Spiriva and Foradil Inhalers - How to Use them?

Tiotropium (Spiriva) is a new bronchodilator approved for COPD management. It is a long-acting, anticholinergic bronchodilator for the long-term, once-daily, maintenance treatment.
With once-daily dosing, tiotropium has greater patient compliance compared with current COPD therapy.
Price: $117
Source: AFP

This is the Spiriva inhaler called HandiHaler.

This is how you put the capsule in the Spiriva HandiHaler. Please take the time to explain to your patients not to swallow the capsules.

You can print out the instructions about the inhaler use from the Spiriva website.

Foradil (formoterol) is the long-acting beta-2 agonist that we use in our hospital, it replaced the Serevent. The problem is the same as with Spiriva - just tell your patient not to swallow the capsules but to use them in their device for inhalation.

Foradil inhaler from inside.

Foradil inhaler use is explained here. You can see it in use on the Foradil website.

Other Inhalers
The best guide for inhaler devices is published on GINA (Global Initiative for Asthma) website, they start with the really simple MDIs and go to something called Spinhaler.
You can also check all forms of inhalers and other asthma devices here. There are so many of them, no wonder it is hard to figure which is which.

Asthma Classification and Treatment
GINA website also offers a downloadable PowerPoint set on asthma classification and treatment which is another excellent resource.
There is more on the AFP website.


  1. wow, this is amazing

  2. Problems: Can't open blister, had to cut open. Aerolizer Inhaler does not puncture capsule, cut it open and poured powder into Inhaler, closed and inhaled.

  3. The capsule should NOT be cut open. It should only be punctured ONCE. Pouring it into the device will change the amount you use. Please contact your doctor or pharmacist about receiving a new device since this one is not working correctly. As a pharmacist, I feel I am inclined to tell you this.