British Lung Foundation
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Which is best

I was diagnosed with COPD 3 years ago.

My initial medication was Spiriva. Which works to a degree.

I say works to a degree because I'm wondering if the spiriva is supposed to make breathing easier or normal.

I can take spiriva and still get puffy when I'm gardening, or drying my hair, and not just a bit puffy.

I've now just started taking onbrez as well. Its only been 3 days but i think from the start it looks like being more beneficial to me. Time will tell.

I'm told to take both the spiriva and the onbrez.

Is there any benefit from taking one before the other ?

Someone told me they inhale Ventolin before they use the inhalers.

My god there's no end to it.

Do we really need oxygen ?

10 Replies

Hi Keith49 I take spiriva and still get sob. Don't think anything is going to stop that - not with COPD. Its a matter of degree thats all.

Oxygen is not used to help with breathing. It is only given when sats are too low and the organs in your body need extra oxygen to support them. They won't work properly if your oxygen level is too low.


The phrase 'we are all different' comes up regularly. What works for one may not be right for another and a lot of the rounds of different medication we go through is rather trial and error until you get one that works for you.

I have Spiriva and it is supposed to last 24 hours as a preventer, in that it opens the airways to stop me getting breathless, but only in 'normal' mode. If I push myself then I will still get short of breath and need to use my Ventolin.

There have been studies that show that using Spiriva and Onbrez (indacaterol) together gives better results than Spiriva alone. However, the research was conducted by the company who make it. I have not used Onbrez myself.

There was a mention of it here before -

> Someone told me they inhale Ventolin before they use the inhalers.

It's been mentioned at but my own thoughts are that this need to be discussed with the professional who prescribes it, as it's not in the instructions.

See how you go with Onbrez and come back and let us know what it's done for you, unless we see you in the 2016 Olympics first... ;-)


Findings of the INTRUST 1 and 2 studies showed significant improvements in lung function of 130 mL and 120 mL respectively for Onbrez Breezhaler plus Spiriva compared to Spiriva alone after 12 weeks of therapy.


Thank you every one for the feed back.

Like I said Ive just started the onbrez so time will tell. I realize that every one is different, but i was wondering if there is a common denominator with this stuff.

I have read a lot of the web jibe about spiriva and onbrez.

You read a lot of clinical test reports, but i was curious to know what is happening in the real world.

But I must say this, when took onbrez for the first time, i actually felt it had a better effect on me than spiriva.(thats after i stopped coughing) Maybe I hyperventilated. :)

I went for a 7 Km bike ride after taking the onbrez and it did seem easier.

Took the spiriva when i got back home.

By the way has anyone else got runkeeper. Its an app for smart phones.I keep a track of my exercise activities, it helps to motivate me. People can become street buddies, and keep tabs on each other.If interested google runkeeper.


Was surprised you took the Spiriva after you got home. I was always told to take Spiriva just once a day in the morning and to take my inhalers in the following order Bricanyl (to open the airways ) then Spirive then Symbicort. Incidentally how long do others allow between Inhalers? I thought it was a full minute but now I`m not so sure. mskpjb (Sheila)


Hi Sheila,I too take spiriva,seretide,ventolin and Ipramol(from a machine).I take them in that order first thing in the morning,one after the other.Then during the day I have to take the Ipramol a further 3 times,the ventolin up to 4-5 times and then the seretide again just before I go to bed.(sandy)x


I was first given spiriva to take once a day in the morning. Then i was given onbrez to take once a day in the morning. To see if the new onbrez made any difference,l took it fist then went for a ride. I think there was a slight improvement. So i then took the spiriva. Im only on spiriva and onbrez, so far. Hopefully with the excercise I can keep it at that.Time will tell i guess.


I know this is a 2yo post but I saw a respiratory specialist a couple of days ago who said I should not be using Spiriva and Onbrez. He said choose one or the other. Now I'm even more confused. I also use Symbicort x twice daily.

I have severe COPD.

Any updates on whether or not we should use Spiriva and Onbrez, please.


Hi, I have just found this post so will update you my Consuktant'views.

I have been taking sembicort for 7 years successfully but this year it's really not been working sadly. She has changed me to (i) Spiriva at night, (ii) onbrez in the morning and (ii) servitide twice a day and after a month of trials I am breathing fairly normally again even under mild exercise. I started just with onbrez plus Seritide but still slight breathlessness. Since I added the Spiriva at night I have notice a significant improvement.

I really trust my Consultant she gas an MSc from imperial college and she has managed my Asthma really well for past 7 years with acute episodes . Prediserone steroid etc..

Sembicort is really great since you can vary the dose from 1 to 3 puff twice a day.

As people say find what works for you? We have have to breath so it's the lesser of two evils !!

At 62 I gave been inhaling all sorts of powders and steroids for nearly 40 years my voice is harsh... But I am alive.

All the best



you started to take medicication from 22, that must be tough!


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