How To Tell If You Got Your Dose From Spiriva Handihaler

The pharmacist discusses how to tell you got a full dose from the Spiriva Handihaler device.

Question

If my Spiriva Handihaler does not rattle when punctured, did I get my medication?

Asked by Grandma On Mar 27, 2019

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Mar 27, 2019
Spiriva HandiHaler With Text Overlay

Overview

The Spiriva Handihaler is a dry powder inhaler, with the powder contents contained inside a capsule.

To use, you place one capsule into the Handihaler device, depress a button to pierce the capsule with a needle, and then inhale the powder released from the capsule through the mouthpiece.

Dry powder inhalers, like the Spiriva Handihaler, utilize a very small amount of powder, and often, it can be difficult to know whether or not you've actually inhaled anything after breathing in.[1]

In fact, the prescribing information for Spiriva contains an image showing just how little powder is contained in one capsule:[2]

Spiriva Capsule Powder Image

How To Tell You Got A Dose

You probably won't 'feel' the powder you are inhaling when taking a dose from the Spiriva Handihaler.

The best way to tell you inhaled all the powder from the Handihaler is, after taking a dose, open the mouthpiece and tip out the used capsule onto a dark surface or darkly-colored paper towel to see if there appears to be an excess of white powder.

If there is, you may not be using the inhaler correctly or breathing in hard enough.

It is important to note that there will likely be a small amount of white powder residue that has built-up if you haven't cleaned the inhaler awhile, but any residue you may see should be discernable from a larger amount of powder that would be left from one capsule if you didn't inhale the entire dose.

Another important thing to look out for is an audible 'rattle' noise when you are breathing in a dose from the Handihaler. You must breathe in fairly strongly to ensure you are getting a dose, and when you do, you should hear the capsule rattle around.

The prescribing information states this point specifically:

"Breathe in deeply until your lungs are full. You should hear or feel the SPIRIVA capsule vibrate (rattle)."

If you don't hear a rattle, you may not be breathing in strongly enough.

Additionally, the manufacturer recommends breathing in 2 times from the same Spiriva capsule to ensure you get the full dose.

If you still are having problems with your Handihaler, talk to your doctor or local pharmacist and they should be able to help you out!

Spiriva Alternative

Since we are talking about Spiriva, you may want to consider switching to the Spiriva Respimat if you don't like using the dry-powder inhaler.

Spiriva is now available as Spiriva Respimat, which contains the same active ingredient ((tiotropium bromide) but in a more traditional looking inhaler.

Spiriva Respirmat uses a slow-moving mist as opposed to a powder and you don't need to breathe in nearly as hard to inhale a dose. It also doesn't use capsules at all, but rather has a cartridge that contains one month of doses before you need a new device.[3]

Summary

You likely won't feel the powder being inhaled when taking a dose from the Spiriva Handihaler. You should however hear or feel the capsule rattle inside the Spiriva Handihaler device when breathing in deeply and there should be minimal powder left from the punctured capsule after emptying.

References
  1. ^ Dry powder inhalers: advantages and limitations. PubMed
  2. ^ Spiriva Prescribing Information
  3. ^ Switching From Spiriva Handihaler to Spiriva Respimat.Spiriva Respimat Manufacturer Website

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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