I have been prescibed spiiva respimat inhaler2.5mcg/actuation 2puffs once a day. The drug stores have all said I'm the first person they have filled it for.They had to order it.So far none of them sound like they know anything about this inhaler. So I'm nervous about using it.I have used spiriva handihaler 18mcg capsules one a day in the past befre I was put on tudorza 400mcg per actuation 1 inhalaation twice a day and I inhale it count to ten or more and have to exhale it out of my nose. I still wheeze on and off. The new spiriva respimat would be only once a day which would be better. Just not sure about the spray and I'm not sure about the amount of the medication ingredation change and it being a spray. Also has anyone heard about the stem cell being used to fix peoplees lungs. I read it would come from your own body.