I'd definitely check with your doc regarding blood in mucous. That's not something that usually happens with either Symbicort or Spiriva. The hoarse, raspy voice is common. For that, you should probably try a different med. Don't dump both Spiriva and Symbicort at the same time. Choose one and discontinue with a different med in the same class. If you don't have a pulmonologist, get one. Your primary care doc probably isn't current enough with meds and treatment plans to play the game.

See your doctor something isnt right

See if your Dr. will let you try other inhalers to see if there is an improvement.

As a result of advice from fellow group members I called my doctor went for a visit and chest X-ray which showed a respiratory infection..and I’m now on an antibiotic and back on both inhalers..also I bought a spacer for my inhalers which has improved my voice

I am a master gardener with the local County Extension..my speciality is pollinator gardening