Spiriva is available in two inhaler forms: dry powder (Spiriva HandiHaler) and 9 mcg liquid inhaler  (Spiriva Respimat). Both medications can be bough through online pharmacy. In this case you may have no prescription and still get the drug. But it is always recommended to consult the therapist before starting any therapy.
  Spiriva inhaler contains the active ingredient tiotropium bromide, a specific anticholinergic agent characterized by a long-lasting effect. The inhalation of spiriva 9mcg tiotropium causes the relaxation of smooth muscles. It this way it opens the airways and makes it easier to breath. Tiotropium works directly inside the lungs.
  Spiriva Respimat: This is a cartridge that is to be inserted into the inhaler. A patient should take not more than two puffs a day at approximately one and the same time each day. If you have any troubles or questions about using the device, you should better consult your pharmacist.
  Spiriva HandiHaler: Dry powder comes in a form of a capsule. A usual dose is 1 capsule per day. Best used of Spiriva should be regularly to help keep the airways open. A capsule must be put inside the inhaler. Don’t swallow the capsule! Just follow the instructions carefully. Once you inhale the powder, its effect will last for approximately 24 hours.