Tiotropium

Spiriva 

Spiriva HandiHaler, a prescribed medication for effectively managing chronic obstructive pulmonary disease (COPD) symptoms, addresses bronchospasm, shortness of breath, and wheezing. This FDA-approved drug, containing the active ingredient tiotropium, provides crucial relief for COPD challenges. Classified as an anticholinergic, Spiriva comes in 2 forms: Respimat & Handihaler. The Respimat includes a cartridge with liquid Spiriva, administered through an inhaler device, delivering a fine mist for inhalation. On the other hand, the Handihaler involves capsules containing Spiriva powder and an inhaler device, allowing the inhalation of Spiriva powder after piercing the capsule. So, if you want to buy Spiriva Respimat from an online Canadian Pharmacy, you must get your doctor’s prescription first.

Product Overview

Spiriva, a medication prescribed for chronic obstructive pulmonary disease (COPD) and asthma, contains the active ingredient tiotropium. Available in two forms, Spiriva Respimat and Spiriva Handihaler, it addresses symptoms like bronchospasm and shortness of breath. Respimat delivers liquid Spiriva as a mist through an inhaler, while Handihaler uses capsules with Spiriva powder.

However, its dosage varies for COPD and asthma. The Respimat strengths of this medication are 1.25 mcg and 2.5 mcg per puff, while Handihaler uses 18 mcg capsules. Administration involves specific steps to ensure proper inhalation. Spiriva works by easing airways within an hour, showing significant improvement in 4 to 8 weeks for asthma. Like many other drugs, Spiriva also has common side effects, including sore throat, cold, dry mouth, and headache, while serious effects include bronchospasm and severe allergic reactions.

Additionally, precautions of this medication include monitoring for hypersensitivity reactions and caution in patients with atropine hypersensitivity or severe milk protein allergies. This medication also has interactions with other anticholinergic drugs. Patients should consult their doctors for personalized guidance, considering individual health conditions and medication interactions.

What Are the Uses of Spiriva?

Spiriva is used in the long-term treatment of:

• Chronic Obstructive Pulmonary Disease (COPD) 
• Asthma in adults and children

[Important Warning: It’s crucial to understand that Spiriva should not be used as a rescue inhaler. Refrain from using it to alleviate sudden breathing difficulties resulting from asthma or COPD.]

What Are the Forms & Strengths of Spiriva? 

Spiriva comes in different forms & strengths:

• Spiriva Respimat: There’s Spiriva Respimat, which has a special inhaler called Respimat. It has a cartridge with liquid Spiriva. The Respimat sprays Spiriva as a fine mist for you to breathe in. It comes in two strengths: 1.25 micrograms (mcg) per puff and 2.5 mcg per puff.
• Spiriva Handihaler: This includes an inhaler device called Handihaler and capsules with Spiriva powder. The Handihaler opens the capsule so you can breathe in the Spiriva powder. Each capsule has 18 mcg of Spiriva.

What Is the Recommended Dosage of Spiriva for Different Patients?

Asthma Dosage

For treating asthma with Spiriva Respimat, adults and children aged 6 years and older should take two puffs of 1.25 mcg once a day.

COPD Dosage

• Both Spiriva Handihaler and Spiriva Respimat are used for treating COPD.
• For Spiriva Respimat, adults should take two puffs of 2.5 mcg once a day.
• For Spiriva Handihaler, adults should take two puffs from one 18 mcg capsule once a day. If you’re unsure which Spiriva form is best for your COPD, consult your doctor.

[Note: Remember these recommendations may vary depending on person to person. Consult your healthcare provider or doctor, and they’ll customize your dosage accordingly.]

How to Use Spiriva?

• Before using Spiriva, you should make sure to read & follow the instructions carefully given in the patient information leaflet and medication guide provided by your healthcare provider and pharmacist. If you have any queries or do not understand any part of the leaflet, you should ask your doctor. 
• Use Spiriva exactly as your doctor prescribes. The usual recommended dosage is two inhalations taken by mouth once daily. Do not use more or less of it in large quantities or more frequently than prescribed. Doing so will not make your symptoms better faster. However, it will worsen your existing condition or cause unwanted side effects. 
• Spiriva is not a rescue inhaler, and it does not work as fast as a rapid-acting inhalation medication during a COPD flare-up. Your doctor may prescribe you an effective fasting-acting inhaler for treating a bronchospasm attack. 
• This medication comes with a cartridge containing the liquid solution and an inhaler device which delivers the solution as a fine mist that you breathe in. 
• Do not breathe out into the HandiHaler mouthpiece at any time during the procedure. 
• You should not crush, chew, open, or break the Spiriva capsules.  
• Sit upright or stand. Ensure the HandiHaler device is not shaken.
• Hold the inhaler away from your face. Breathe out without blowing into the inhaler.
• Place the mouthpiece between your lips. Close your lips around it and inhale a long, steady breath through your mouth and the inhaler. Inhale quickly and deeply; you should hear the Spiriva capsule vibrating inside.
• Remove the inhaler from your lips and hold your breath for 10 seconds or as long as possible.
• Breathe out slowly.
• Repeat steps 1-5, but do not press the green piercing button again. Ensure you inhale each Spiriva capsule twice from the HandiHaler inhaler to receive the total dose.
• Pull up on the mouthpiece, allowing the empty Spiriva capsule to fall into a trash can. Do not touch the empty capsule.
• Hold the HandiHaler upside down and tap it gently to remove any remaining Spiriva powder.
• Close the mouthpiece, followed by the dust cap. Store the Spiriva HandiHaler until the next dose.
• To prevent dry mouth & throat irritation, you should rinse your mouth after using the inhaler each time. 
• Properly clean the HandiHaler device at least once a month and allow it to air-dry entirely before using it again.
• If your doctor has prescribed that you use other inhalers simultaneously, you should wait at least one minute between the use of each medicine. 
• Do not discontinue the medication or change your dosage without consulting your doctor. 
• Inform your doctor if you suspect your medications are not working as well as they should.
• To ensure the medication is not causing any side effects and is effective in treating your condition, your doctor may recommend you to take certain lung function tests on a regular basis. 
• To get the most benefit from the treatment you are receiving with Spiriva, you should maintain consistency in dosage and take it at the same time every day to help you remember to take it. 
• Tell your doctor if your condition does not get better or if it worsens. 

Following these steps diligently ensures the proper administration of Spiriva, providing adequate respiratory support.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Spiriva Work?

Spiriva works to effectively manage the symptoms of COPD and Asthma by improving airflow and overall lung function for patients. When taken via inhaler, it begins to ease and expand airways in individuals with asthma or COPD within just one hour of administration. The most significant symptom improvement for those with asthma generally becomes noticeable after 4 to 8 weeks.

Important Safety Information for Using Spiriva 

What Are the Side Effects of Spiriva?

Common side effects of Spiriva: Similar to other medications, Spiriva may cause certain side effects in some people. These side effects are temporary, do not usually require medical attention and disappear within a few days as your body starts to adjust to the medication. It is important to mention that not every individual using this medication experiences the side effects caused by this medication. However, if you are concerned about the side effects of Spiriva, you can talk to your doctor, and they will help you prevent and manage them. Common side effects of Spiriva may include: 

• Sore Throat: Spiriva is an inhaled medication, which can irritate your throat, leading to soreness. Its symptoms may include pain in thr throat, hoarseness, coughing, sneezing, runny nose, difficulty swallowing, swollen red tonsils and a scratchy sensation in the throat. 
• Common Cold: While it unlikely for Spiriva to directly cause common cold, it can increase the susceptibility to upper respiratory infections. 
• Dry Mouth: It is one of the most commonly found side effects of Spiriva. Its symptoms may include thick saliva, cracked lips, and bad breath. This condition is usually mild and should improve as your body adjusts to the medication. 
• Sinusitis: The medication may irritate the nasal passages, potentially leading to sinus inflammation. Its symptoms may include headache, runny nose, and more.  
• Headache: Some patients may experience headaches due to changes in blood flow or sinus irritation. 
• Indigestion (upset stomach): This medication can affect the digestive system, causing upset stomach and indigestion in some patients. 
• Constipation: This medication can slow down the gut motility (the movement of food through your digestive tract, from the mouth to the anus). This can potentially cause constipation. 
• Urinary Tract Infection (UTI): Due to its effects on the digestive system, it can raise the risk of UTI in some people using it. 
• Blurry Vision and other vision changes
• Dizziness: Due to the medication’s effect on the nervous system, it can cause dizziness in some people. 
• Oral Thrush: Inhaled medications such as Spiriva can cause the risk of oral fungal infections. To prevent this, you should thoroughly rinse your mouth each time you use the inhaler. 
• Fast Heart Rate: This medication can cause an increase in the heart rate. 

Mild side effects of Spiriva: In some cases, this medication can cause mild side effects for people using it. They are not usually serious and disappear within a few days or weeks. You should report any new or bothersome side effects to your doctor immediately. Mild side effects caused by Spiriva may include:  

• Upper respiratory tract infection: While using Spiriva, it is possible that you may develop an upper respiratory tract infection, including the common cold. Its symptoms may include runny nose, sore throat, fever, and cough.  
• Heart related side effects: Spiriva can cause certain heart-related side effects such as increased heart rate. In rare cases, this may be associated with an increased risk of stroke/heart attack. 
• Mild Allergic Reaction: You should call your doctor immediately if you experience signs of a mild allergic reaction, such as trouble breathing, swelling in the eyes/mouth/nose/hands/ankles/feet, skin rash, or flushing. 
• Chest pain: If you feel chest pain due to Spiriva, reach out to your medical giver. If you feel a tightness in your chest along with nausea, pain that extends to the left arm, shortness of breath, it may be a sign of a heart attack. 

Serious side effects of Spiriva: In rare cases, Spiriva can cause serious side effects in people belonging to certain groups. These adverse side effects require prompt medical attention and may become life-threatening if they are not properly treated. If you experience any of the side effects given below, immediately discontinue using the medication and call your doctor or 911. It is important to mention that this list is not exhaustive and that Spiriva may cause other side effects.

• Severe allergic reaction. Its symptoms may include skin rash, difficulty breathing, flushing, itchiness, and swelling under your skin.
• New or Worsened Urinary Retention. Its symptoms may include painful urination and the inability to empty your bladder completely. 
• Paradoxical Bronchospasm: It refers to the sudden tightening of the airways after taking an inhalation of Spiriva. Its symptoms can include difficulty breathing and persistent wheezing.  
• Acute angle galucoma: It refers to an increase the ocular pressure. Its symptoms may include eye redness, sudden eye pain, seeing halos around the lights, and blurry vision.
• Eye pain, swelling, redness, seeing rainbows or halos around the lights, blurred vision and other vision changes
• Cardiovascular events: It can increase the risk of heart-related events, especially in patients with pre-existing heart conditions. Its symptoms may include heart palpatitions, heart attack, stroke, and chest pain.  

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Spiriva?

While using Spiriva, there are certain warnings that you should take into consideration for a safe and effective use of the medication. 

• This medication is intended to be used only in a HandiHaler device. Do not take the Spiriva capsule orally by mouth and use only one capsule at a time. 
• Avoid getting the contents of the capsule in your eyes as it can cause momentary blurred vision, irritation, eye pain or other visual changes. If this happens, immediately call your doctor. 
• Spiriva can affect your mental alertness and reactions. You should not drive a vehicle, use heavy machinery, or engage in other hazardous tasks unless you determine how this medication affects you.  
• While receiving treatment with Spiriva, you should limit your consumption of alcohol. You should also avoid medications and beverages that may contain alcohol. Talk to your doctor if you are using Marijuana.
• If you plan to have a surgery, including dental procedure, you should tell your surgeon, dentist, or doctor beforehand about all the medications you are using, including all prescription, non prescription, over-the-counter drugs, or herbal and vitamin supplements. 
• Geriatric patients may have a greater risk of certain side effects caused by Spiriva. Elderly men using this medication may also have difficulty urinating. 
• Immediate hypersensitivity reactions, such as angioedema, itching, or rash, may occur post-Spiriva HandiHaler administration. Cease Spiriva HandiHaler promptly if such reactions manifest; consider alternative treatments. Patients with a history of atropine hypersensitivity should be closely monitored. Caution is advised in patients with severe hypersensitivity to milk proteins.
• Inhaled medications, including Spiriva HandiHaler, may induce paradoxical bronchospasm. Discontinue Spiriva HandiHaler if this happens and explore other treatment options.
• Patients with moderate to severe renal impairment (creatinine clearance ≤50 mL/min) using Spiriva HandiHaler should be closely monitored for anticholinergic side effects due to its predominantly renal excretion.

What Are the Spiriva Precautions?

Before you start taking Spiriva, share your complete medical and pesonal history with your doctor. Spiriva might not be suitable for you if you have specific health issues. These include:

• Glaucoma: If you’ve had increased Glaucoma (eye pressure) before, using Spiriva may raise the risk of acute narrow-angle glaucoma. This rare side effect leads to a sudden increase in eye pressure. If you experience blurry vision, eye pain, redness, halos, or colors, contact your doctor right away. Discuss any history of eye problems with your doctor before starting Spiriva.
• Urination Issues: If you’ve had difficulties passing urine before, using Spiriva may pose a higher risk of this side effect. Conditions like an enlarged prostate or bladder-neck obstruction can affect urination. If you have these issues or have experienced trouble urinating, talk to your doctor before starting Spiriva. If you face difficulties or pain while urinating on Spiriva, contact your doctor.
• Allergies: Avoid taking Spiriva if you’re allergic to tiotropium (the active drug), ipratropium, or any inactive ingredients in Spiriva. If you’re unsure about medication allergies, discuss it with your doctor.
• Pregnancy: It’s unclear if Spiriva is safe during pregnancy. Tell your doctor at once if you are pregnant, think you may be pregnant, or plan to become pregnant while using this medication. The benefits of treating asthma during pregnancy may outweigh the risks to the unborn baby associated with its use. 
• Breastfeeding: The safety of Spiriva during breastfeeding is uncertain. You should consult your doctor before breastfeeding a baby while using this medication.
• The safety and efficacy of Spiriva is not established in anyone younger than 6 years old and hence it is not approved for use in children under six years of age.  

What If You Miss a Dose of Spiriva?

To prevent missing doses, you should buy Spiriva Handihaler online and get a refill before you completely run out of your prescription. If you miss a dose of Spiriva, take it as soon as possible. But if it’s almost time for your next dose, skip the missed Spiriva dose and take your next dose as scheduled. You should not take two doses at once to make up for a missed dose. This can raise your risk of side effects. You should not use oral inhalation more than two times in a 24-hour period.  

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Spiriva?

Only use Spiriva as directed by your doctor to avoid serious side effects. Overdosing may result in symptoms such as dry mouth, nose, and throat, as well as pink eye. If you believe you’ve used too much Spiriva, contact your doctor. In case of severe symptoms, call 911 or your local emergency number, or head to the nearest emergency room.

[Note: If you consumed more than the recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]

How to Store Spiriva?

Spiriva is an FDA-approved prescription medication available in two forms: HandiHaler and Respimat. To preserve its quality & ensure its safety and efficacy, special storage guidelines need to be followed. Key factors of storage conditions may include keeping it at room temperature in a dark and dry environment, away from moisture, and out of the reach and sight of children and pets to avoid accidental consumption. For detailed storage guidelines, refer to the section below.  

• Always keep Spiriva HandiHaler capsules in the pack.
• Keep them in their blister pack at room temperature (77°F/25°C) and away from moisture, excess heat, and direct light unless you are ready to use them.
• Do not keep Spiriva in the bathroom, near the sink, or in places with high moisture. 
• Once you open the blister pack for Spiriva capsules, you should immediately open it. Discard the tablet if its blister package is opened and is not used right away. 
• Do not keep the Spiriva capsules in the inhaler device. 
• Keep all medications, including Spiriva, in a secure place away from the sight and reach of children and pets. 
• Throw away Spiriva HandiHaler capsules when they are no longer needed or if their expiration date has passed. The expiration date is the last day of the month specified on the back of the blister pack or carton.
• You should not pour them into the wastewater, throw them into the household trash bin, or flush them into the toilet unless instructed otherwise. 
• Unwanted medications should be disposed of in a way that keeps them out of the reach of kids, pets, and other people. 
• Don’t freeze them.
• Once put together, Spiriva Respimat lasts three months until the marked expiration date or when the inhaler locks, whichever is first.
• Spiriva can be kept between 59°F and 86°F (15°C to 30°C).
• For more information on how to dispose of unwanted medications you should talk to your pharmacist, medical team, or local waste disposal company. 

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Spiriva? 

Spiriva can interact with certain medications, and it’s important to be aware of potential complications. Keep in mind that the lists provided may not cover all possible interactions. Before starting Spiriva, have a discussion with your doctor or pharmacist, sharing details about all your prescriptions, over-the-counter drugs, vitamins, herbs, and supplements.

It’s crucial to know about potential interactions to prevent any complications. If you have concerns or questions about how Spiriva might interact with other medications, don’t hesitate to ask your doctor or pharmacist for guidance.

Spiriva belongs to a class of drugs known as anticholinergic agents. It should not be used simultaneously with other medications from this class, as doing so may increase the risk of side effects. These side effects can include difficulty urinating and acute narrow-angle glaucoma (increased eye pressure).

Examples of other inhaled medications in the anticholinergic class include:

• Incruse Ellipta (umeclidinium)
• Combivent (ipratropium bromide/albuterol sulfate)
• Atrovent (ipratropium)
• Stiolto Respimat (tiotropium bromide/olodaterol)
• Trelegy (vilanterol/umeclidinium/and fluticasone)
• Anoro Ellipta (umeclidinium/vilanterol)
• Yupelri (revefenacin)

Note that this list is not exhaustive, and there are other anticholinergic agents taken orally. Apart from its interactions with Anticholinergic agents, there are other medications that may interact with Spiriva and cause unwelcomed side effects or reduce its effectiveness. They are as follows: 

• RimabotulinumtoxinB
• Trimeprazine
• Pilocarpine Ophthalmic
• Thiothixene
• Bethanechol
• Eluxadoline
• Procyclidine
• Methacholine
• Fesoterodine
• Chlorcyclizine
• Triprolidine
• Prucalopride
• Methotrimeprazine
• Maprotiline
• Trospium
• Quinidine
• Pilocarpine
• Acetylcholine Ophthalmic
• Mepenzolate
• Brompheniramine
• Dexbrompheniramine
• Dexchlorpheniramine
• Aripiprazole
• Physostigmine Ophthalmic
• PrabotulinumtoxinA
• Disopyramide
• LetibotulinumtoxinA
• OnabotulinumtoxinA
• Doxepin Topical
• DaxibotulinumtoxinA
• Thioridazine
• Methscopolamine
• Dimenhydrinate
• Haloperidol
• Fluphenazine
• Cevimeline
• Carbachol Ophthalmic
• Molindone
• Thiethylperazine
• Demecarium Bromide Ophthalmic
• Chlorpromazine
• Promethazine
• Clomipramine
• Pyrilamine
• Propantheline
• Revefenacin
• Glycopyrronium Topical
• Mesoridazine
• Acrivastine
• Perphenazine
• Triflupromazine
• Propiomazine
• Protriptyline
• Nortriptyline
• Quetiapine
• Insulin Inhalation, Rapid Acting
• Ipratropium Nasal
• Carbinoxamine
• Azatadine
• Amoxapine
• Clemastine
• Imipramine
• Methdilazine
• Cimetidine
• Trifluoperazine
• AbobotulinumtoxinA

What Are the Other Spiriva Interactions? 

While there are no specific reports of herbs or supplements interacting with Spiriva, it’s still essential to consult with your doctor or pharmacist before using these products alongside Spiriva. Taking this precaution can help ensure your safety and well-being.

Before initiating Spiriva or any new medication, consult with your healthcare professional. They will review your entire medication list to determine the safety of taking Spiriva in your specific case. Spiriva can interact with certain medications and supplements such:

• Oxybutynjn 
• Ipratropium 
• Revefenacin 

Apart from the medications, Spiriva may interact with five diseases, namely:

• Angiodema 
• Liver 
• Tachycardia 
• Renal dysfunction 
• Anticholinergic effects 

[Note: This isn’t a complete list, and there could be other drugs that interact with Spiriva. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Spiriva Alternatives?

While Spiriva is an effective medication used to treat asthma and COPD, it can cause unwanted side effects and may fail to provide desirable results to patients. For these reasons, people are looking for alternatives to Spiriva. There are many popular alternatives to Spiriva available on the market, such as Advair, Prednisone, and more. However, you should not take it without consulting your doctor. If you plan to switch or start a new medication, tell your doctor. Based on your needs, condition, and other factors, they will help you decide which medication will suit you the best. Some of the popular alternatives to Spiriva are as follows:

• Prednisone (prednisone)
• Yupelri (revefenacin)
• Serevent Diskus (salmeterol)
• Ventolin HFA (albuterol)
• Bevespi Aerosphere (formoterol–glycopyrrolate)
• Lonhala Magnair (glycopyrrolate)
• Albuterol Nebulizer Solution (Ipratropium)
• Breztri Aerosphere (budesonide–formoterol–glycopyrrolate )
• Arformoterol (brovana nebulizer solution)
• Incruse Ellipta (umeclidinium)
• Breo Ellipta (fluticasone furoate-vilanterol )
• Tudorza Pressair (aclidinium)
• Spiriva Handihaler (tiotropium bromide) 
• Theophylline ER
• Azithromycin (zithromax)
• Advair Diskus (fluticasone-salmeterol)
• Daliresp (roflumilast)
• N-Acetylcysteine

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Spiriva Cost & Coupons

Spiriva Respimat is only available as a brand-name medication used to treat COPD and asthma, with no generic versions currently on the market. The Spiriva Handihaler price without insurance may differ considerably based on numerous factors, which include the specific treatment regimen and dosage prescribed, whether you are using Spiriva Respimat or HandiHaler, the pharmacy selected, and the length of the prescription, whether it’s for 30 days or an extended period like 90 days. Furthermore, patients may reduce the cost of Spiriva Respimat by participating in various cost-saving programs for which they qualify. Health insurance coverage greatly influences the accessibility and affordability of medications such as Spiriva, as it can vary from one policy to another, sometimes leaving patients with substantial out-of-pocket costs. For these reasons, many people turn to pages like Polar Bear Meds to buy Spiriva Respimat online at affordable prices. 

Frequently Asked Questions

Who should not use Spiriva?

Patients who have an allergy to tiotropium, atropine, ipratropium, or any of the excipients listed in Spiriva should not use it. If you are not sure about all the ingredients present in the product, you can consult your pharmacist or medical provider for the full list of ingredients present in Spiriva. This medication should not be used to treat bronchospasm attacks. 

If I stop taking Spiriva, will I have withdrawal symptoms?

No, you won’t experience withdrawal symptoms if you suddenly stop taking Spiriva. However, your breathing symptoms may worsen without the treatment. If you’re thinking of discontinuing Spiriva, it’s important to consult your doctor. They can advise you on whether it’s safe to stop using the medication and discuss alternative ways to manage your breathing condition.

Does Spiriva contain steroids?

No, Spiriva doesn’t have steroids. It has a drug called tiotropium bromide, which is part of a group of drugs called anticholinergic agents. These drugs do things in your body in a different way than steroids. However, both steroids and anticholinergic agents can be used to help people with asthma or chronic obstructive pulmonary disease (COPD) breathe better.

How quickly does Spiriva work?

Spiriva helps you breathe better by relaxing the air passages that let air in and out of your lungs. It starts working in about 30 minutes and should last the whole day. Spiriva has something called tiotropium bromide in it, which is part of a group of medicines called anticholinergics.

Is Spiriva intended for long-term use?

Yes, Spiriva is typically prescribed as a long-term treatment. Upon consultation with your doctor and mutual agreement on its safety and effectiveness for your condition, you can expect to use Spiriva over an extended period. It is important to follow your healthcare provider’s guidance regarding its long-term usage.

What are the signs of an overdose with Spiriva HandiHaler?

Overdose symptoms associated with Spiriva HandiHaler include dry mouth and conjunctivitis (pink eye). While rare, there have been reports of individuals experiencing a change in mental status, tremors, abdominal pain, and constipation after the availability of the HandiHaler form. The likelihood of these symptoms occurring due to excessive Spiriva intake is unknown. If you suspect an overdose, promptly contact your healthcare provider. Immediate medical attention is essential if you believe you have used too much Spiriva.

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