Expert Pharmacy Insights

Tiotropium Inhaler Guide: Why 18 mcg and 5 mcg Are the Same Dose, and Who Actually Benefits

Tiotropium comes as 18 mcg capsules, 5 mcg soft mist and 9 mcg puffs, and the 17,135 patient TIOSPIR trial showed the capsule and soft mist doses perform the same. UPLIFT found 14 percent fewer COPD exacerbations but no slowing of lung function decline. Where it sits under GOLD 2025, its role as an asthma add-on, and side effects against placebo.