoms of long-term lung conditions, specifically[1]: 

• Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema 

• Asthma, as an additional treatment for adults and children aged 6 years and over when other inhalers are insufficient 

How do tiotropium inhalers work?

Tiotropium is an anticholinergic bronchodilator. It works by blocking the action of acetylcholine, a chemical messenger that causes the airway muscles to tighten. This action[1]: 

• Opens the airways 

• Reduces breathlessness 

• Helps prevent flare-ups 

Because its effects last for 24 hours, it is taken once daily.

Who can take tiotropium inhalers?

Tiotropium is suitable for[1]: 

• Adults with COPD or asthma 

• Children aged 6 years and older (for asthma, under specialist advice) 

However, you should speak to your doctor first if you[1]: 

• Are allergic to tiotropium, atropine, or similar medicines 

• Have glaucoma, urinary retention, or prostate problems  

• Have had a heart attack in the last 6 months, heart failure, or heart arrhythmia 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of tiotropium inhalers?

The typical dose is one puff (or capsule) once daily, at the same time each day. It is important not to exceed the prescribed dose or use it to relieve sudden breathing problems[1]. 

How do you take tiotropium inhalers?

The method of use depends on the device prescribed. Here’s what you need to know[1]: 

• Respimat inhaler: This device delivers a fine spray. To use it, turn the base, open the cap. Press the button whilst breathing in slowly and deeply, holding your breath after for a few seconds. 

• Zonda or Handihaler: These devices use a capsule that contain a dry powder. It is important not to swallow this capsule. Place the capsule into the device. Close the device and pierce the capsule by pressing the button once but firmly. This prevents small pieces of capsule breaking off. Breathe in the powder through the mouthpiece with a quick  strong inhale. Once used, discard the empty capsule. 

Always follow the instructions provided with your inhaler or from your healthcare provider. 

Can you stop taking tiotropium inhalers?

You should not stop taking tiotropium unless advised by your pharmacist or doctor. It is a long-term treatment and stopping may cause symptoms to return or worsen[1]. 

What do you do if you take too much tiotropium inhalers?

Taking too much tiotropium can lead to side effects such as[1]: 

• Blurred vision 

• Dry mouth 

• Fast heartbeat 

• Difficulty urinating 

If you suspect an overdose, contact your GP, NHS 111, or go to A&E immediately[1]. 

What do you do if you forget to take tiotropium inhalers?

If you forget a dose[1]: 

• Take it as soon as you remember 

• If it’s nearly time for your next dose, skip the missed one 

• Do not take a double dose to make up for the missed one 

How to store tiotropium inhalers

Proper storage is essential to maintain effectiveness[1]: 

• Keep inhalers in their original packaging 

• Store capsules in their bottle or blister pack, not inside the inhaler 

• Keep away from moisture and heat 

• Do not freeze 

What medicines can’t you take with tiotropium inhalers?

Tiotropium may interact with certain medicines. Be cautious if you are taking[1]: 

• Other anticholinergics (e.g. ipratropium, atropine) 

• Medicines for bladder issues (e.g. oxybutynin) 

• Medications for Parkinson’s disease (e.g. benztropine) 

• Antihistamines 

• Some medicines for nausea or travel sickness (e.g. scopolamine) 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of tiotropium inhalers?

Common side effects of tiotropium inhalers include[1]: 

• Dry mouth 

• Headache 

• Cough 

• Throat irritation 

Less common or rare side effects may include[1]: 

• Constipation 

• Blurred vision 

• Difficulty urinating 

• Sleeping problems 

• Heart palpitations 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

 If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about tiotropium inhalers

Is tiotropium a steroid? 
No, it is a bronchodilator, not a steroid[1]. 

Can I use tiotropium during an asthma attack? 
No, it is not a rescue inhaler and will not provide immediate relief[1]. 

How long does it take to work? 
It begins working within about 30 minutes, but full benefits develop over several days with continued use[1]. 

Can I use tiotropium with my blue inhaler? 
Yes, but only if advised by your doctor[1]. 

Is it safe during pregnancy? 
It should only be used if clearly needed and under medical supervision[1]. 

Can I drink alcohol while using tiotropium? 
Yes, there are no known interactions with alcohol[1]. 

Can I use it if I have kidney problems? 
Possibly. Your doctor may monitor your condition more closely if you do[1]. 

What if I accidentally swallow the capsule? 
It won’t be effective but may cause you to experience the side effects listed. Contact your doctor if you are unsure what to do[1]. 

For the official NHS guide to tiotropium inhalers, visit their website.