Need other changes: Tiotropium has been shown to reduce hospitalizations & improve quality of life for people with COPD. Its benefits are experienced over time & it is absolutely not a rescue inhaler. 18mcg is the dose in the Handihaler, and is the maximum daily dose from that device. If still having problems, changes elsewhere in your treatment plan should be considered - best to see your doc ASAP.
Answered 7/6/2015
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