Jan 6, 2019 · 3-4 years on Spiriva Hand. and Symbicort 160/-for treatment of COPD/Emphsym. NO Asthma. Is there a combo as an alternative as they are both very costl? Developed joint & muscle pain after 4 mo. on Spiriva & Advair. D/C meds and pain gone. Any reliable alternatives to these meds for dx: "mild COPD"? Are there deaths related to spiriva?