I have copd,,I take spiriva,,,,,and albuteral,,,I work out doors and live in new england ,last winter it was around 20 degrees,I was fine then coughed twice went to breath and just wheezed to no weezing could not get any air in,,,after a mintue maybe two,i weezed again,and remembered i had albuteral in my work bag,,,This attack came out of no were, I noticed in the cold weather It is harder for me to breath,,,Is there anything better then spriva,,,,