I really doesn't matter because they target completely different receptors. The Spiriva acts on the bronchial tubes, and the Breo on receptors in the lungs.

I do my nebulizer first.then breo and incruise

I use Advair first thing in the morning then an hour later I use the second one which is Incruse. Then later on will use nebulizer and a rescue inhaler if I need one. Sometimes I don't need the rescue inhaler because I use my nebulizer 4 times a day

Thank u,,the spirival first thru the bronchial tubes, then breo to the lungs....