Compare Combivent vs. Spiriva

Head-to-head comparisons of medication uses, side effects, ratings, and more.

(Ipratropium / Albuterol)


Makes it easier to breathe. Combivent (Ipratropium / Albuterol) is good for people who need 2 medicines to relieve their COPD symptoms, but you need to be okay with taking it four times a day.Makes it easier to breathe. Spiriva (Tiotropium) works well to reduce COPD symptoms and flare-ups with fewer side effects than some medicines that open airways, but you have to use it every day.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
Reviews for Combivent (Ipratropium / Albuterol)
of people say Combivent (Ipratropium / Albuterol) is worth it
say it works well
say it's a big hassle
Reviews for Spiriva (Tiotropium)
1% vs. Combivent (Ipratropium / Albuterol)
+6% vs. Combivent (Ipratropium / Albuterol)
+4% vs. Combivent (Ipratropium / Albuterol)
Side effects

The Combivent FDA package insert doesn’t have numbers about how common side effects are.

More about Combivent side effects »
  • Dry mouth 13%
  • Respiratory tract infection 4%
  • Sore throat 2%
  • Sinus inflammation 2%
  • Urinary tract infection 2%
  • Chest pain (non-specific) 2%
  • Abdominal pain 2%
  • Yeast infection 2%
  • Rash 2%
  • Nosebleed 2%
More Spiriva side effects »
How it works
Combivent (Ipratropium / Albuterol) is a combination medicine. It contains two bronchodilators (ipratropium and albuterol), which relax muscles in your lungs to open airways and make breathing easier.Spiriva (Tiotropium) is a bronchodilator. It relaxes muscles in your lungs to open your airways and make breathing easier.
Type of medication
Short-acting bronchodilator
Short-acting bronchodilator
Prescription only
Long-acting bronchodilator
Prescription only
Available as
  • Inhaler
  • Inhaler
Used for (click to learn more)
Risk factors for serious side effects
    • History of rapid heartbeat
    • History of high blood pressure
    • history of heart failure or chest pain.
    • History of narrow-angle glaucoma
    • History of high eye pressure
    • Spraying Combivent (Ipratropium / Albuterol) into eyes
    • History of urinary bladder blockage (urinary obstruction)
    • History of enlarged prostate
    • History of atropine allergic reaction
    • Taking Combivent (Ipratropium / Albuterol) with drugs that decrease potassium
    • History of low potassium
    • Taking Combivent (Ipratropium / Albuterol) aerosol inhaler
    • History of soybean allergy
    • History of peanut allergy
    Detailed Combivent (Ipratropium / Albuterol) risks & warnings »
    • History of atropine allergic reaction
      • History of narrow-angle glaucoma
      • History of urinary bladder blockage (urinary obstruction)
      • History of enlarged prostate
      • Severe milk protein allergy
      • History of moderate to severe kidney disease
      • Taking with other anticholinergic medications
      Detailed Spiriva (Tiotropium) risks & warnings »
      Pregnancy category
      No specific alcohol-related info.No specific alcohol-related info.
      • There are reports of severe allergic reactions in people taking Combivent (Ipratropium / Albuterol) aerosol inhaler who have allergies to soybean or peanuts. This is because the aerosol contains soya lecithin. Call 911 or your doctor right away if you develop severe rash, itching, swelling or difficulty breathing while taking Combivent (Ipratropium / Albuterol). Talk to your doctor about other medication choices to treat your COPD if you know you have food allergies to soybean and/or peanuts.
      No specific food-related info.
      Kidneys and liver
      No specific kidneys and liver-related info.
      • The kidney is mainly responsible for removing Spiriva (Tiotropium) from the body so people with kidney disease or reduced function need to be watched closely. Spiriva (Tiotropium) can build up in the body and cause certain side effects. Tell your doctor if you develop dry mouth, blurry vision, confusion, sweating, increased heart rate or constipation. You may need to discuss other medication options to treat your COPD.
      No specific sex-related info.No specific sex-related info.
      • One of the medications in Combivent (Ipratropium / Albuterol) may increase blood pressure and heart rate, especially if you already have these conditions. Tell your doctor if you notice a tremor, rapid heartbeat, get dizzy or have difficulty sleeping while taking Combivent (Ipratropium / Albuterol), you may need to change or stop this medication.
      No specific sleep-related info.
      No specific weight-related info.No specific weight-related info.
      Upsides and benefits
      • 2-in-1 medicine that opens airways and makes it easier to breathe. Medicines are more effective together than alone.
      • Effectively relieves COPD and asthma symptoms.
      • Respimat formulation has a clear display for dosing, doesn't require shaking, and only needs one inhalation per dose.
      • Helps you breathe easier and lessens the need for a fast-acting (rescue) inhaler.
      • Reduces flare-ups and hospitalizations with fewer side effects compared to some other medicines that open airways.
      • You only need to take it once a day.
      Downsides and risks
      • You have to use Combivent four times a day.
      • Can make your heart race.
      • Can make symptoms of enlarged prostate or urinary blockage worse.
      • Can worsen a certain type of glaucoma.
      • Won't cure your COPD (but it will relieve your symptoms).
      • You'll need to use this medicine for a long time, and you have to take it every day.
      • You might feel dizzy or have blurry vision while taking this medicine.
      • Can make symptoms of enlarged prostate or urinary blockage worse.
      • Can worsen a certain type of glaucoma.
      Tips from our pharmacists for people taking the medication
      • Starts working in 15 to 30 minutes, and lasts about 4 to 6 hours.
      • Make sure to read the instructions about how to set up your first dose.
      • Clean the mouthpiece with a damp cloth once a week.
      • The inhaler shows you how much medication you have left so you can plan ahead for refills.
      • Don't take it more often or change your dose without talking to your doctor first.
      • Tell your doctor if the medication stops working or if your symptoms get worse.
      • One type of inhaler contains soya lecithin, so don't use if you have soybean, peanut, or allergies to atropine.
      • Don't swallow the capsule. Insert the capsule into an inhaler device only.
      • Use daily to control your COPD.
      • Starts working the first few hours, but it may take longer to feel full effects.
      • Prevents breathing problems, but doesn't stop sudden cough or wheezing once they start.
      • Don't breathe out into the inhaler.
      • You might feel dizzy and notice changes in your vision.
      • Don't use it if you have an allergy to atropine.
      • Contains lactose, so don't use it if you're allergic to milk protein.
      Learn more
      More about CombiventSide effectsReviews & ratingsAlternativesFDA package insert
      More about SpirivaSide effectsReviews & ratingsAlternativesFDA package insert