There are a range of treatment options to manage chronic obstructive pulmonary disease (COPD). Many are directed at aiding the airways to keep them open as much as possible, help with mucus clearance, and decrease inflammation. No single strategy or medicine is "best" for all people. Personalization is key to address each person’s COPD and devise the best plan for symptom control. This involves identifying the right medicine to take at the right time to ensure:
- Better breathing
- Participation in the activities you enjoy
- Fewer flare-ups
Managing COPD often requires many different types of medicine that need to be taken daily, and it can be confusing especially if you are taking other medicines for other health conditions. The goal is for you to be able to take the right medicine at the right time. This will help you to feel the best.
COPD medicines can be swallowed in pill form, inhaled using a metered-dose inhaler or a breath-actuated device. Your healthcare team will devise the best method to deliver your COPD medicines. You are encouraged to review your inhalation technique with your healthcare provider at every visit.
Some patients with COPD will choose to use a nebulizer instead of an inhaler. Learn how to use a nebulizer.
Types of medicines often prescribed for COPD:
Bronchodilators relax the muscles around the airways which helps to keep them open and makes breathing easier. Most bronchodilators are often delivered through an inhaler or can be nebulized so you breathe the medicine straight into your lungs. Inhalers operate in different ways, so make sure to ask your healthcare team to show you how your specific inhaler works. This ensures you will get a full dose of medicine with each breath.
Bronchodilators can be short-acting or long-acting. Short-acting bronchodilators work quickly so that you get relief from symptoms fast, but they wear off in a few hours. Long-acting bronchodilators provide relief for many hours, but the effect may be slower. Short- and long-acting bronchodilators include beta2-agonists and anticholinergics.
- Beta2-Agonists are very potent at relaxing tightened muscles around your airways. This opens the airway and makes breathing easier. Short-acting beta-agonists work within minutes but last only 4-6 hours. Long-acting beta-agonists may be slow to start working but can last up to 12 to 24 hours so are used to maintain open airways throughout the day or the night.
- Anticholinergics prevent the muscles around your airways from tightening so keep the airways open and help clear mucus from your lungs. This combination allows your cough to expel mucus more easily. There are short-acting and long-acting anticholinergics.
Decreasing inflammation leads to less swelling and mucus production in the airways and that makes it easier to breathe. These medicines are known as corticosteroids or steroids. They are usually inhaled with an inhaler device.
Corticosteroids can also be swallowed as a pill and are usually prescribed for short periods of time in special circumstances when your symptoms are getting more severe. Steroids have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and increased risk of infection so they must be monitored carefully. Your doctor will talk with you about these side effects.
A corticosteroid, an anticholinergic and a beta-agonist can be combined into one inhaler or nebulizer solution. The most common combinations contain two or three of these medicines as a:
- Short-acting beta-agonist and short-acting anticholinergic
- Long-acting beta-agonist and corticosteroid
- Long-acting anticholinergic and corticosteroid
- Long-acting beta-agonist and long-acting anticholinergic
- Long-acting beta-agonist, long-acting anticholinergic and corticosteroid
People with COPD do experience flare-ups with more coughing, more mucus and more shortness of breath. This is often caused by bacterial or viral infections. Your doctor may give you an antibiotic to keep on hand and fill for when you have an infection.
Make sure you take all of the antibiotic exactly as prescribed. You may start to feel better during the antibiotic course but make sure you take the antibiotic for the prescribed duration. Short cutting the antibiotic course may allow the infection to come back or become resistant to the antibiotic. Learn more about protecting your lungs to avoid an infection.
COPD increases your risk for infection with influenza (flu) and pneumonia. Vaccines are available to protect you against the flu and you should get immunized every year. You need a yearly flu shot because the influenza virus changes slightly every year and you must get the latest and newest vaccine. Find where you can get vaccinated in your area.
Pneumococcal pneumonia is a bacterial infection of the lung that often follows an influenza infection. There are two vaccines to protect against this infection. You only need to get vaccinated once but you need to get each one. Your doctor can provide these to you.
Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.
Page last updated: November 17, 2022