Spiriva handihaler is the best! I have C.O.P.D. and my doctor perscribed me Spiriva. I am totally amazed at the results i have gotten from this. I can breathe so much better, my weezing has tremendously subsided and my lungs feel lighter! I have Spontaneus Pneumothorax a condition that I was born with and also to be found in thin males. Which means my lungs collapse when they feel like it. Even though Spiriva isnt perscribed for this, I have to tell you, it has made my lungs collapse less! C.O.P.D is why I take it. It keeps my lungs "medicated". You can take this anytime of day, but I take mine before bedtime as it helps me breathe better when i sleep. I also only have to take it once per day. For every refill they give you a new inhaler, and thats nice too. There is no "generic" for this medication as of right now and I did some research on it and it does not look like there will be one anytime soon. But with insuance it should not cost you that much. With my insurance I pay $15.00 a month. I RECOMMEND THIS!