Flare-ups (exacerbations)

You can reduce your risk of COPD flare-ups.

Chronic Obstructive Pulmonary Disease (COPD) is a serious lung disease that usually causes breathing to get worse over time. COPD includes chronic bronchitis, emphysema, or both.

COPD also includes symptom flare-ups. Flare-ups are episodes of new or increasing symptoms, including cough, mucus, wheezing, shortness of breath, or tightness in the chest. When you experience a COPD flare-up, you may require treatment beyond your normal medications and, in some cases, flare-ups may require hospitalization. Talk to your doctor about ways to reduce the risk of COPD exacerbations.

What is a COPD symptom flare-up?

If you experience a flare-up, call your doctor. A flare-up may require immediate medical attention. And if your symptoms are severe, call your doctor and 911.

SPIRIVA can help reduce the likelihood of COPD flare-ups and help you breathe easier:

In addition to adding SPIRIVA to your treatment plan, there are things you can do to improve your overall health: if you smoke, quit, and try to identify your COPD triggers. Do everything you can to avoid respiratory illnesses or infections—talk to your doctor about the flu shot, pneumonia vaccine, and other things you can do and how you can breathe better with SPIRIVA.

Talk to your doctor if you think you've had a flare-up.

Learn more about COPD.

Learn more about COPD.

SPIRIVA can help COPD patients breathe better.


Do not use Spiriva® HandiHaler® (tiotropium bromide inhalation powder) if you are allergic to tiotropium or ipratropium (e.g., Atrovent®) or any of the ingredients in SPIRIVA. If your breathing suddenly worsens, your face, throat, lips, or tongue swells, you get hives, itching or rash, stop taking SPIRIVA and seek immediate medical help.

SPIRIVA HandiHaler is not a rescue medicine and should not be used for treating sudden breathing problems.

Do not swallow SPIRIVA capsules. The contents of the capsule should only be inhaled through your mouth using the HandiHaler device.

If you have vision changes or eye pain or if you have difficulty passing urine or painful urination, stop taking SPIRIVA and call your doctor right away.

Tell your doctor if you have glaucoma, problems passing urine or an enlarged prostate, as these may worsen with SPIRIVA. Tell your doctor if you have kidney problems or are allergic to milk proteins. Ask your doctor if you are not sure. Also discuss with your doctor all the medicines you take, including eye drops.

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

Do not let the powder from the SPIRIVA capsule get into your eyes.

Dizziness and blurred vision may occur with SPIRIVA. Should you experience these symptoms, you should use caution when engaging in activities such as driving a car or operating appliances or other machines.

Read the Patient Information and the step-by-step Instructions for Use for SPIRIVA before you use your inhaler.


Spiriva® HandiHaler® (tiotropium bromide inhalation powder) is a prescription medicine used once each day (a maintenance medicine) to control symptoms of chronic obstructive pulmonary disease (COPD) by relaxing your airways and keeping them open. COPD includes chronic bronchitis, emphysema, or both.

SPIRIVA HandiHaler also reduces the likelihood of flare-ups and worsening of COPD symptoms (COPD exacerbations).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see full Prescribing Information, including Patient Information and Instructions for Use.


The tips contained on this site convey general information and are not intended to be, nor should they be used as, a replacement for the advice of a licensed physician. Your doctor knows your specific condition. As with all things medical, you should talk to your doctor before you start any treatment, exercise, diet, or other lifestyle change.