Spiriva Side Effects

by on December 24, 2011


Common but easily treatable side effects of Spiriva (Tiotropium) include dry mouth, sore throat and upper respiratory infections.  More serious but rarer Spiriva side effects include a worsening of breathing problems, wheezing, chest pain and severe constipation.

Common Spiriva Side Effects

There are many potential side effects of Spiriva . Clinical studies have found that the most common of these side effects are:

  • Dry mouth
  • Sore throat
  • Upper respiratory infections such as the common cold
  • Sinus infection
  • Bladder infection
  • Stomach pain
  • Constipation
  • Indigestion
  • Vomiting
  • Muscle pain
  • Yeast infection
  • Runny nose
  • Nosebleeds

Of these side effects, upper respiratory infection is by far the most reported, followed by dry mouth, sinus infection, sore throat and bladder infection. Although this list of side effects is long, most of them are very minor and can easily be treated either by a healthcare provider or by the user his or herself. In some cases they may not require any treatment at all.

Serious Spiriva Side Effects

Spiriva Side Effects

Spiriva (Tiotropium) users are also at risk of more serious side effects, but these are far less common. Still, should any of the following complications arise, the patient should immediately get in touch with his or her doctor:

  • Worsening breathing problems
  • Severe constipation
  • Difficulty passing urine
  • Irregular heart rhythm (arrhythmia)
  • Changes in vision
  • Changes in voice
  • Chest pain
  • Leg pain
  • Bone pain
  • Signs of an allergic reaction, such as hives, itching, unexplained rash  or difficulty breathing or swallowing
  • Unusual sensations, such as burning or tingling
  • Gastroesophageal reflux disease (GERD)
  • Canker sores
  • High cholesterol
  • High blood sugar (hyperglycemia)
  • Depression
  • Shingles
  • Cataracts

The majority of these serious side effects are very rare.  Amongst the rarest are depression, voice change, cataracts, high cholesterol and hyperglycemia. However, patients should still be vigilant for symptoms of any of these complications. If they believe themselves to be presenting any symptoms they should contact a healthcare provider.

Immediate Side Effects

In extremely rare cases, patients may experience immediate hypersensitivity reactions to Spiriva. These reactions include

  • urticaria
  • angioedema (including swelling of the lips, tongue or throat)
  • bronchospasm or anaphylaxis

If one of these reactions occurs, the patient should stop using Spiriva immediately and consult his or her doctor in regards to alternative treatments. As tiotropium has a similar structural formula to atropine, patients with a history of hypersensitivity reactions to atropine should be carefully monitored for similar reactions to Spiriva.

Other Medications

Tiotropium can cause an adverse reaction when combined with other medication; therefore patients should inform their doctor of all the prescription and non-prescription medicines they take before being prescribed Spiriva. This includes eye drops, vitamins and herbal supplements. Spiriva users should not take other anticholinergic medicines, including ipratropium. If a patient isn’t sure whether or not a particular medicine is an anticholinergic, she or he should consult a doctor.

Once taking Spiriva, patients should check with a health care provider that any subsequent medicines they start taking do not cause an adverse reaction when used in conjunction with tiotropium.

Spiriva and Patients with Existing Conditions

In some cases, the use of Spiriva can worsen a pre-existing condition. Such conditions include narrow-angle glaucoma and  urinary retention. Patients with these conditions should be closely monitored in their use of tiotropium. If a Spiriva user with narrow-angle glaucoma starts presenting symptoms such as eye pain, blurred vision or visual halos, he or she should consult a doctor at once. Patients with urinary retention need to be vigilant for signs of prostatic hyperplasia or bladder-neck obstruction, including difficulty passing urine or painful urination. Should these symptoms develop, the patient must inform his or her doctor.

As tiotropium is a predominantly renally excreted drug, Spiriva users with moderate to severe renal impairment should also be carefully monitored because they are at risk of developing anticholinergic side effects. In addition to the side effects specifically associated with Spiriva, further anticholinergic side effects may include memory loss, confusion, light-headedness and mental fogginess. Should a tiotropium user with moderate to severe renal impairment start presenting any of these symptoms, he or she should seek  medical consultation immediately.


There are no adequate and well-controlled studies regarding the effects of Spiriva on pregnant women. In clinical studies where doses of tiotropium were applied to rats and rabbits, no evidence of structural alterations was observed. However, in rats the drug caused such effects as fetal resorption, litter loss and decreases in the number of live pups at birth. In rabbits, tiotropium caused an increase in post-implantation loss. Given these tiotropium side effects and the lack of clinical trials on pregnant humans, Spiriva should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.

Although people with certain medical conditions must be careful when taking Spiriva, the drug is safe to take in the majority of cases. However, Spiriva is no different to any other medicine in so much as there will always be a risk of side effects. Patients may experience  several Spiriva side effects or they may experience none. The important thing is to remember to be vigilant for any side effects of Spiriva when taking the drug.