Spiriva HandiHaler® 18 mcg Capsules for Maintenance Therapy

What Spiriva HandiHaler® Is and How It Works

Spiriva HandiHaler is a dry powder inhalation system used for long-term maintenance treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It contains tiotropium bromide in a 18 mcg capsule that is inhaled through the HandiHaler device once daily. Spiriva HandiHaler is not a rescue inhaler. Some adults with asthma may also be prescribed tiotropium as an add-on maintenance option.

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Tiotropium is a long-acting muscarinic antagonist (LAMA). It relaxes airway smooth muscle by blocking M3 receptors in the bronchial tree. This reduces bronchospasm, opens the airways, and improves airflow. The HandiHaler device delivers medication from a single Spiriva inhaler capsule that is pierced in the chamber and then inhaled in two deep breaths. The typical dosing cadence is one capsule each day at about the same time.

Spiriva HandiHaler fits common questions about spiriva inhaler use, spiriva handihaler dose, and spiriva handihaler directions. It is available as spiriva 18 mcg capsules sealed in blisters. The device is breath-actuated and requires a firm, deep inhalation to draw the powder into the lungs.

Dosage and Usage

• Use one spiriva 18 mcg capsule via the HandiHaler once daily. Do not take more than one capsule in 24 hours.
• Keep the capsule in the blister until ready. Peel back the foil just before use. Do not swallow the capsule.
• Open the dust cap and mouthpiece. Place the spiriva handihaler capsule in the chamber. Close the mouthpiece until it clicks.
• Hold the device upright. Press the green button once to pierce the capsule.
• Exhale fully away from the device. Seal lips on the mouthpiece. Inhale deeply and steadily to hear or feel the capsule vibrate.
• Hold the breath as comfortable, then breathe out. Repeat one more deep inhalation from the same capsule to receive the full dose.
• Open the mouthpiece. Tip out the used capsule. Spiriva capsules should look empty; if powder remains, inhale again until emptied.
• Missed dose: take the next dose at the usual time the following day. Do not use two capsules to make up for a missed dose.
• Spiriva handihaler instructions for use and cleaning are included in the package. Follow the device leaflet for spiriva handihaler how to use and spiriva inhaler directions.

• Storage: keep capsules at 20–25 °C (68–77 °F) in the original blister to protect from moisture. Do not store capsules in the HandiHaler.
• Keep the device dry. Clean the HandiHaler once weekly: rinse under warm water, shake out excess, and air‑dry for 24 hours before use.
• Do not use a wet device. If cleaned, plan the next dose after the device is completely dry.
• Travel: carry capsules and device in hand luggage. Avoid heat above 30 °C (86 °F), direct sun, and high humidity. Do not freeze.
• Leave capsules sealed until needed. Do not puncture a capsule in advance. Keep out of reach of children.

Benefits and Savings

Spiriva HandiHaler improves lung function, reduces breathlessness, and lowers COPD exacerbation rates. Once-daily dosing supports steady bronchodilation over 24 hours. Many patients find the device simple after a short learning period, and the tactile feedback from capsule vibration helps confirm a good inhalation.

Ordering through Canadian pharmacy pricing can lower spiriva handihaler cost. Typical savings are 60–80% compared with many US pharmacy prices. Checking spiriva handihaler price or spiriva inhaler price across pack sizes may help reduce monthly costs. Multi‑month supplies and occasional bulk promotions can further lower the per‑month spend. You can set a quick reminder to reorder before running out.

For current offers, see our spiriva handihaler coupon information on the promotions page.

Side Effects and Safety

• Dry mouth
• Hoarseness or sore throat
• Cough or throat irritation after inhalation
• Nasal dryness or sinusitis
• Constipation or abdominal discomfort
• Headache or dizziness
• Urinary hesitancy, especially in men with prostate enlargement
• Blurred vision if powder contacts the eyes

Serious but uncommon risks include immediate hypersensitivity reactions, paradoxical bronchospasm, acute narrow‑angle glaucoma from ocular exposure, and urinary retention. Use caution with conditions such as glaucoma, bladder neck obstruction, or severe kidney impairment. Spiriva HandiHaler is not for sudden breathing problems; keep a rescue inhaler available. Avoid duplicate anticholinergic therapy.

Onset Time

Bronchodilation can begin within 30 minutes of the first dose. Breathing comfort often improves over several days as technique and daily dosing become consistent. Lung function gains and fewer exacerbations tend to develop over 2–8 weeks. Some measures, such as reduced rescue inhaler use and improved exercise tolerance, may continue to strengthen over the first few months.

Compare With Alternatives

Tiotropium also comes as a soft‑mist inhaler (Respimat) that does not use capsules. Some prefer HandiHaler for its simple mechanism and capsule feedback, while others favor the Respimat spray for a slower mist. Efficacy for maintenance COPD control is comparable when used correctly.

Short‑acting rescue therapy remains important. Many patients use a quick‑relief beta‑agonist such as Ventolin® for sudden symptoms. For those who benefit from both anticholinergic and beta‑agonist relief in a single device, a combination SAMA/SABA such as Combivent® Respimat Inhaler may be considered for rescue or as directed by a prescriber.

Other once‑daily LAMAs, like umeclidinium (Ellipta) or glycopyrrolate, and LAMA/LABA combinations (for example, umeclidinium/vilanterol) are alternatives when tailoring therapy and inhaler technique preferences. Inhaled corticosteroid combinations may be added in patients with frequent exacerbations or overlapping asthma features.

Combination Therapy

• LAMA + LABA: add a long‑acting beta‑agonist for persistent symptoms despite tiotropium.
• LAMA + ICS/LABA: consider triple therapy when exacerbations continue on dual agents.
• Rescue SABA: keep a short‑acting beta‑agonist on hand for acute relief.
• Avoid duplicate anticholinergics: do not combine multiple LAMAs or SAMA with LAMA as routine maintenance unless specifically directed.

Patient Suitability and Cost-Saving Tips

Spiriva HandiHaler is for maintenance treatment in adults with COPD, and in some regions, as add‑on maintenance for adults with asthma. It is not indicated for sudden bronchospasm or as initial therapy for acute episodes. Those with hypersensitivity to tiotropium, ipratropium, or other atropine derivatives should not use it. Use caution with narrow‑angle glaucoma, urinary retention, or prostate enlargement. Powder contains lactose; patients with severe milk protein allergy should avoid it.

Consistent inhalation technique is essential. Patients with limited hand strength or difficulty generating a deep breath may prefer a different device. Review technique during clinic visits to ensure the spiriva handihaler capsule empties with two inhalations.

To manage costs, compare pack sizes to find the best spiriva 18 mcg price. Ordering a multi‑month supply can reduce per‑month expenses and reduce shipping fees. Reorder reminders help prevent gaps in therapy. Pricing varies by brand availability and quantity; spiriva inhaler price listings on the product page reflect current stock.

Authoritative Sources

Boehringer Ingelheim Spiriva HandiHaler product information

Health Canada Drug Product Database: Tiotropium (Spiriva HandiHaler)

FDA Prescribing Information: Spiriva HandiHaler (tiotropium bromide)

Order Spiriva HandiHaler® from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express shipping.

This page is educational and does not replace professional medical advice, diagnosis, or treatment.