Tiotropium inhalation is a bronchodilator that is used to prevent bronchospasm (narrowing of the airways in the lungs) in adults with COPD (chronic obstructive pulmonary disease), including bronchitis and emphysema.

Tiotropium inhalation is also used to prevent asthma attacks in adults and children who are at least 6 years old.

Tiotropium inhalation may also be used for purposes not listed in this medication guide.

You should not use this medicine if you are allergic to tiotropium or ipratropium (Atrovent, Combivent, DuoNeb).

Tell your doctor if you have ever had:

• narrow-angle glaucoma;
• kidney disease;
• a milk allergy; or
• an enlarged prostate or urination problems.

Tell your doctor if you are pregnant. It is not known whether tiotropium will harm an unborn baby. However, having uncontrolled asthma during pregnancy may cause premature birth, a low birth weight baby, or complications such as eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating asthma may outweigh any risks to the baby.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Tiotropium inhalation is not approved for use by anyone younger than 6 years old.

Use Spiriva Respimat 28 ACT (Inhalation) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: hives, itching; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• wheezing, choking, or other breathing problems after using this medicine;
• blurred vision, eye pain or redness, seeing halos around lights;
• sores or white patches on your mouth, lips, or tongue;
• pain or burning when you urinate; or
• little or no urinating.

Common side effects may include:

• dry mouth;
• blurred vision;
• constipation, painful urination;
• upset stomach;
• chest pain, fast heart rate; or
• cold symptoms such as stuffy or runny nose, sinus pain, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Avoid getting the powder from a tiotropium capsule in your eyes. If this does happen, call your doctor.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.