Drug Uses
Spiriva HandiHaler is used for long–term treatment of bronchospasm associated with chronic obstructive pulmonary disease.

How Taken
Use Spiriva HandiHaler as directed by your doctor. For best results, the canister should be at room temperature before use. Before using Spiriva HandiHaler Aerosol Inhaler, be sure that the canister is properly placed in the inhaler unit. Shake well before each use. Breathe out slowly and completely. Place the mouthpiece between your lips and try to rest your tongue flat, unless your doctor has told you otherwise. Your doctor may have told you to hold the inhaler 1 or 2 inches (2 or 3 centimeters) away from the open mouth or to use a special spacing device. As you start to take a slow deep breath, press the canister and mouthpiece together at exactly the same time. This will release a dose of Spiriva HandiHaler Aerosol Inhaler. Continue breathing in slowly and deeply and hold for as long as comfortable, then breathe out slowly through pursed lips or your nose. If more than 1 inhalation is to be used, wait a few minutes and repeat the above steps. Keep the spray away from your eyes. After inhaling, rinse your mouth with water without swallowing.

Warnings/Precautions
Before using Spiriva HandiHaler, tell your doctor or pharmacist if you have any medical conditions, especially if you have allergies to medicines, foods, or other substances, if you are allergic to any ingredient in Spiriva HandiHaler, if you have active or inactive tuberculosis or a positive skin test for tuberculosis, have infections of the respiratory tract, untreated fungal or bacterial infections, parasitic or viral infections, measles, chickenpox, herpes simplex in or around the eye, or recently received a vaccination, if you have diarrhea, glaucoma or cataracts, if you are pregnant, planning to become pregnant or are breast–feeding. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Spiriva HandiHaler Aerosol Inhaler while you are pregnant. It is not known if Spiriva HandiHaler Aerosol Inhaler is found in breast milk. If you are or will be breast–feeding while you use Spiriva HandiHaler Aerosol Inhaler, check with your doctor. Discuss any possible risks to your baby. Some medicines may interact with Spiriva HandiHaler. Therefore tell your doctor of all prescription or nonprescription medicine, herbal preparation, or dietary supplement that you are taking. Do not use Spiriva HandiHaler if you are having a severe asthma attack requiring quick relief. Spiriva HandiHaler is used to prevent asthma attacks. It is not to be used for a severe asthma attack that requires quick relief. If you are also using a bronchodilator inhaler, be sure to always carry the bronchodilator inhaler with you to use during asthma attacks. Use caution if you switch from an oral steroid (eg, prednisone) to Spiriva HandiHaler. It may take several months for your body to make enough natural steroids to handle events that cause physical stress. Such events may include injury, surgery, infection, loss of blood electrolytes, or a sudden asthma attack. These may be severe and sometimes fatal. Contact your doctor right away if any of these events occur. You may need to take an oral steroid (eg, prednisone) again. Carry a card at all times that says you may need an oral steroid (eg, prednisone) if any of these events occur. Some patients may have trouble using Spiriva HandiHaler correctly. Some may also get mouth sores or a bad taste in the mouth after using it. If you have any of these problems, ask your doctor if a spacing device may help. Contact your health care provider at once if episodes of asthma that are not responsive to bronchodilators occur. Contact your health care provider at once if signs of an infection occur. If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does. Tell your doctor or dentist that you take Spiriva HandiHaler before you receive any medical or dental care, emergency care, or surgery. Spiriva HandiHaler should not be used in children younger than 12 years old, safety and effectiveness in these children have not been confirmed. Children and teenagers may need regular growth checks while they use Spiriva HandiHaler.

Missed Dose
If you miss a dose take it as soon as you remember. However if it is almost time for the next dose, skip the Missed Dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Possible Side Effects
Some of the Possible Side Effects are– Dry mouth, flu, headache, hoarseness, nasal discharge, runny nose, sinus swelling, sore throat, stuffy nose, upper respiratory tract infection. Contact your doctor if any of these or other side effects occur. If you experience any of the following serious side effects, you should seek medical attention immediately– allergic reactions (rash, hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), fainting, lack of energy, nausea, severe dizziness, slowed growth in children, sudden weight loss, tingling of the arms and legs, tiredness, vomiting, weakness, wheezing, white curd–like patches in the mouth.

Storage
Store Spiriva HandiHaler between 36 – 86 °F (2 – 30 °C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Spiriva HandiHaler out of the reach of children.

Overdose
If overdose is suspected seek medical attention immediately.

More Information
Improvement may be noticeable within the first day or 2 of using Spiriva HandiHaler. However, you may need to use Spiriva HandiHaler for 1 to 2 weeks before the full benefit is achieved. If your symptoms do not improve or if they worsen, contact your doctor. Spiriva HandiHaler should be used only by the patient for whom it has been prescribed. Do not take less or more or take it more often than prescribed by your doctor.

Disclaimer
This is only general information, it does not cover all directions, drug integrations or precautions. You should not rely on it for any purpose, it does not contain any specific instructions for a particular patient. We disclaim all responsibility for the accuracy and reliability of this information. We`re not responsible for any damage.