Spiriva HandiHaler's active ingredient is tiotropium, specifically in the form of tiotropium bromide monohydrate. It is an anticholinergic drug that targets muscarinic receptors. The medication is delivered as a dry powder in a capsule intended for oral inhalation using the HANDIHALER device, with each capsule containing 18 mcg of tiotropium. Key inactive ingredients include lactose monohydrate.

How should I use this medication?

This medication is inhaled through the mouth. Do NOT swallow the capsules. Take it as directed on the prescription label at the same time every day. Do not use it more often than directed. Keep taking it unless your care team tells you to stop. A patient package insert for the product will be given with each prescription and refill. Be sure to read this information carefully each time. The sheet may change often. Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medication?

Keep out of the reach of children and pets. Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original packaging until you are ready to use it. Get rid of any unused medication after the expiration date. To get rid of medications that are no longer needed or have expired: -Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location. -If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible: -Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat -Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss -Trouble passing urine -Wheezing or trouble breathing that is worse after use Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): -Constipation -Dry mouth -Runny or stuffy nose -Sore throat -Upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions: -Glaucoma -Kidney disease -Prostate disease -An unusual or allergic reaction to tiotropium, lactose, other medications, foods, dyes, or preservatives -Pregnant or trying to get pregnant -Breastfeeding

What may interact with this medication?

-Antihistamines for allergy, cough, and cold -Atropine -Certain medications for bladder problems, such as oxybutynin, tolterodine -Certain medications for Parkinson disease, such as benztropine, trihexyphenidyl -Certain medications for stomach problems, such as dicyclomine, hyoscyamine -Certain medications for travel sickness, such as scopolamine -Ipratropium

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse. Never use this medication for an acute asthma attack. You should use your short-acting rescue inhaler for an acute attack. If your symptoms get worse or if you need your short-acting inhalers more often, call your care team right away. Your mouth may get dry. Chewing sugarless gum or sucking hard candy and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe. This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.