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I have COPD. I take Spiriva once in mornings. Also take Advair. Once in morning, once in evening. I have ProAir inhaler for whenever needed, but never need it. Keep it around just in case. If you have insurance, and COPD, those are the caddilacs. If no insurance, the two will come to $470 a month. My insurance ran out, start new policy 1st of January, so I have to pay for this months...oh well, they work.  
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