Can I take tiotropium inhalers while pregnant or breastfeeding?
A plain-words look at what the NHS, the US drug label and LactMed say about tiotropium inhalers.
In short
Pregnancy: Tiotropium inhalers can be used in pregnancy.
Breastfeeding: You can use your tiotropium inhaler as normal while breastfeeding, including inhalers that combine tiotropium with olodaterol.
Your doctor, midwife or pharmacist can help you decide.
What this means for you
Pregnancy
- Keeping your asthma or chronic obstructive pulmonary disease (COPD) under control during pregnancy is important, as breathing problems can be dangerous for both you and your baby.
- If you become pregnant while using tiotropium, talk to your doctor.
- They may want to review your medicine to make sure your asthma or COPD treatment is the best one for you.
Breastfeeding
- Information about tiotropium inhalers and breastfeeding is limited, but only tiny amounts are thought to reach breast milk.
- Your baby won't be able to absorb much of it, so side effects are very unlikely.
- As soon as you can, get in touch with your health visitor, midwife, pharmacist or doctor if your baby is feeding less well than normal, or if anything else about your baby worries you.
Talk to your doctor or pharmacist
This page is educational, not advice for your own situation. Talk to your doctor, midwife or pharmacist before you start, stop or change any medicine in pregnancy or while breastfeeding.
The details: what each source says
Tiotropium inhalers in pregnancy
The NHS says
Tiotropium inhalers can be used in pregnancy.
Keeping your asthma or chronic obstructive pulmonary disease (COPD) under control during pregnancy is important, as breathing problems can be dangerous for both you and your baby.
If you become pregnant while using tiotropium, talk to your doctor. They may want to review your medicine to make sure your asthma or COPD treatment is the best one for you.
In our words, from the NHS page Tiotropium inhalers (nhs.uk). Contains public sector information licensed under the Open Government Licence v3.0 (OGL v3.0). The NHS does not endorse this site.
The US drug label says
8.1 Pregnancy Risk Summary The limited human data with SPIRIVA RESPIMAT use during pregnancy are insufficient to inform a drug-associated risk of adverse pregnancy-related outcomes.
Prescribing label, section “8.1 Pregnancy” (opening excerpt): Spiriva Respimat (respiratory (inhalation)), Boehringer Ingelheim Pharmaceuticals, Inc. Read the full section on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.
This quote is from the respiratory (inhalation) formulation label.
Tiotropium inhalers while breastfeeding
The NHS says
You can use your tiotropium inhaler as normal while breastfeeding, including inhalers that combine tiotropium with olodaterol.
Information about tiotropium inhalers and breastfeeding is limited, but only tiny amounts are thought to reach breast milk. Your baby won't be able to absorb much of it, so side effects are very unlikely.
As soon as you can, get in touch with your health visitor, midwife, pharmacist or doctor if your baby is feeding less well than normal, or if anything else about your baby worries you.
In our words, from the NHS page Tiotropium inhalers (nhs.uk). Contains public sector information licensed under the Open Government Licence v3.0 (OGL v3.0). The NHS does not endorse this site.
LactMed says
Although no published data exist on the use of tiotropium, its use produces negligible maternal serum levels and any drug in breastmilk would not be absorbed by the infant. The risk to the breastfed infant of maternal tiotropium inhalation is small. International guidelines agree that breastfeeding can continue during tiotropium therapy.[1,2]
“Summary of Use during Lactation”, LactMed record “Tiotropium” (LM598), quoted verbatim. Everything LactMed reports about Tiotropium while breastfeeding.
What these words mean
- metabolite
- a substance made when the body breaks down a medicine
Definitions adapted from the NCI Dictionary of Cancer Terms (National Cancer Institute).
The US prescribing label says
8.2 Lactation Risk Summary There are no data on the presence of tiotropium in human milk, the effects on the breastfed infant, or the effects on milk production. Tiotropium is present in milk of lactating rats; however, due to species-specific differences in lactation physiology, the clinical relevance of these data are not clear (see Data ) . The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for SPIRIVA RESPIMAT and any potential adverse effects on the breastfed child from SPIRIVA RESPIMAT or from the underlying maternal condition. Data The distribution of tiotropium bromide into milk was investigated after a single intravenous administration of 10 mg/kg to lactating rats. Tiotropium and/or its metabolites are present in the milk of lactating rats at concentrations above those in plasma.
Prescribing label, section “8.2 Lactation”: Spiriva Respimat (respiratory (inhalation)), Boehringer Ingelheim Pharmaceuticals, Inc. Label on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.
This quote is from the respiratory (inhalation) formulation label.
Other names
UK brand names (per the NHS): Braltus, Spiriva, Spiriva Respimat.
US name: tiotropium.
Sources
- NHS, Tiotropium inhalers (nhs.uk), page last reviewed 31 October 2023. Paraphrased. Contains public sector information licensed under the Open Government Licence v3.0.
- US drug label: Spiriva Respimat (respiratory (inhalation)), Boehringer Ingelheim Pharmaceuticals, Inc., human prescription drug, label effective 17 August 2026, set ID 7b656b14-fcaa-2741-f6f0-e0be48971c02. DailyMed (National Library of Medicine). Public domain; quoted verbatim.
- Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Tiotropium” (LM598), bulk release of 22 September 2026. LactMed on NCBI Bookshelf. Public domain; quoted verbatim. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Sources checked 26 September 2026. How we source and check every page.
Educational summary of named sources, not medical advice.