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Tiotropium (cont.)

Medical and Pharmacy Editor:

What Are Warnings and Precautions for Tiotropium?


This medication contains tiotropium. Do not take Spiriva HandiHaler and Spiriva Respimat if you are allergic to tiotropium or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.


  • History of hypersensitivity to ipratropium or tiotropium
  • History of severe hypersensitivity to milk proteins (excipient in powder contained in capsule)
  • Lactose allergy

Effects of Drug Abuse

  • None

Short-Term Effects

  • See "What Are Side Effects Associated with Using Tiotropium?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Tiotropium?"


  • Not for acute use; not a rescue medication
  • Immediate hypersensitivity reactions (e.g., angioedema, itching, rash); stop treatment immediately
  • Capsule not to be swallowed; to be administered only by oral inhalation via HandiHaler device
  • Worsening of narrow-angle glaucoma
  • Worsening of urinary retention
  • Potential for paradoxical bronchospasm
  • Prostatic hyperplasia
  • Bladder-neck obstruction
  • Wash hands after handling capsules

Pregnancy and Lactation

  • The limited human data with tiotropium therapy during pregnancy are insufficient to inform a drug-associated risk of adverse pregnancy-related outcomes; there are risks to mother and fetus associated with poorly controlled asthma in pregnancy
  • Consult your doctor
  • There are no data on presence of tiotropium in human milk, effects on breastfed infant, or effects on milk production. Tiotropium is present in milk of lactating rats, however, clinical relevance of these data are not clear
  • The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition

Medscape. Tiotropium.

RxList. Spiriva Respimat.

Medically Reviewed by a Doctor on 6/15/2017

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