When to take my Spiriva

Hi All,

I changed to Spiriva a couple of months ago and normally take it around 0630-0700 when i get up, it takes a little while to kick in so i find i am a little bit SOB in the mornings, but most days not too bad.

Spiriva is a 24 hour drug so i realise it is not so effective early hours of the morning.

2 nights ago my girlfriend had a shock as she woke up about 2am to find me fighting for breath, apparently i was lifting myself up slightly but could not get a breath. She tried slapping me, pinching me and then shouting at me to try and get me to wake up.

She says this went on for about 5 minutes, but time in a stressful situation like that tends to get exaggerated so it was probably only a couple of minutes.

She was about to call for an ambulance when apparently i managed to take a deep breath and fell into a deep sleep. She was petrified and i don't want to put her in that situation again. So am i better off taking the medication later in the day or evening?

I remember a post recently and the member wrote that he/she takes the medication around 3pm to ensure a peaceful sleep knowing that the airways are open.

I am thinking of doing the same, but probably around 5pm as sometimes i am out working in the afternoons.

If i started today for example, does it matter that i took a dose this morning? The alternative is not to take a dosage tomorrow morning and wait until evening, but don't fancy a day being SOB.

Any advice please?


19 Replies

  • I shouldn't worry about taking two doses in 24 hours, if you get ill they bang loads more into you ;-) I use spiriva every morning, taking it after ventolin has opened my airways. I'm not really sure that taking it in the evening would make much difference either way. Have you been tested for sleep apnoea?

  • Hi Frose

    I have not been tested for sleep apnea but think i need to as i have been a long time snorer. Due to see my pulmonologist on xmas day so will talk to him about it.

    I very rarely use my ventolin, it was not prescribed by my doctor, just felt it was handy to have around in an emergency. I used it today mid morning as i was feeling SOB shopping.

    Maybe i should take it at night?


  • Yes, it can't hurt and may help. I use ventolin both morning and night and do find it helpful. But I think asking about sleep apnoea is important. But... Christmas day?! That's plain mean :-)

  • Hi Frose,

    Don't worry about xmas day, i live in Thailand so just another day for us. Not celebrated xmas for many, many years.

    If you are using ventolin can i ask what stage COPD and FEV% you are? My Dr. did not prescribe i just bought at my local pharmacy. Came in handy when we had the haze from Indonesia last month.


  • Definitely ask about the sleep apnoea. I recognise your symptoms from just before my husband was diagnosed.

  • Hi Toci

    Been in touch with my hospital and they do an overnight test in the neurology department, just waiting to see if my insurance will cover it. As i will be admitted it should do, but as it is just a test, maybe not.

    About 500 pounds, so not cheap.


  • No, not cheap, but better than the alternative! (oxygen starvation)

  • Current FEV 58%. Once diagnosed as severe but moderate these days. But I have both COPD and asthma. I'm prescribed ventolin twice daily and spiriva and duoresp spiromax once daily, to be taken after ventolin. The thing is, if you're SOB then I'd suggest using ventolin but obviously you need to discuss this with your doctor. Maybe try it for a few days so you can feed back to him/her on it.

  • Hi Frose,

    Ok, thanks for that. I am FEV69%, mild copd bronchitis but moderate emphysema, plus of course asthma. Hoping that my FEV will have improved next month, but have a gut feeling it will be worse. Was only diagnosed with emphysema in September after a ct scan. My Dr. wanted me to have a ct scan every 3 months to check progression, which i thought unusual plus expensive. So i told him 6 months would suit me better, although other people have told me that a scan is usually only required once a year. Maybe the Dr. Knows something i don't?


  • Do not get a CAT scan more than once a year, if that. It emits extreme radiation. You don't want to get cancer of the lungs! I also have asthma and an FEV of 67%. I use YouTube for respiratory exercises and/or yoga every day.

    Sounds like it's sleep apnea.

    Also, I followed the advice of some on this post, and although I don't need it most of the time, I found that taking Ventolin before the Spiriva did seem to help.


  • Hi Irene

    I have also started taking ventolin morning and night and yes, it does help.


  • Hi Swerv

    As frose said it will be worth asking about sleep apnoea, Do you sleep flat or elevated? I cannot lie flat for any length of time, When I do my sats drop and then my lungs start to stutter and the noise wakes my wife. If you do sleep flat it may be worth investing in a bed wedge prices start on Amazon from £10 in the UK.


  • Hi Andy

    I do try to sleep in a slightly elevated position, in fact after the episode 2 nights ago my girlfriend packed me in with pillows last night, but found by this morning that i had managed to slip down the bed onto my back again.

    I am going to try Frose's suggestion and take ventolin tonight.

    Also found out that my hospital does test for sleep apnea, so will set that up, depending on cost.


  • Have you tried an inflatable backrest or VPillow to help your position at night.

    Good luck.

  • Hi, i set my pillows up at nighttime so that i am in a raised position but find by morning i have slipped back down the bed during the night.

    Need to look at something else.


  • I was interested to see you take Duoresp Spiromax Frose - do you have any problems with it? I found that it made my condition worse, wheezing and very SOB so took it back to doc with hard copy of all the complaints regarding it that I've read on-line; I currently have no preventor, just Ventolin and Spiriva, short and long-term relievers. If I get an exacerbation I'll be back on Seretide which suits me fine but I've seen complaints on HU about that too. Seems we all respond differently to different meds.

  • Hi

    No, I don't have problems with it - I take it twice a day. Originally I'd been on symbicort but as I was keen to reduce my steroid dose it was changed to relvar ellipta (??) which made me very ill very fast, so then that was replaced with duoresp which I seem fine on. As you say, different strokes...

  • I'm told to take mine in the morning and again at night.

  • Hi SquirrelsHot

    Spiriva is supposed to be long acting so the normal is one dose a day. Just googled it:

    SPIRIVA HandiHaler (tiotropium bromide inhalation powder) is indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. SPIRIVA HandiHaler is indicated to reduce exacerbations in COPD patients.


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