A Guide to COPD Medications

Medically Reviewed By Ami Patel PharmD, BCPS

Some people may take medications for chronic obstructive pulmonary disease (COPD) to ease breathing by opening the airways. They may be short acting and relieve COPD flare-ups, or they may be long acting and manage inflammation. Your doctor can choose a class of COPD medication, such as an anticholinergic or a corticosteroid, based on your situation. They may also recommend a combination of medications.

Read on to learn more about COPD medications, including their functions and the main classes your doctor may prescribe.

How COPD medications work

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COPD medications may reduce inflammation, open your airways, and help you breathe better. The American Lung Association (ALA) notes that there are two main types of medications: short acting and long acting.

Short-acting medications

Also called quick-relief medications, these can manage COPD exacerbations, which occur when the symptoms flare up suddenly Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in response to triggers like tobacco smoke or pneumonia. Short-acting medications quickly relax your airways, allowing you to breathe better and preventing your symptoms from worsening.

While these medications can provide quick relief, it’s important to know that COPD is a chronic and progressive condition.

Learn more about what causes COPD.

Long-acting medications

Also called maintenance medications, people usually take these daily to manage their symptoms in the long term, so it’s a good idea to take them regularly even if you don’t have symptoms. They can reduce airway inflammation and swelling and work to prevent exacerbations.

Classes of COPD medications

The main classes of COPD medications are below.

Bronchodilators

Bronchodilators relax your airway muscles, allowing your air passages to open wider and making it easier for you to breathe. There are a few subtypes of bronchodilators that doctors may prescribe for people with COPD:

  • Beta-agonists: These may be short- and long-acting types.
    • Short-acting beta-agonists (SABAs) take effect quickly but may only last for 4–6 hours, according to the ALA. Examples include albuterol (Proair) and levalbuterol (Xopenex).
    • Long-acting beta-agonists (LABAs) may take longer to work, but you can take them daily to keep your airways open. Examples include indacaterol (Arcapta) and foromterol (Perforomist).
  • Anticholinergics: These can also be short- or long-acting types. Ipratropium (Atrovent) is short acting, while tiotropium (Spiriva) and umeclidinium (Incruse Ellipta) are long acting.

Possible side effects Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of bronchodilators include:

Inhaled corticosteroids

Inhaled corticosteroids are powerful anti-inflammatory medications that can reduce inflammation and swelling in the airways.

Current COPD guidelines from the Global Initiative for Chronic Obstructive Lung Disease state that inhaled corticosteroids are more effective when people take them with a LABA. This article discusses these combination medications later.

Examples of inhaled corticosteroids for COPD include:

  • fluticasone (Flovent)
  • budesonide (Pulmicort)
  • beclomethasone (Qvar)

Possible side effects include rapid heart rate, dizziness, and headaches.

PDE4 inhibitors

This medication class inhibits an enzyme, phosphodiesterase-4 (PDE4), involved in inflammation. Doctors may use this class to decrease lung swelling in people with severe COPD and reduce the frequency of exacerbations.

Learn more about the stages of COPD.

Digestive side effects, such as nausea and diarrhea, are common side effects Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of PDE4 inhibitors. Examples of PDE4 inhibitors for COPD include roflumilast (Daliresp) and cilomilast (Ariflo).

Combination medications

Some people may need a combined version of two medications to relieve their symptoms. Examples include:

  • Budesonide/formoterol (Symbicort): This combines an inhaled corticosteroid and a LABA. It comes as an inhaler you use twice daily.
  • Fluticasone/salmeterol (Advair HFA): This combination involves an inhaled corticosteroid and a LABA. You use this inhaler twice a day.
  • Fluticasone/vilanterol (Breo Ellipta): This comprises an inhaled corticosteroid and a LABA. You use this inhaler once a day.
  • Ipratropium/albuterol (Combivent Respimat): This involves two bronchodilators, including a short-acting anticholinergic and a SABA. The usual frequency for the nebulizer solution and the inhaler is four times daily as necessary.

Other medications that may benefit people with COPD

People with COPD may benefit from additional precautions or medications that treat or prevent complications.

For example, some doctors may recommend flu and pneumonia vaccines Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . These conditions may cause severe symptoms and complications that could result in hospitalization or even death in people with COPD. Your doctor may also recommend getting the COVID-19 vaccine.

Antibiotics may also reduce the exacerbations some people experience. These medications may not be right for everyone, as taking antibiotics too often may promote antibiotic resistance, meaning bacteria might not respond as well to antibiotics.

Ask your doctor whether antibiotics may have a place in your treatment plan and which ones may be right for you.

Over-the-counter medications

In general, over-the-counter (OTC) medications aren’t strong enough to manage breathing difficulties related to COPD. Getting prescription medication from a doctor is important.

Tips for effective medication

You can take several steps to make your COPD medication as effective as possible.

The ALA recommends taking the right medication at the right time and in the right way. This means knowing when and how to take your short-acting medications for exacerbations and your long-acting medications for long-term management.

Your doctor can help you understand how and when to take your medications, including how to recognize the symptoms of an exacerbation and how to operate devices like inhalers or nebulizers.

Learn 8 tips for sticking with your COPD medications.

It may also help to create a medication schedule laying out all the medications you take and when you need to take them. Setting an alarm on your phone at certain times of the day may help remind you to take your long-acting medications, or you may wish to use a pill box with sections for different times of the day.

Taking your medications consistently and precisely can help you manage your condition.

Learn 7 daily tips for living with COPD.

Summary

Many medications can help manage COPD. The exact types your doctor recommends may depend on the severity of your condition.

Ask your doctor about which COPD medications may be right for you.

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Medical Reviewer: Ami Patel PharmD, BCPS
Last Review Date: 2023 Nov 10
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.