Tiotropium delivered at a dose of 5 μg with the Respimat inhaler showed efficacy
similar to that of 18 μg of tiotropium delivered with the HandiHaler inhalation device
in placebo-controlled trials involving patients with chronic obstructive pulmonary
disease (COPD). Although tiotropium HandiHaler was associated with reduced mortality,
as compared with placebo, more deaths were reported with tiotropium Respimat
than with placebo.