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Spiriva handihaler Prescription
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Generic Name: tiotropium inhalation (TYE oh TROE pee um)
Brand Names: Spiriva HandiHaler, Spiriva Respimat
Spiriva (tiotropium) is used to prevent bronchospasm in people with bronchitis, emphysema, or COPD. Includes Spiriva side effects, interactions and indications.
Generic Name: tiotropium inhalation (TYE oh TROE pee um)
Brand Names: Spiriva HandiHaler, Spiriva Respimat
Spiriva (tiotropium) is used to prevent bronchospasm in people with bronchitis, emphysema, or COPD. Includes Spiriva side effects, interactions and indications.
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30 tablets of Spiriva Handihaler 40 mg
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Spiriva Handihaler Drug Information:

Spiriva (tiotrOpium) is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. Spiriva is used to prevent bronchospasm (narrowing of the airways in the lungs) in adults with COPD (chronic obstructive pulmonary disease), including bronchitis and emphysema. Spiriva Respimat is also used to prevent asthma attacks in adults and children who are at least 6 years old. Spiriva Respimat is not for use in children. A Spiriva capsule is for use only in the HandiHaler device. Do not take the capsule by mouth. Use only one capsule at a time. Learn more

Spiriva Handihaler Side Effects

Note: This document contains side effect information about tiotropium. Some of the dosage forms listed on this page may not apply to the brand name Spiriva.

In Summary

Common side effects of Spiriva include: xerostomia. Other side effects include: infection and skin rash. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to tiotropium: inhalation capsule, inhalation spray

Along with its needed effects, tiotropium (the active ingredient contained in Spiriva) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tiotropium:

More common

  • Arm, back, or jaw pain
  • chest pain or discomfort
  • chest tightness or heaviness
  • fast or irregular heartbeat
  • nausea
  • sweating
  • trouble breathing

Less common

  • Cough
  • difficulty with swallowing
  • dizziness
  • hives, itching, or skin rash
  • painful blisters on the trunk of body
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • tightness in the chest
  • unusual tiredness or weakness


  • Fainting
  • fast, pounding, or irregular heartbeat or pulse
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Some side effects of tiotropium may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Acid or sour stomach
  • belching
  • bladder pain
  • bloody or cloudy urine
  • body aches or pain
  • chest pain
  • chills
  • congestion
  • cough
  • difficult, burning, or painful urination
  • dry mouth
  • dryness of the throat
  • ear congestion
  • fever
  • frequent urge to urinate
  • headache
  • heartburn
  • hoarseness
  • indigestion
  • loss of voice
  • lower back or side pain
  • pain or tenderness around the eyes and cheekbones
  • runny or stuffy nose
  • sneezing
  • sore throat
  • stomach discomfort, upset, or pain
  • tender, swollen glands in the neck
  • voice changes

Less common

  • Bloody nose
  • blurred vision
  • bone pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • canker sores
  • difficulty having a bowel movement (stool)
  • discouragement
  • feeling sad or empty
  • flushed, dry skin
  • fruit-like breath odor
  • increased hunger
  • increased thirst
  • increased urination
  • irritability
  • lack of appetite
  • leg pain
  • loss of interest or pleasure
  • muscle pain
  • nausea
  • painful or difficult urination
  • sore mouth or tongue
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • sweating
  • swelling or inflammation of the mouth
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • unexplained weight loss
  • vomiting

Incidence not known

  • Bloating
  • change in vision
  • diarrhea
  • red skin

For Healthcare Professionals

Applies to tiotropium: inhalation aerosol, inhalation capsule


The most commonly reported adverse reaction was dry mouth, usually mild and often resolved during continued treatment.

Other reactions consistent with possible anticholinergic effects included constipation, tachycardia, blurred vision, glaucoma (new onset or worsening), dysuria, and urinary retention.


Very common (10% or more): Pharyngitis (11.5%)

Common (1% to 10%): Respiratory tract infection, cough, sinusitis, rhinitis, epistaxis, dysphonia, chest pain, laryngitis

Rare (less than 0.1%): Epistaxis, bronchospasm,

Postmarketing reports: Pharyngolaryngeal pain, throat irritation, hoarseness


Common (1% to 10%): Palpitations, angina pectoris (including aggravated angina pectoris)

Uncommon (0.1% to 1%): Atrial fibrillation

Rare (less than 0.1%): Palpitations, supraventricular tachycardia, tachycardia


Common (1% to 10%): Pruritus, rash

Rare (less than 0.1%): Angioneurotic edema, urticaria, skin infection, skin ulcer, dry skin


Common (1% to 10%): Dry mouth, constipation, gastroesophageal reflux, oropharyngeal candidiasis, dyspepsia, abdominal pain, vomiting

Uncommon (0.1% to 1%): Dysphagia, gingivitis, intestinal obstruction including ileus paralytic, stomatitis (including ulcerative stomatitis)

Rare (less than 0.1%): Dental caries, glossitis

Frequency not reported: Nausea

Postmarketing reports: Oral candidiasis, throat irritation, mouth ulceration


Common (1% to 10%): Urinary tract infection

Uncommon (0.1% to 1%): Urinary retention, dysuria


Common (1% to 10%): Allergic reactions

Rare (less than 0.1%): Angioedema, hypersensitivity (including immediate reactions)

Frequency not reported: Anaphylactic reactions


Common (1% to 10%): Hypercholesterolemia, hyperglycemia

Frequency not reported: Dehydration


Common (1% to 10%): Myalgia, arthritis, skeletal pain, leg pain

Frequency not reported: Join swelling

Nervous system

Common (1% to 10%): Dizziness, paresthesia

Uncommon (0.1% to 1%): Headache, insomnia, taste disorder


Common (1% to 10%): Cataract

Uncommon (0.1% to 1%): Blurred vision

Rare (less than 0.1%): Glaucoma, intraocular pressure increased


Common (1% to 10%): Edema, infections, moniliasis, influenza-like symptoms, herpes zoster


Common (1% to 10%): Depression

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/3/2022.

Source: Drugs.com Spiriva Handihaler (www.drugs.com/spiriva.html).