Reported Reactions

Drugs

Brand name · Tiotropium bromide

Spiriva Handihaler: adverse event reports filed with FDA

776 reports list it as a suspect or interacting product, 2004–2024.

776
reports as suspect product
0% of all reports · about 36 a year
0
reports, 12 months to June 2026
10 in the 12 months before
18.3%
marked serious by the reporter
57.4% across all reports
3.1%
record death among outcomes, as reported
24 reports · not verified by FDA

776 adverse event reports received by FDA list the brand name Spiriva Handihaler (tiotropium bromide) as a suspect or interacting product, from December 2004 to August 2024. A further 241 reports list it only as a concomitant medication, and those are not counted in the figures on this page.

In the 12 months to June 2026, 0 reports listed it, against 10 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 36 reports a year and 0% of the 20,646,523 reports in the database. How many people take it is not in the data, so a count is not a rate of occurrence.

The reactions recorded most often are incorrect route of product administration (25.1%), product physical issue (14%) and dyspnoea (12.5%). A report can list several reactions, so shares add to more than 100%; 124 different terms appear across these reports. Incorrect route of product administration is recorded in 25.1% of these reports, against 0.1% of all reports in the database.

18.3% of the reports are marked serious by the reporter; 3.1% record death among the outcomes and 8.2% record hospitalisation, as reported. 91.2% of the reports came from consumers, and the largest patient age group is 75 and over (20.5%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

02345Jul 2021: 0Aug 2021: 2Sep 2021: 0Oct 2021: 2Nov 2021: 4Dec 2021: 32022Jan 2022: 24Feb 2022: 34Mar 2022: 45Apr 2022: 29May 2022: 38Jun 2022: 34Jul 2022: 34Aug 2022: 28Sep 2022: 16Oct 2022: 26Nov 2022: 27Dec 2022: 212023Jan 2023: 24Feb 2023: 17Mar 2023: 22Apr 2023: 13May 2023: 23Jun 2023: 27Jul 2023: 15Aug 2023: 30Sep 2023: 19Oct 2023: 16Nov 2023: 19Dec 2023: 132024Jan 2024: 8Feb 2024: 15Mar 2024: 15Apr 2024: 9May 2024: 11Jun 2024: 7Jul 2024: 6Aug 2024: 4Sep 2024: 0Oct 2024: 0Nov 2024: 0Dec 2024: 02025Jan 2025: 0Feb 2025: 0Mar 2025: 0Apr 2025: 0May 2025: 0Jun 2025: 0Jul 2025: 0Aug 2025: 0Sep 2025: 0Oct 2025: 0Nov 2025: 0Dec 2025: 02026Jan 2026: 0Feb 2026: 0Mar 2026: 0Apr 2026: 0May 2026: 0Jun 2026: 0

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

01783562004: 420042006: 12007: 320072008: 32009: 520092010: 142011: 1920112012: 292013: 1320132014: 22020: 120202021: 132022: 35620222023: 2382024: 752024

Reactions recorded in the reports

share of Spiriva Handihaler reports recording the termall reports in the database

  1. Incorrect route of product administrationthe product was given by the wrong route25.1%195
  2. Product physical issuea physical defect in the product14%109
  3. Dyspnoeashortness of breath12.5%97
  4. Product use issuea problem in how the product was used12.2%95
  5. Product quality issuea problem with the product itself9.5%74
  6. Off label useused for a purpose or in a way not on the label9.1%71
  7. Intentional product use issuedeliberate use not as intended5.2%40
  8. Drug ineffectivethe medicine did not work as expected4.6%36
  9. Coughcough3.2%25
  10. Covid-19COVID-19 infection3.1%24
  11. Dry mouthdry mouth3%23
  12. Chronic obstructive pulmonary diseaseCOPD, a long-term lung disease2.7%21
  13. Pneumonialung infection2.6%20
  14. Deaththe patient died; cause not stated by this term2.2%17
  15. Dysphoniaa hoarse voice1.8%14
  16. Intentional overdosea deliberate overdose1.8%14
  17. Oropharyngeal painsore throat1.7%13
  18. Bronchitischest infection1.3%10
  19. Dizzinesslight-headedness or unsteadiness1.3%10
  20. Incorrect route of drug administrationthe medicine was given by the wrong route1.3%10
  21. Intentional product misusedeliberate use not as intended1.3%10
  22. Chest painchest pain1.2%9
  23. Fatiguetiredness1.2%9
  24. Constipationconstipation1%8
  25. Product delivery mechanism issue1%8
  26. Atrial fibrillationan irregular heart rhythm0.9%7
  27. Device delivery system issuea problem with the delivery system0.9%7
  28. Device issuea problem with the device0.9%7

Top 30 of 124 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the share of all reports in the database; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death3.1%24
Life-threatening0.8%6
Hospitalisation (initial or prolonged)8.2%64
Disability1.3%10
Congenital anomaly0%0
Other serious12.5%97
Not serious81.7%634

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 20,646,523 reports. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 20%0
2 to 110%0
12 to 170%0
18 to 440.1%1
45 to 6412.6%98
65 to 7416.4%127
75 and over20.5%159
Age not given50.4%391

Patient sex

Female65.3%507
Male30.3%235
Not given4.4%34

Who reported

Physician1.7%13
Pharmacist3.2%25
Other health professional2.7%21
Lawyer0%0
Consumer or non-health professional91.2%708
Not given1.2%9

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 99.5% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Chronic obstructive pulmonary disease39250.5%
Asthma476.1%
Emphysema202.6%
Dyspnoea60.8%
Lung disorder60.8%
Bronchitis chronic30.4%

The indication field is filled in by the reporter and is often blank; shares are of all 776 reports.

In context

MeasureSpiriva HandihalerAll reports
Reports as suspect product77620,646,523
Share of that pool—0%
Reports, latest 12 months01,332,454
Marked serious18.3%57.4%
Death recorded among outcomes, per 1,000 reports3191
Hospitalisation recorded, per 1,000 reports82213
Consumer-filed share91.2%45.8%
Top term, share of reportsIncorrect route of product administration 25.1%0.1%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Questions about Spiriva Handihaler reports

How many adverse event reports has FDA received for Spiriva Handihaler?

776 reports list Spiriva Handihaler as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 0 of them arrived in the latest 12 months. Another 241 list it only as a concomitant medication.

What reactions are recorded in Spiriva Handihaler reports?

incorrect route of product administration (25.1%), product physical issue (14%), dyspnoea (12.5%), product use issue (12.2%) and product quality issue (9.5%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Spiriva Handihaler was responsible.

How serious are the reports?

18.3% are marked serious by the reporter. Among the outcomes recorded, 3.1% of reports include death and 8.2% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

consumer or non-health professional (91.2%), pharmacist (3.2%) and other health professional (2.7%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Spiriva Handihaler rising?

0 reports in the 12 months to June 2026, against 10 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Spiriva Handihaler was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Spiriva Handihaler?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Spiriva Handihaler as a suspect or interacting product; reports listing it only as a concomitant medication (241) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.