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Spiriva Side Effects

Generic name: tiotropium

Medically reviewed by Last updated on Jan 25, 2024.

Note: This document contains side effect information about tiotropium. Some dosage forms listed on this page may not apply to the brand name Spiriva.

Applies to tiotropium: inhalation capsule, inhalation spray.

Serious side effects of Spiriva

Along with its needed effects, tiotropium (the active ingredient contained in Spiriva) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tiotropium:

More common

Less common


Other side effects of Spiriva

Some side effects of tiotropium may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

Incidence not known

For Healthcare Professionals

Applies to tiotropium: inhalation aerosol, inhalation capsule.


The most commonly reported adverse reaction was dry mouth, usually mild and often resolved during continued treatment.

Other reactions consistent with possible anticholinergic effects included constipation, tachycardia, blurred vision, glaucoma (new onset or worsening), dysuria, and urinary retention.[Ref]


Very common (10% or more): Pharyngitis (11.5%)

Common (1% to 10%): Respiratory tract infection, cough, sinusitis, rhinitis, epistaxis, dysphonia, chest pain, laryngitis

Rare (less than 0.1%): Epistaxis, bronchospasm,

Postmarketing reports: Pharyngolaryngeal pain, throat irritation, hoarseness[Ref]


Common (1% to 10%): Palpitations, angina pectoris (including aggravated angina pectoris)

Uncommon (0.1% to 1%): Atrial fibrillation

Rare (less than 0.1%): Palpitations, supraventricular tachycardia, tachycardia[Ref]


Common (1% to 10%): Pruritus, rash

Rare (less than 0.1%): Angioneurotic edema, urticaria, skin infection, skin ulcer, dry skin[Ref]


Common (1% to 10%): Dry mouth, constipation, gastroesophageal reflux, oropharyngeal candidiasis, dyspepsia, abdominal pain, vomiting

Uncommon (0.1% to 1%): Dysphagia, gingivitis, intestinal obstruction including ileus paralytic, stomatitis (including ulcerative stomatitis)

Rare (less than 0.1%): Dental caries, glossitis

Frequency not reported: Nausea

Postmarketing reports: Oral candidiasis, throat irritation, mouth ulceration[Ref]


Common (1% to 10%): Urinary tract infection

Uncommon (0.1% to 1%): Urinary retention, dysuria[Ref]


Common (1% to 10%): Allergic reactions

Rare (less than 0.1%): Angioedema, hypersensitivity (including immediate reactions)

Frequency not reported: Anaphylactic reactions[Ref]


Common (1% to 10%): Hypercholesterolemia, hyperglycemia

Frequency not reported: Dehydration[Ref]


Common (1% to 10%): Myalgia, arthritis, skeletal pain, leg pain

Frequency not reported: Join swelling[Ref]

Nervous system

Common (1% to 10%): Dizziness, paresthesia

Uncommon (0.1% to 1%): Headache, insomnia, taste disorder[Ref]


Common (1% to 10%): Cataract

Uncommon (0.1% to 1%): Blurred vision

Rare (less than 0.1%): Glaucoma, intraocular pressure increased[Ref]


Common (1% to 10%): Edema, infections, moniliasis, influenza-like symptoms, herpes zoster[Ref]


Common (1% to 10%): Depression[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics."

2. Cerner Multum, Inc. "Australian Product Information."

3. (2015) "Product Information. Spiriva Respimat (tiotropium)." Boehringer Ingelheim (Canada) Ltd

4. (2002) "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim

5. (2004) "Tiotropium (Spiriva) for COPD." Med Lett Drugs Ther, 46, p. 41-42

6. Grosso A, Douglas I, Hingorani AD, MacAllister R, Hubbard R, Smeeth L (2009) "Inhaled tiotropium bromide and risk of stroke." Br J Clin Pharmacol, 68, p. 731-6

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.