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I've been started on Spiriva (tiotropium) by my consultant, and I've got a few questions about it which I didnt get chance to ask my con (as my appointment had ran over by way too long), and was wondering if anyone could help;

1) Is spiriva the same as atovant? and if so does that mean I can't have atrovant nebules?

2) It seams to be helping me a bit, and was wondering if there are different strengths? mines 18 micrograms.

3) can you get just the drug prescribed withought the strange HandiHaler thing? because I've had two lots prescribed and both came with a Handihaler which i feels a bit of a waste...

4) this isn't about spiriva in perticular but does anyone know if you can take the herbal drug Karlms with theophylline, singulair, sprivia, seretide, pred and citrizine? I'm rather stressed out with all my exams and was considering trying Karlms.

thank you!


8 Replies

Hello ally I too am on tiotropium but on the respimat its not the same as atrovent but is part of the same drug family( antimuscarinic drug). TheoreticLLY you shouldn't have both atrovent and spiriva together but i know people who do ( i have both).

I think spiriva only comes in two strenths (sorry if i am wrong) the handihaler which you are on which is 18mcgs and mine the respimat which is 2.5 mcg but they are both equal in dosage. There's just one dose is what i'm trying to say. The respimat is faIRLY new and not used eveywhere yet :(

Not sure if you can get the capsules but your pharmacy should know :)

As for Karlms i'm not sure, but would say not (my pharmacist won't sell me anything) but again ask them they will be able to help.

Glad its helping you the spiriva :)

Goodluck with your exams.

take care


ally i to take spiriva respimat 2inh once a day i also have atrovent nebs.When im admitted i never use spiriva i always have just atrovent ...when im home i have both where is the sense in that then ?? My brittle asthma consultant prescribed both but my local consultant only wants me to take atroventt grrrr the hassle of multiple consultants ah!!

The drug does the same but in atrovent its stronger i think!!

I as i say i take both and sadwheezer does its never done me any harm but i should just check with your consultant/GP or pharmacy tho..

Spiriva is a drug they use a lot in COPD patients as it has an action on mucus producin membranes..

hope this helps

if your worried ask tho !


PS as for the respimist----its the same as an inhaler its very good and i think all inhalers should be made like this !


Hey there

I have just changed from atrovent to spiriva, mostly on a convenience thing rather than any particular medical benefits. Atrovent is ipratropium, spiriva is tiotropium. They are not the same thing, though they both have the same functional group, i.e. the active drug bit - just spirivia is longer acting, lasting 24 hours rather than the 4 hours that atrovent lasts for.

The medicine is only available in one strength, and as far as I am aware, you can be prescribed just the capsule for your inhaler, you dont need a new device everytime. And to answer your first question a bit more, I still have the atrovent nebules as well, though I only use them for emergencies. It would make no sense to take atrovent regularly on top of spiriva though I should imagine, but check with your cons first if you haven't had the atrovent stopped.

As for the Karlms tablets, I have used those with no ill effect, although I am on different meds to you - i am on spiriva, ciclesonide, symbicort and oxis, and I was fine, however, although Karlms is purely herbal some drugs will interact (and I think it's pretty common for theophylline to be an awkward one) so do check with the doctor first, or pharmacist if your really stuck as they tend to advise you to ask your doctor.

Hope this helps, I am not a medical professional (yet!) so don't take my word for it, do check with your cons or GP.



Thank you!

Then infos been great :)

I only use atrovant nebules, and only when I'm really bad and on top dose of pred and still at home trying to avoid hospital or in hospital... so i guess it should be okay! - will ask next time i see my con.

mmm.. as for kalms, my local pharmasist is the same, wont let me buy anything lol, might ask and see anyways. I'm not normally a stressed person (in fact I don't think ive ever been stressed before), but all this revision is driving me to stress and starting to get to my lungs a bit too.

thank you again!

ally x


I take the Spiriva Respimat (the respimat turns the solution into a fine mist a bit like a neb rather than inhaling powder) and for me it appears to have made a lot of difference (although I'm on other meds so I couldn't say it was definitely that).

I think it only comes in one strength with a standard dosing. It's intended more for COPD patients than asthma, but my cons said it was worth trying and it has really helped - the good thing is that it lasts 24 hours. Had to get the pharmacy to order it in as it's obs not a common med (or form of the med) but now they know me, they keep one in stock.

I don't know about using it (or other meds) with Kalms - I would ask GP/pharmacist/nurse etc. I have something to do something similar on prescription from my GP and she said it was fine with the other stuff I'm on.

If you do a search for 'Spiriva' or 'Tiotropium' on this forum, there were a couple of threads people found for me when I started this med which were helpful.



Bumped up for Frazerdgreat.took some digging up love GLYNIS X


Hi although spiriva and atrovent are different drugs. They belong to the same family. Similar drugs acting on the same target. As such they shouldn't be used together. I wouldn't take one when using the other. Your dr Or asthma nurse should clarify this for you.

Also spiriva come in refill packs without the mechanism. Ask for refill pack when repeating your prestiption.


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