Spiriva respimat

I have not been using Spiriva with the spacer, only the other two. I had thought Spiriva was not supposed to be taken with the spacer but appears that studies have shown it’s as effective with or without. Great info about which is a LABA and LAMA.

Interesting, I had been on symbicort for 3+ years. NJH added spiriva and gave me samples of the asthma dose which worked well. Once I filled the full dose script, I coughed too much with added irritation. I complained to my multiple Dr's but to nothing was changed. I took my self off one, then the other and decided to stay with spiriva only. I told the Dr's and they both agreed with me. I guess sometimes you gotta take charge yourself.

I don't know if this will help anyone, but I'll share docs decision for me. The local pulmonologist started me on Spiriva Respimat when I first saw him after CT looked like I had MAC. He stated he'd hold off on steroid inhaler until cultures. He went on leave 3 months later and I ended up going to Mayo to get diagnosis and plan. Doc there said it was usually used for COPD and asked why I was on it. I told her what doc said about not using steroids until good cultures clarified diagnosis. She left me on it until my bronchoscopy cultures came back 6 weeks later. They were negative and she switched me to Advair, so I was on it almost 8 months. I tolerated it ok, but Advair got rid of my long standing nagging little cough. I do have mild asthma and cough rather than wheeze.
That's the extent of my experience with it.

I used it for about a year but it did not help. There were I side effects.

Adding my anecdotal tale: a general pulmonary NP put me on Spiriva after I complained about having much mucus and coughing. Indeed it dried up the mucus, which resulted in not to be able to clear my lungs. With bronchiectasis it's essential we are able to clear out the pooled phlegm that accumulates in the "pockets" in our lung tubes. It was not a good fit for me since it made clearance even more challenging than it was before. A bronchiectasis specialist who I see now, commented that Spiriva is effective in emphysema but not bronchiectasis.

A lot of comments I could reply to with this but I’ll put it here. https://www.prescriber.org.uk/inhalers.php
This is a list of a LOT of different inhalers and what meds they have and what class. LAMA, LABA, ICS, etc.
My pulm at Mayo - FL took me off ICS (Advair) as soon as i got the MAC diagnosis. It took 2 years to get it from first suspected and I’ve been in Advair years. She said no inhaled steroids for MAC. (I have BE and some asthma issues, but only when I get a cold.)