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Drug Info

When is the best time to take Spiriva?

You can take it in the morning or at night, as long as it’s the same time daily
Heidi Borst
By | Apr. 15, 2025 Medically reviewed by Karen Berger, Pharm.D.
An image of Spiriva inhaler | when to take Spiriva morning or night

Key takeaways

  • Spiriva can be taken either in the morning or at night, but morning doses may be easier to remember for some patients.

  • You can take Spiriva with or without food, but to reduce the risk of side effects, you should only take it once every 24 hours.

  • If you miss a dose, take it as soon as possible, but never double it to make up for a missed one.

In this article:

If you have long-term breathing problems, you may be prescribed a long-acting bronchodilator like Spiriva, the brand name for tiotropium bromide. Spiriva is FDA approved as a maintenance treatment for asthma and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. It works by relaxing the muscles surrounding the airways to make breathing easier.

There are two versions of Spiriva: Spiriva Respimat and Spiriva Handihaler. While both options work through the same mechanism of action—targeting muscarinic receptors to improve lung function—they differ significantly in their delivery methods.

The Spiriva HandiHaler device uses a dry powder inhalation system, where patients load a capsule into the device and inhale the medication in powder form. On the other hand, Spiriva Respimat is a soft mist inhaler that delivers the medication in a fine mist, allowing for easier inhalation and potentially better absorption. And since it doesn’t require capsules, it’s a more user-friendly option.

Unlike rescue inhalers like albuterol, which can be used to manage acute symptoms like shortness of breath, chest tightness, coughing, and wheezing, Spririva is not used to manage sudden breathing problems. Instead, it is used once daily as a maintenance medication to prevent asthma and COPD symptoms. 

Spiriva is a once-daily medication, but is there a best time of day to take Spiriva? You can take Spiriva in the morning or at night, as long as you take it at the same time each day. 

Should I take Spiriva in the morning or at night?

There’s no “best” time to take Spiriva, according to Fady Youssef, MD, a board-certified pulmonologist, internist, and critical care specialist at MemorialCare Long Beach Medical Center in California. Asthma and COPD patients can take it whenever it’s most convenient for them. The most important thing to remember is to take it at the same time each day. You can take it with or without food.

Some healthcare providers may recommend taking Spiriva in the morning to avoid missing a dose. Ultimately, deciding whether to take Spiriva in the morning or at night should be based on your lifestyle and preferences. Dr. Youssef says that Spiriva is not known to cause sleep disturbances in general. However, some patients may experience side effects, such as dry mouth, that could indirectly influence their sleep quality.

What’s more, Sprivia should only be taken once per day. Using Spiriva more frequently can increase the likelihood of side effects without offering additional therapeutic benefits. It is crucial to follow the prescribed regimen meticulously to avoid any complications.

Common Spiriva side effects include:

  • Dry mouth
  • Dry skin
  • Indigestion
  • Nausea or vomiting
  • Constipation
  • Muscle pain
  • Stomach pain
  • Sneezing or runny nose
  • Painful white patches in the mouth
  • Nosebleeds

If you experience the following serious side effects, seek emergency medical help for urgent situations or consult a healthcare professional for medical advice:

  • Skin rash or hives
  • Itching
  • Red eyes
  • Signs of a life-threatening hypersensitivity reaction, including swelling of the lips, tongue, and throat that causes trouble breathing or swallowing
  • Hoarseness
  • Chest pain or tightness
  • Signs of an infection (sore throat, fever, chills)
  • Sinus infection symptoms, including headache
  • Urinary tract infection
  • New or worsening urinary retention (painful or difficult urination) 
  • Fast heart rate or heart palpitations
  • Symptoms of narrow-angle glaucoma, such as eye pain or blurred vision, seeing halos or colored images
  • COPD exacerbations, such as bronchospasm

Contraindications include patients who have had allergic reactions to tiotropium, ipratropium, atropine, or similar anticholinergic drugs.

Spiriva Respimat coupons, Spiriva Handihaler coupons

What if I miss a dose of Spiriva?

If you accidentally skip a dose of Spiriva, you can inhale your missed dose as soon as you remember, says Stanley Abraham, DO, a pulmonologist at Northwell Health’s Lenox Hill Hospital in New York. But it’s important not to take the next dose until 24 hours later. If it’s almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Never double up on doses to make up for a missed dose because it can increase the risk of side effects.

Doses vary according to the type of inhaler and condition being treated:

For COPD:

  • Spiriva Respimat: 2 puffs of Spiriva Respimat (2.5 mcg per puff) inhaled by mouth once daily
  • Spiriva Handihaler: 2 puffs of the powder contents of an 18 mcg capsule inhaled by mouth once daily

For asthma (6 years and older): 

  • Spiriva Respimat: 2 puffs of Spiriva Respimat (1.25 mcg per puff) inhaled by mouth once daily

How long does it take for Spiriva to start working?

“The initial effects of Spiriva may be seen within 30 minutes,” says Dr. Abraham. However, its peak effect typically occurs between one and a half and three hours of administration. Maximum results typically take four to eight weeks of consistent use.

Spiriva can provide sustained bronchodilation for more than 24 hours, which is one reason why it is effective as a once-daily medication. The onset of action can be influenced by several factors, including:

  • The severity of the respiratory condition being treated.
  • Individual patient responses to the medication.
  • Adherence to the prescribed treatment plan.

How do I get the most out of my Spiriva?

To get the most out of your medication, use Spiriva every day at the same time, says Dr. Abraham. “Consistent use of Spiriva can lead to improved lung function, reduced exacerbations/hospitalizations, and improved quality of life,” he says, adding that if you have questions about how to take Spiriva do not hesitate to reach out to your healthcare provider to review the appropriate technique. 

To optimize Spiriva’s benefits, try these tips and strategies:

  • Adhere to your prescribed schedule: Dr. Youssef emphasizes that the best way to enhance Spiriva’s effectiveness is to take it consistently, at the same time each day.
  • Use the correct technique: It’s crucial to administer the inhaler correctly to deliver the medication effectively, Dr. Youssef stresses. It’s also important not to shake your Spiriva Respimat inhaler before use—it is designed to provide the correct dose without shaking. And unlike inhaled corticosteroids like fluticasone and budesonide, you don’t have to rinse out your mouth after using Spiriva, says Dr. Youssef. Your healthcare provider or pharmacist can demonstrate the proper technique, or you can watch an instructional video here. 
  • Monitor for side effects: If you experience concerning or uncomfortable side effects, communicate them to your healthcare provider so that any necessary adjustments to your treatment plan can be made.

RELATED: How to use your inhaler

The bottom line 

It doesn’t matter what time of day you take Spiriva as long as you take it consistently and at the same time each day. If remembering to take your medication is a challenge, you may choose to take it first thing in the morning. Stick with your prescribed dose, ensure you’re using the inhaler correctly, and seek guidance from your healthcare provider about any bothersome side effects you may experience.