Spiriva (Tiotropium) belongs to a class of medications called bronchodilators. Spiriva (Tiotropium) helps preventing symptoms of lung disease such as wheezing, shortness of breath, coughing, and chest tightness in patients with chronic obstructive pulmonary disease (COPD). COPD also includes chronic bronchitis (swelling of the tubes leading to the lungs) and emphysema (damage to the air sacs in the lungs). This medication works by relaxing and opening the air passages to the lungs to make breathing easier.

Doctor's prescription is required to use this medicine.

Always use Spiriva (Tiotropium) as directed by your physician.

Follow all directions on your prescription label and read all medication guides or instruction sheets. This medicine usually comes with patient instructions. Read them carefully before using the medicine. If you do not understand the instructions or have questions about using the inhaler, talk to your doctor.

Spiriva (Tiotropium) comes as a capsule to use with a specially designed inhaler. Use the inhaler to breathe in the dry powder contained in the capsules. It is usually taken once a day in the morning or evening. Take Spiriva at around the same time every day. Do not stop taking Spiriva without talking to your doctor.

Do not swallow tiotropium capsules.

Any child using Spiriva should be supervised by an adult while using this medicine.

Do not take more or less of it or take it more often than prescribed by your doctor.

Always use Spiriva (Tiotropium) exactly as directed by your doctor.

Before using Spiriva (Tiotropium), tell your doctor or pharmacist if you are allergic to it or any other medications. Tell your doctor or pharmacist about your medical history. Tell your doctor about all the other prescription and nonprescription medications you are taking.

Do not use Spiriva if you are allergic to tiotropium or ipratropium.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• narrow-angle glaucoma;

• kidney disease;

• a milk allergy; or

• an enlarged prostate or urination problems.

Do not take the capsule by mouth.

Spiriva (Tiotropium) capsule will only work if you use the inhaler it comes with to inhale the powder in the capsules. Never try to inhale them using any other inhaler. Never use your tiotropium inhaler to take any other medication.

Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tiotropium, call your doctor.

Be careful not to get tiotropium powder in your eyes. If tiotropium powder gets into your eyes, your vision may become blurred and you may be sensitive to light. Call your doctor if this happens.

NOTE: This medicine is only for you. Do not share this medicine with others.

Contact your doctor at once if you have:

• Wheezing, choking, or other breathing problems after using this medicine
• Blurred vision, eye pain or redness, seeing halos around lights
• Sores or white patches on your mouth, lips, or tongue
• Pain or burning when you urinate
• Little or no urinating.

Common Spiriva side effects may include:

• Dry mouth
• Blurred vision
• Constipation, painful urination
• Upset stomach
• Chest pain, fast heart rate
• Cold symptoms such as stuffy or runny nose, sinus pain, sore throat

This is not a colpete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What happens if I miss a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What happens if I overdose?

In case of overdose, seek emergency medical attention or call the Poison Help line.

Overdose symptoms may include dry mouth, eye redness, constipation, stomach pain, and confusion or drowsiness.

Where should I keep my medicine?

Keep out of reach of children.

Store the medicine at room temperature.

Throw away any unused medicine after the expiration date.

What should I avoid while taking this medication?

Avoid getting the powder from a Spiriva capsule in your eyes. If this does happen, call your doctor.

Avoid driving or hazardous activity until you know how this medication will affect you. Your reactions could be impaired.