I am already on spiriva which I take first thing in the morning the copd nurse has now given me symbicort ,as this is also inhaled and I have to take it am and pm is it best to take it after or before the spiriva or should I leave a gap between them or is it safe to take one after the other ....... would be grateful for any advice 
Cales
My husband is on both those inhalers and has been for some time. He takes the symbicort as soon as he wakes up as he usually needs it then, as he getting dressed he takes the Spiriva and then uses the symbicort before bed. It seems to work for him and I think it is about finding out what works for you. The Spiriva opens the airways for 24 hours and that is why it is only taken once a day ( a nurse did once explain the technicalities!). I have read though that other people take the Spiriva at night and find that suits them.
He has been told to take two puffs of the symbicort twice a day but tends to take only one puff in the morning and one in the evening as he finds this inhaler the best reliever. If he just takes one puff then he has two puffs in hand (if you know what I mean) and can use them if he needs a reliever.
Take care. Hope this info helps and does not confuse! TAD xx
Hello Cales, I was wondering the very same thing as I take my inhalers at the same time in the morning otherwise I would probably forget.I've read the patient info leaflet and it does not mention taking other meds along side so how are we supposed to know! I've been doing so for a while without any adverse effect,but perhaps someone has been advised otherwise?
hp.
Hiya Cales
I take Spiriva in the morning followed fifteen minutes afterwards by Seretide 500. I take another dose of Seretide twelve hours later. It seems to work ok. Hope this helps.
Bobby
I do the Spiriva about 15 mins before the steroid inhaler in the mornings but really your respiratory nurse should advise you on this. Helpline will be able to advise also on this.
BC
Thank you for your answers when the nurse said that she wanted me on this inhaler as it would make the world of difference to me I think I just got over excited and stopped listening so she may well have told me when to take it have googled it a bit today and all the answers have come back with pretty much the same as you lovely people have said already ,so I think its a case of whats best for me , was more concerned that taking one straight after the other would prevent one working correctly if that makes sense
any way thank you all for the replies
Cales
I open my eyes in the morning, two puffs of symbicort then a few minutes later take the Spiriva. Works really well for me, no side effects.
If you are on the low dose (200) it can be used as a reliever, but when I was in hospital and overdid it, the Sister suggested using the stronger dose (400) as a reliever in emergency circumstances. It works quickly, mine is never out of reach now, but luckily it's not very often that I have to use it.
If it helps, I am advised to take Symbicort morning (06.00) & evening (22.00) and Spiriva at the middle of my day (14.00).
Keep on puffing,
Brian
Which is best
I was diagnosed with moderate emphysema (57) and I am 68 year old. I was told by the Pulmonologist to exercise 30 minutes a day, 
Onbrez and Spiriva memory loss and eyes side effects???
