WATCH and READ about the four steps to take SPIRIVA below:

Please see Important Product Information below.

	Open the dust cap of the HandiHaler by pressing the green piercing button.
	Pull the dust cap upwards to expose the mouthpiece.
	Open the mouthpiece by pulling the mouthpiece ridge upwards.
	Next, separate one of the blisters from the blister card by tearing along the perforation.
	To open the blister, start from the corner tab and carefully peel back the aluminum foil where indicated by an arrow. Continue peeling back the foil until the capsule is fully visible. Turn the blister upside down and tip the capsule out, tapping the back of the blister if necessary.

Capsules should always be stored in the sealed blisters and only removed immediately before use. Do not store capsules in the HandiHaler device. The drug should be used immediately after the packaging of an individual capsule is opened, or else its effectiveness may be reduced.

DO NOT CUT THE FOIL OR USE SHARP INSTRUMENTS TO REMOVE THE CAPSULE FROM THE BLISTER, AND DO NOT PUSH THE CAPSULE OUT OF THE BLISTER THROUGH THE ALUMINUM FOIL.

If additional capsules are exposed to the air, they should not be used and should be discarded.

	Insert the capsule in the center chamber of the HandiHaler device. It does not matter which end of the capsule is placed in the chamber.
	Close the mouthpiece firmly until you hear a click, leaving the dust cap open. Be sure that the mouthpiece sits firmly against the gray base.

	Hold the HandiHaler device with the mouthpiece upwards and press the green piercing button until it is flush against the base, and release. This makes holes in the capsule and allows the medicine to be released when you breathe in. DO NOT PRESS THE GREEN PIERCING BUTTON MORE THAN ONCE TO PUNCTURE THE CAPSULE.
	Breathe out completely. Important: Do not breathe (exhale) into the HandiHaler mouthpiece at any time.

	To inhale your medicine with the HandiHaler: Hold the HandiHaler device by the gray base, being careful not to block the air intake vents. Raise the HandiHaler device to your mouth and close your lips tightly around the mouthpiece. Keep your head upright and breathe in slowly and deeply but at a rate sufficient to hear or feel the capsule vibrate. Breathe in until your lungs are full. Hold your breath as long as is comfortable while removing the HandiHaler from your mouth. Resume normal breathing.
To ensure that you get the full dose of SPIRIVA, breathe out completely and inhale your medicine one more time as described above. DO NOT PRESS THE GREEN PIERCING BUTTON AGAIN. If you do not hear or feel the capsule vibrate, tap the HandiHaler gently on a table, holding it in an upright position. Check to see that the mouthpiece is completely closed. Then breathe in again — slowly and deeply. If you still do not hear or feel the capsule vibrate after repeating the steps above, please consult your physician.
	After you have finished taking your daily dose of SPIRIVA, open the mouthpiece again. Tip out the used capsule and discard.
	Close the mouthpiece and dust cap to store your HandiHaler device until the next dose.

Clean the HandiHaler once a month by following these steps:

Open the dust cap and mouthpiece Open the base by lifting the green piercing button Rinse the complete inhaler with warm water to remove any powder Do not use cleaning agents or detergents Do not place the HandiHaler in the dishwasher for cleaning Dry the HandiHaler thoroughly by tipping the excess water out on a paper towel and air-dry afterwards, leaving the dust cap, mouthpiece, and base open It takes 24 hours to air dry, so clean it right after you use it and it will be ready for your next dose Do not use the HandiHaler device when it is wet. If needed, the outside of the mouthpiece may be cleaned with a moist, but not wet, tissue

Do not store the used or unused capsules in the HandiHaler device SPIRIVA capsules should not be removed from the package until immediately before use, or else their effectiveness may be reduced Avoid getting SPIRIVA powder into your eyes Keep away from children

For more detailed instructions, download the Patient's Instructions for Use.

IMPORTANT PRODUCT INFORMATION

Talk to your doctor to see if Spiriva® HandiHaler® (tiotropium bromide inhalation powder) is right for you.

SPIRIVA HandiHaler is a once-daily inhaled maintenance prescription treatment for breathing problems (airway narrowing) associated with chronic obstructive pulmonary disease (COPD). COPD includes both chronic bronchitis and emphysema.

SPIRIVA does not replace fast-acting inhalers for sudden symptoms.

Do not swallow the SPIRIVA capsule. Only use the HandiHaler device to take the SPIRIVA capsule. Do not use the HandiHaler to take any other medications.

Do not get SPIRIVA powder in your eyes.

The most common side effect with SPIRIVA is dry mouth. Others include constipation and problems passing urine. For a complete list of reported side effects, ask your doctor or pharmacist.

Tell your doctor about your medicines, including eye drops, and illnesses like glaucoma and urinary or prostate problems. These may worsen with SPIRIVA.

If you have vision changes, eye pain, your breathing suddenly worsens, you get hives, or your throat or tongue swells, stop taking SPIRIVA and contact your doctor.

Do not use SPIRIVA if you are allergic to atropine, ipratropium, tiotropium bromide, or lactose. A lactose allergy is not the same as lactose intolerance.

Read the step-by-step Patient's Instructions for Use for SPIRIVA before you take your medicine.

The information provided on this site is for general information and educational purposes only. You should always consult a doctor for diagnosing and treating a health or fitness problem, and before using any drug product discussed on this site.

Click here for Full Prescribing Information and Patient's Instructions for Use.

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This information is for U.S. residents only. Products discussed herein may have different labeling in different countries.