Olodaterol and tiotropium

Spiolto Respimat is used to treat COPD. Find out how to use Spiolto Respimat correctly and possible side effects.

What is Spiolto Respimat?

Spiolto Respimat are 2 medications (olodaterol and tiotropium) mixed together in a single inhaler. This combination is used to prevent symptoms of COPD such as  such wheezing, coughing and shortness of breath. It reduces your symptoms over the long term. Spiolto Respimat is long-acting, which means that it works throughout the day. It must be used every day. 

In New Zealand, Spiolto Respimat is available as an inhaler. Using an inhaler device enables the medicine to go straight into your airways when you breathe in. This means that your airways and lungs are treated, but very little of the medicine gets into the rest of your body.

Spiolto Respimat does not give immediate relief from wheezing, tight chest and shortness of breath
If you need quick relief from these symptoms, use your ‘reliever’ medicine such as salbutamol or terbutaline.


  • The dose of Spiolto Respimat is 2 inhalations once daily.
  • Follow your doctor's instructions carefully. The pharmacy label on your medicine will tell you how much to use, how often to use it and any special instructions.


  • Keep using your inhaler every day. Do not stop using it, even if you feel better. Since COPD is a long-term condition, prevention with Spiolto Respimat is ongoing and it will need to be used every day.
  • Try to use your inhaler at the same time each day, to help you to remember to use it regularly.
  • If you miss a dose, you can take it as soon as you remember. But if it is nearly time for your next dose, just take your next dose at the right time.

How to use your Respimat device

To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist or nurse to show you how to use your Respimat device. Here is some guidance:

Health Navigator & Auckland District Health Board, NZ, 2020

If using your Respimat device for the first time:

  • Insert the cartridge: Keep the cap closed. Remove clear base – press the safety catch while firmly pulling the base with other hand. Insert the narrow end of the cartridge into the inhaler. Press down on a hard surface (such as a table) to secure the cartridge into the device and close the base.
  • Prime the inhaler: To ensure the device releases the medicine properly, you will need to prime it. Do this by turning the clear base in the direction of the arrows on the label until it clicks (half a turn). Open the cap, push the release button on the front, until you see the mist come out of the mouth piece. You may need to do this a few times.

Inserting the cartridge and priming the Respimat device can be tricky. Ask your pharmacist to load the cartridge for you.

To use your Respimat device: 

  • Load the dose: Hold the inhaler upright with the cap closed. Turn the base in the direction of arrows until until you hear a click.
  • Breathe out: Breathe out, away from the device. Do not blow directly into your device.
  • Inhale your dose: Open the cap and press your lips around the mouthpiece without covering the air vents on either side. Breathe in slowly and deeply through your mouth. Press the dose release button and continue to breathe in. Hold your breath for up to 10 seconds. Breathe out slowly.

When to start a new device:
There is a counting device on the side of your inhaler, to tell you how many doses are left. When it gets into the red section, it is time to get a new inhaler.

Precautions before using Spiolto Respimat

  • Do you have heart disease?
  • Do you have an overactive thyroid (hyperthyroid)?
  • Do you have high blood pressure (hypertension)?
  • Do you have an irregular heartbeat or rhythm, including a very fast pulse?
  • Do you have diabetes?
  • Do you have problems with your prostate, or have you had difficulty passing urine?
  • Do you have glaucoma?
  • Are you pregnant or breastfeeding?
  • Do you have problems with your liver or kidneys?
  • Do you have lactose intolerance?

If so, it’s important that you tell your doctor or pharmacist before you start using Spiolto Respimat. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

What are the side effects of olodaterol + tiotropium?

Like all medicines Spiolto Respimat can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Side effects What should I do?
  • Dry mouth
  • Sore throat
  • After using your inhaler device, rinse your mouth to prevent dry mouth and throat irritation.
  • Tell your doctor if troublesome.
  • Headache
  • Difficulty urinating (peeing)
  • Constipation (difficulty passing poos) or diarrhoea (runny poos)
  • Bleeding nose
  • Tell your doctor.
  • Dizziness or blurred vision
  • Tell your doctor.
  • Do not drive or use machinery.
  • Do not drink alcohol.
  • Feeling nervous, restless, agitated
  • Trembling or shakiness
  • Problems sleeping
  • Tell your doctor if troublesome.
  • Changes in your heartbeat (fast or irregular)
  • Tell your doctor immediately or ring Healthline on 0800 611 116.
  • Difficulty breathing or worsening of your breathing problem
  • Tell your doctor immediately or ring Healthline on 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product

Learn more

Spiolto Respimat Medsafe Consumer Information Sheets


  1. Tiotropium + olodaterol New Zealand Formulary

Additional resources for healthcare professionals

Newly-subsidised medicines for the treatment of patients with COPD BPAC, NZ, 2016

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 22 Jun 2019