Mark Mangus, a respiratory therapist with an international reputation answers questions at COPD Canada's website (Ask the Respiratory Therapist). According to him, it doesn't matter which one of those meds you take first because they go to different receptors. He also says limited research suggests it is best to take the two close together (one right after the other).

Sorry, I don't have the time to go through the 100s of questions to find the citations for this information.

Mangus' sequence for inhaler use is found here:

http://www.emphysema.net/inhaler_sequence.asp

Ask the Respiratory Therapist is found here:

http://copdcanada.ca/ask_the_rt_your_COPD_question.htm

By the way, since I started using Mangus' suggested sequence of inhaler use, I very rarely use my rescue inhaler.

I hope this helps.

Susan

I have been on sprivia for last 10yrs. I have tried all dif times of day on when I use it to see when I would get the fullest benefit from it.
I take Serevent and flovent when I first get up and then I take my sprivia around noon time as I dont feel like I can feel it working for at least a couple hrs after using it.So by taking it at noon it seems to kick in around 2pm. And then around 6p I take my other 2 again.
Always follow your Dr advice. I am lucky that my dr told me to play with it on the times to take it.
Good luck

I've tried them both ways (for a few weeks at a time) and wasn't able to tell any difference.

I take spireva in the am & spireva at night

I take my Seretide/advair, spiriva, singular/ montelukast, calcium tabs all first thing in the morning n then hope i have a good day...

My number 1 preference is to make sure I don't forget to take my meds. So I take them first thing in the a.m. and first thing at night(no delay between meds). There is a med reminder which buzzes to let you know it's time - I prefer birds singing or even the growling of the garbage truck to confirm I'm alive and "well.."

It's an attitude problem with me - just don't want to be reminded during the day that I'm not be as good as I think/feel.

denise you said you take spirvia 2x a day??

I have always been told to take it once a day

Oops -- glad you caught that - No, spireva once a day & advair. I'm waiting now for delivery on advair roto caps instead of discus. Sometimes I wonder if I'm getting any from the disc so this way I can actually SEE the med in the capsules. Thanks for catching that

Denise I'm with you on the Advair. I can't feel or taste anything when I do my Advair. After reading the articles that Susan put down, I'm doing my Advair first thing in the morning and following it with Spiriva within 10 minutes. Thank you all for your responses.

I take Spiriva and Advair at the same time once a day sometime in the afternoon.

I'd like to add that I don't think it's nearly as important when you take them as it is to take the full measure of the drugs.

Spiriva has the capsule system and delivers a more accurate dose than the powder inhalers. But as good as it is, it's possible that you didn't suck all the powder out of the cap or you eject the cap and toss it without checking if any powder is left inside. So you have to check for that.

I use the generic powder inhalers for both drugs and the powder kind of hardens much like sugar does from humid days. So I have to shake them hard and tap them on the rim of the sink to loosen the powder up. I found that the most effective way to shake them is for them to be horizontal to the ground. If it's ready to go you can feel the powder moving inside when you shake it kinda slow.

I have a clear spacer so I can see how big the dose is... but only if I breathe in very slowly. We are supposed to breathe in very slow anyway to insure proper dispersal of the drug.

Soooooo.... In the immortal words of Jerry Lee Lewis;

SHAKE IT BABY SHAKE IT!

tom

Thanks Tom, I never thought of shaking the spiriva capsule or Advair diskus. I was told to wait 5 minutes between each one, I usually wait more. I do the Spiriva first, then the Advair, then rinse, rinse, rinse.
Now I will shake and rinse.

I was on Spiriva & Advair. I took both of mine at the same time. It was a good combination for me.

Jazzkeys I'm saying the powder spray inhalers need to be shook up good. I don't think there is a need to shake the rotohaler/capsule type delivery system.

I think the reason the more expensive capsule rotohaler system was developed was because many people were not getting consistant doses of the proper measurement with the spray inhalers. I think many don't realize the effort it takes to get the proper dosage, so they don't get enough medication.

I take Symbicort and Spiriva. I was waiting 1 hour between meds. I asked my pulmy about how much time should elapse between doses and he said they can be taken one right after the other. Just remember to rinse and gargle after the doses.