Precautions and Warnings With Tiotropium

Precautions and warnings with tiotropium should be reviewed prior to taking the drug. This includes being aware of possible side effects and telling your healthcare provider if you have certain medical conditions. For example, precautions and warnings with tiotropium apply to people with allergies, glaucoma, and an enlarged prostate. Women who are pregnant or nursing should talk with their healthcare provider before taking the drug.

Tiotropium: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking tiotropium bromide (Spiriva®) if you have:


Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Tiotropium

Warnings and precautions to be aware of prior to taking tiotropium include the following:
  • Early information suggests there may be a slightly increased risk of strokes associated with the use of tiotropium. In studies, the risk of a stroke for people taking tiotropium was 8 in every 1000 people over one year, compared to 6 in every 1000 people over one year in people not taking Spiriva. It is too soon to know if this is a real problem or not. It may be a good idea to discuss this risk with your healthcare provider.


  • Tiotropium is not a fast-acting asthma medication and cannot replace fast-acting rescue inhalers. Let your healthcare provider know if the drug is not adequately controlling your breathing problems.
  • The capsules should never be swallowed. Rather, the contents should be inhaled using the inhaler.
  • Sometimes, inhaled medications (including tiotropium) can make breathing problems worse. Let your healthcare provider know if the medication seems to be having this effect on you.
  • Tiotropium is an anticholinergic medication, and as such can make glaucoma, bladder problems, and prostate problems worse. Talk to your healthcare provider before taking the drug if you have any of these problems.


  • The kidneys remove tiotropium from the body. If your kidneys are not functioning properly, your risk for side effects of tiotropium may be increased. Your healthcare provider may want to monitor you more closely or perhaps use a different medication in some circumstances. 


  • Tiotropium can interact with other medications (see Drug Interactions With Tiotropium).
  • Tiotropium is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug while pregnant (see Spiriva and Pregnancy).
  • It is not known if tiotropium passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider before using the drug (see Spiriva and Breastfeeding).

Tiotropium Bromide Inhalation Powder

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