spiriva inhalation spray soft mist hero image

Ease of inhalation

Just a slow, deep breath is required–no need to sharply inhale^1*

Deep lung delivery

Nebulized medicine reaches deep into the lungs^2,3†

Soft mist

Soft mist delivery helps patients inhale their medicine¹*

*
As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as the coordination between the actuation of the inhaler and inspiration through the delivery system. The duration of inspiration should be at least as long as the spray duration (1.5 seconds).
†
It is important to note that a correlation between lung deposition and clinical efficacy has not been established.

Take a closer look at how SPIRIVA RESPIMAT is delivered into the lungs^1,3-5

The RESPIMAT Soft Mist Inhaler was developed using a patient-focused design approach.³ The RESPIMAT inhaler delivers medication in a soft mist.^*3-5

A 3D medical illustration showing a person using a Respimat inhaler with a highlighted view of the lungs

This means patients take a slow, deep breath — no need to sharply inhale.^3-5 The soft mist lasts approximately 1.5 seconds, and helps patients inhale their medicine.^*1

Nebulized medicine reaches deep into the lungs.^†3-5 Small particle-sized droplets are deposited into peripheral airways, supporting lung deposition.^3-5

*
As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as the coordination between the actuation of the inhaler and inspiration through the delivery system. The duration of inspiration should be at least as long as the spray duration (1.5 seconds).
†
It is important to note that a correlation between lung deposition and clinical efficacy has not been established.

Backed by Decades of Evidence^2,6-13

The RESPIMAT Soft Mist Inhaler clinical profile has been established across two decades, a large and diverse patient population, and a robust body of controlled and real-world research.

Metrics chart about Spiriva's repimat soft mist inhaler.

Patient Considerations for SPIRIVA RESPIMAT

Consider SPIRIVA RESPIMAT for your appropriate patients^1,5,14

The RESPIMAT inhaler delivers a soft mist for inhalation with a slow, deep breath^*3,5

The RESPIMAT inhaler has a turn-and-press mechanism^1,14

*
As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as the coordination between the actuation of the inhaler and inspiration through the delivery system. The duration of inspiration should be at least as long as the spray duration (1.5 seconds).

Teaching Patients Proper Inhaler Use: The Turn-Open-Press (T-O-P) Technique¹

Based on the SPIRIVA RESPIMAT Instructions for Use (January 2025). Use the following as a patient teaching guide and a basis for in-office demonstration.

Step	Action	What to Teach the Patient	Common Error to Watch For
T — Turn	Turn the clear base	Keep the cap closed. Turn the clear base in the direction of the arrows on the label until it clicks (half a turn). A full half-turn is required—the device will not dispense without it.	Stopping the turn before it clicks. Remind patients: turn until you hear the click.
O — Open	Open the cap	Open the cap until it snaps fully open. Do not open the cap before completing the Turn step.	Opening the cap before completing the turn, or not opening it fully.
P — Press	Press and inhale	Breathe out slowly and fully. Close lips around the mouthpiece without covering the air vents. Point the inhaler to the back of the throat. While taking a slow, deep breath through the mouth, press the dose-release button and continue to breathe in. Hold breath for 10 seconds or as long as comfortable. Repeat T-O-P for a total of 2 puffs.	Inhaling before pressing, or pressing without a coordinated breath. Reassure patients that just a slow, deep breath is required to inhale the medicine and to hold breath for 10 seconds or as long as comfortable.
Daily Dose	Two puffs, once daily	Take 2 puffs (2 complete T-O-P sequences) at the same time every day. Close the cap after the second puff.	Taking only one puff, or taking doses more than once a day.

Before a patient uses SPIRIVA RESPIMAT for the first time, the inhaler must be primed. Walk patients through the following steps at their first appointment:

Insert the cartridge narrow-end first into the inhaler and press firmly until it clicks
Replace the clear base and turn, open, and press until an aerosol cloud is visible. Repeat 3 more times
For complete instructions to review with your patient on how to prepare the inhaler for first use click here
The inhaler is now primed and ready for use
If not used for more than 3 days: actuate once before use
If not used for more than 21 days: repeat the priming process (turn, open, press until mist visible; repeat 3 times)

Clean the mouthpiece (including the metal part inside) with a damp cloth or tissue at least once a week
Store at room temperature between 68°F to 77°F (20°C to 25°C). Do not freeze
Discard the inhaler 3 months after the cartridge is inserted, when the dose indicator reaches zero, or when it expires—whichever comes first

INDICATIONS

SPIRIVA RESPIMAT, 2.5mcg, is indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, and for reducing COPD exacerbations.

SPIRIVA RESPIMAT, 1.25mcg, is a bronchodilator indicated for the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older.

SPIRIVA RESPIMAT is not indicated for relief of acute bronchospasm.

IMPORTANT SAFETY INFORMATION

SPIRIVA® RESPIMAT® (tiotropium bromide) Inhalation Spray is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, or any component of this product. Immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported.

SPIRIVA RESPIMAT is intended as a once-daily maintenance treatment for COPD and asthma, and should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. In the event of an attack, a rapid-acting beta₂-agonist should be used.

Immediate hypersensitivity reactions, including urticaria, angioedema (including swelling of the lips, tongue, or throat), rash, bronchospasm, anaphylaxis, or itching may occur after administration of SPIRIVA RESPIMAT. If such a reaction occurs, discontinue SPIRIVA RESPIMAT at once and consider alternative treatments. Given the similar structural formula of atropine to tiotropium, patients with a history of hypersensitivity reactions to atropine or its derivatives should be closely monitored for similar hypersensitivity reactions to SPIRIVA RESPIMAT.

Inhaled medicines, including SPIRIVA RESPIMAT, may cause paradoxical bronchospasm. If this occurs, it should be treated with an inhaled short-acting beta₂-agonist, such as albuterol. Treatment with SPIRIVA RESPIMAT should be stopped and other treatments considered.

SPIRIVA RESPIMAT should be used with caution in patients with narrow-angle glaucoma. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema). Instruct patients to consult a physician immediately should any of these signs or symptoms develop.

Since dizziness and blurred vision may occur with the use of SPIRIVA RESPIMAT, caution patients about engaging in activities such as driving a vehicle, or operating appliances or machinery.

SPIRIVA RESPIMAT should be used with caution in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Instruct patients to consult a physician immediately should any of these signs or symptoms develop.

Patients with moderate to severe renal impairment (creatinine clearance of <60 mL/min) treated with SPIRIVA RESPIMAT should be monitored closely for anticholinergic side effects.

The most common adverse reactions >3% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in COPD trials were pharyngitis 11.5% (10.1%), cough 5.8% (5.5%), dry mouth 4.1% (1.6%), and sinusitis 3.1% (2.7%).

The most common adverse reactions >2% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in asthma trials in adults were pharyngitis 15.9% (12.4%), headache 3.8% (2.7%), bronchitis 3.3% (1.4%), and sinusitis 2.7% (1.4%). The adverse reaction profile for adolescent and pediatric patients was comparable to that observed in adult patients with asthma.

SPIRIVA RESPIMAT may interact additively with concomitantly used anticholinergic medications. Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs.

Inform patients not to spray SPIRIVA RESPIMAT into the eyes as this may cause blurring of vision and pupil dilation.

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.

CL-SVR-100065 2.15.2017

Please see full Prescribing Information, including Instructions for Use, for SPIRIVA RESPIMAT.

References

STIOLTO RESPIMAT [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc; January 2025.
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for Prevention, Diagnosis and Management of COPD: 2026 Report.
Wachtel H, Kattenbeck S, Dunne S, Disse B. The RESPIMAT® development story: patient-centered innovation. Pulm Ther. 2017;3(1):1-12.
Anderson P. Use of RESPIMAT® Soft Mist™ Inhaler in COPD patients. Int J Chron Obstruct Pulmon Dis. 2006;1(3):251-259.
Iwanaga T, et al. Clin Drug Investig. The Respimat Soft Mist inhaler: Implications of drug delivery characteristics for patients. Clin Drug Investig. 2019;39(11):1021–1030.
O'Donnell DE, Flüge T, Gerken F, Hamilton A, Webb K, Aguilaniu B, Make B, Magnussen H. Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD. Eur Respir J. 2004 Jun;23(6):832-40.
Vestbo J, Vogelmeier CF, Small M, Siddall J, Fogel R, Kostikas K. Inhaled corticosteroid use by exacerbations and eosinophils: a real-world COPD population. Chron Obstruct Pulmon Dis. 2019;14:853-861
Palli SR, Zhou S, Shaikh A, Willey VJ. Effect of compliance with GOLD treatment recommendations on COPD health care resource utilization, cost, and exacerbations among patients with COPD on maintenance therapy. J Manag Care Spec Pharm. 2021 May;27(5):625-637.
Tzanakis N, Koulouris N, Dimakou K, et al. Classification of COPD patients and compliance to recommended treatment in Greece according to GOLD 2017 report: the RELICO study. BMC Pulm Med. 2021;21(1):216.
Quint JK, et al. Effectiveness and Safety of COPD Maintenance Therapy with Tiotropium/Olodaterol versus LABA/ICS in a US Claims Database. Adv Ther. 2021 May;38(5):2249-70.
Halpin DMG, de Jong HJI, Carter V, Skinner D, Price D. Distribution, Temporal Stability and Appropriateness of Therapy of Patients With COPD in the UK in Relation to GOLD 2019. EClinicalMedicine. 2019 Jul 24;14:32-41.
Singer D, et al. Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers. Int J Chron Obstruct Pulmon Dis. 2020;15:3239–3250.
SPIRIVA RESPIMAT [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; January 2025
Luley M-C, et al. Training improves the handling of inhaler devices and reduces the severity of symptoms in geriatric patients suffering from chronic-obstructive pulmonary disease. BMC Geriatrics. 2020;20:398.

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Soft mist delivery helps patients inhale their medicine^1,*

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