10 Drugs Commonly Prescribed for COPD

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COPD (chronic obstructive pulmonary disease) is a progressive lung disease that causes difficulty breathing. COPD includes both chronic bronchitis and emphysema. Symptoms include shortness of breath, chest tightness, wheezing, and a chronic cough that produces a lot of mucus. The cough is often called a smoker’s cough because smoking is the most common cause of COPD. Symptoms can worsen suddenly in a COPD flare and the disease will worsen with time.

Stopping smoking is the most important thing you can do to improve breathing when you have COPD. The other main COPD treatment components are pulmonary rehabilitation, oxygen therapy, and medications.

Classes of COPD Medications

Understanding when and why to use the different types of COPD medications can help you breathe better. Some medicines are long-term control, or maintenance medicine. You use these medicines on a regular basis to control symptoms and prevent flares. Other medicines for COPD are for use when you experience worsening symptoms or during flares.

Doctors follow expert treatment guidelines when choosing medication therapy for COPD.

Classes of COPD drugs include:

  • Anticholinergics. These drugs are bronchodilators—they open the airways. They come as both short-acting and long-acting drugs. The long-acting ones are called long-acting muscarinic antagonists (LAMAs). Dry mouth is the common side effect.

  • Inhaled corticosteroids. Corticosteroids are powerful anti-inflammatory drugs. By delivering medicine directly into the lungs, inhalers decrease the risk of side effects. Current COPD guidelines only recommend these drugs in combination with a long-acting beta agonist.

  • Long-acting beta agonists (LABAs). LABAs are bronchodilators. For COPD, doctors may use a LABA in combination with another bronchodilator. This two-bronchodilator approach is preferred over a bronchodilator and an inhaled corticosteroid when a second medicine is necessary.

  • Oral PDE4 inhibitors. This class inhibits an enzyme involved in inflammation. This decreases swelling in the lungs. Doctors use this class to treat severe COPD. Digestive side effects, such as nausea and weight loss, are common side effects.

  • Short-acting beta agonists (SABAs). SABAs are also bronchodilators. However, they act very quickly to relax the airways to relieve worsening symptoms. Common side effects include dizziness, nervousness, shakiness and headache.

After starting treatment, your doctor will regularly monitor your lung function. Your doctor will want to know about your symptoms and how often you have a flare. Your doctor will use all this information to decide whether your current treatment is working.

Common COPD Medications

Your doctor can choose among various drugs within each class of COPD medicine. Finding the right treatment for you may involve some trial and error.

Here are 10 drugs commonly prescribed for COPD:

  1. Albuterol (Accuneb, Proair HFA, Proair Respiclick, Proventil HFA, Ventolin HFA) is a SABA. It comes as a nebulizer solution and inhalers you use for fast symptom relief.

  2. Beclomethasone (Beclovent, QVAR) is an inhaled corticosteroid. The usual dose is twice daily for long-term control. Rinse your mouth and spit after using an inhaled corticosteroid to decrease side effects.

  3. Budesonide (Pulmicort, Pulmicort Flexhaler) is also an inhaled corticosteroid. It comes as both a nebulizer solution and an inhaler. You usually take it twice a day.

  4. Budesonide/formoterol (Symbicort) is a combination of an inhaled corticosteroid and a LABA. It comes as an inhaler you use twice daily.

  5. Fluticasone (Flovent Diskus, Flovent HFA) is an inhaled corticosteroid you twice a day.

  6. Fluticasone/salmeterol (Advair Diskus, Advair HFA) combines an inhaled corticosteroid and a LABA. You use this inhaler once a day.

  7. Fluticasone/vilanterol (Breo Ellipta) combines an inhaled corticosteroid and a LABA. You use this inhaler once a day.

  8. Ipratropium (Atrovent, Atrovent HFA) is a short-acting anticholinergic. It comes as a nebulizer solution and an inhaler. The dose is usually four times a day.

  9. Ipratropium/albuterol (Combivent Respimat, Duoneb) combines two bronchodilators in the form of a short-acting anticholinergic and a SABA. The usual dose for both the nebulizer solution and the inhaler is four times a day.

  10. Tiotropium (Spiriva HandiHaler) is a LAMA. It is an inhaler you use once daily. Tiotropium is also available in combination with olodaterol, a LABA, under the brand name, Stiolto.

Several other options are available for treating COPD. The disease is different for everyone and you may respond better to one COPD medication over another. If your current COPD treatment is not controlling your symptoms, talk with your doctor. It may be possible to get better results with a different drug.
Researchers continue to study COPD and look for new ways to treat the disease. Several types of drugs are in various stages of clinical studies. This includes potential immune-based and stem cell therapies. Ask your doctor if new COPD drugs coming to market are likely to help with your symptoms.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Aug 14

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