Medications

Medicine for COPD is used to:

• Reduce shortness of breath.
• Control coughing and wheezing.
• Prevent COPD flare-ups, also called exacerbations, or keep the flare-ups you do have from being life-threatening.

Most people with COPD find that medicines make breathing easier.

Some COPD medicines are used with devices called inhalers or nebulizers. Most doctors recommend using spacers with inhalers. It's important to learn how to use these devices correctly. Many people don't, so they don't get the full benefit from the medicine.

Breathing Problems: Using a Metered-Dose Inhaler with or without a spacer

Breathing Problems: Using a Dry Powder Inhaler

Medication choices

• Bronchodilators are used to open or relax your airways and help your shortness of breath.
  • Short-acting bronchodilators ease your symptoms. They are considered a good first choice for treating stable COPD in a person whose symptoms come and go (intermittent symptoms). They include:
    • Anticholinergics (such as ipratropium).
    • Beta2-agonists (such as albuterol or levalbuterol).
    • A combination of the two (such as a combination of albuterol and ipratropium).
  • Long-acting bronchodilators help prevent breathing problems. They help people whose symptoms do not go away (persistent symptoms). They include:
    • Anticholinergics (such as tiotropium).
    • Beta2-agonists (such as arformoterol, formoterol, or salmeterol).
• Phosphodiesterase-4 (PDE4) inhibitors are taken every day to help prevent COPD exacerbations. The only PDE4 inhibitor available is roflumilast (Daliresp).
• Corticosteroids (such as prednisone) may be used in pill form to treat a COPD flare-up or in an inhaled form to prevent flare-ups. They are often used if you also have asthma.
• Other medicines include methylxanthines, which generally are used for severe cases of COPD. They may have serious side effects, so they are not usually recommended.

What to think about

• The first time you use a bronchodilator, you may not notice much improvement in your symptoms. This does not always mean that the medicine will not help. Try the medicine for a while before you decide whether it is working.
• Metered-dose inhalers (MDIs) and nebulizers work equally well. MDIs are easier to carry. Nebulizers usually need to be plugged in.
• Many people don't use their inhalers right, so they don't get the right amount of medicine. Ask your doctor or nurse to show you what to do. Read the instructions on the package carefully.

  Breathing Problems: Using a Metered-Dose Inhaler with or without a spacer

  Breathing Problems: Using a Dry Powder Inhaler