COPD Drugs and Medications

Written by Tricia Kinman | Published on September 2, 2014
Medically Reviewed by Brenda B. Spriggs, MD, MPH, MBA on September 2, 2014

COPD Overview

Chronic Obstructive Pulmonary Disease (COPD) is the name for a group of conditions that occur because the lungs and airways have been damaged. Individuals with COPD have trouble breathing, and many have emphysema or a combination of asthma and chronic bronchitis.

COPD is often caused by smoking, but in a few cases it’s caused by inhaling toxins in the environment. The damage to the lungs and airways is permanent. There is no cure for COPD, but there are medications that can help you breathe easier by opening the airways and reducing the inflammation.

Short-Acting Bronchodilators

Bronchodilators are a type of medication that helps open the airways to make breathing easier. Your doctor may prescribe short-acting bronchodilators in an emergency situation or as needed for quick relief. Albuterol (Vospire ER, in Combivent, in Duoneb), levalbuterol (Xopenex), and ipratropium (Atrovent) are all short-acting bronchodilators. They come in the form of an inhaler or as a liquid that you can add to a nebulizer to inhale.

The side effects are few, but some people will experience dry mouth, blurred vision, or a cough. Other side effects include tremors (shaking), as well as the feeling that the heart is racing or beating faster than normal. If you have a heart condition, you should tell your doctor before taking these medications.

Long-Acting Bronchodilators

Long-acting bronchodilators are medications that are used to treat COPD over a longer period of time. They are usually taken once or twice daily over an extended period, and they come as inhalers or nebulizers. The long-acting bronchodilators are:

  • tiotropium (Spiriva)
  • salmeterol (Serevent)
  • formoterol (Foradil, Perforomist)
  • arformoterol (Brovana)
  • indacaterol (Arcapta)
  • aclidinium (Tudorza)

Because these are used to gradually help with breathing, they are not effective in an emergency or as rescue medication.

There are some side effects that can happen when you use these medications. Some people complain of:

  • dry mouth
  • dizziness
  • tremors
  • runny nose
  • an irritated or scratchy throat

Other more serious side effects that people have experienced include allergic reactions (rashes), blurred vision, and a rapid heart rate.

The FDA recently approved a new medication, olodaterol (Striverdi Respimat), for treatment of COPD as well. This medication comes as an inhaler that you use once a day. According to the FDA, olodaterol (Striverdi Respimat) should not be used for people who have severe COPD or in emergency situations. The side effects are the same as the other long-acting bronchodilators, though some people complain of diarrhea and back and joint pain after taking this inhaled medication.

Corticosteroids

For someone with COPD the airways can be inflamed, which makes it more difficult to breathe. Corticosteroids are a type of medication that reduce inflammation in the body, making air flow easier to the lungs. There are several corticosteroids. Some are prescribed with bronchodilators because these two medications can work together to make breathing more effective. Fluticasone (Flovent), budesonide (Pulmicort), and prednisolone are the ones doctors commonly prescribe for COPD.

  • Fluticasone comes as an inhaler that you use once or twice daily. Some people report headaches, sore throat, a change in their voice, and allergic reactions.
  • Budesonide comes as a powder, liquid, or in an inhaler. Some people who have used this medication get colds or an infection in the mouth (thrush).
  • Prednisolone comes as a pill, liquid, or as a shot and is usually given for emergency rescue.

Phosphodiesterase-4 Inhibitors

Your doctor may prescribe you a phosphodiesterase-4 inhibitor. This medication helps relieve inflammation, which can improve air flow to the lungs. Roflumilast (Daliresp) is a phosphodiesterase-4 inhibitor and comes as a pill that you take once per day. Your doctor will usually prescribe this along with a long-acting bronchodilator. The side effects of roflumilast are weight loss, diarrhea, cramps, and tremors. You should tell your doctor if you have liver problems before taking this medication.

Methylxanthines

Some people have severe difficulty with COPD and the regular or first-line treatments alone don’t seem to help. When this happens, some doctors will prescribe theophylline, which works as an anti-inflammatory and relaxes the muscles in the airway, to take along with a bronchodilator. Theophylline comes as a pill or a liquid that you take on a daily basis, and combined with other medications, it can help you breathe easier.

Some people have had side effects when they have used theophylline. Some people report feeling queasy or vomiting. People who take theophylline have also had tremors and trouble sleeping.

Serious Side Effects

Regardless of the medication prescribed for you, make sure to take it according to the instructions. If you have an allergic reaction, such as a rash or swelling, call your doctor immediately. Because some of the COPD medications can affect your cardiovascular system, be sure to tell your doctor if you have an irregular heartbeat or cardiovascular problems.

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Article Sources:

  • Bloch, S.A. and Kon, O.M. (2008). “Smoking cessation” in O.M. Kon, T.T. Hansel & P.J. Barnes (Eds.) Chronic Obstructive Pulmonary Disease (COPD) (45-51). Oxford: Oxford University Press.
  • Dahlin, C. (March 2006). It takes my breath away: End-stage COPD. Home Healthcare Nurse, 24(3), 148-155.
  • ​Evensen, A.E. (1 March 2010). Management of COPD exacerbations. American Family Physician, 81(5), 607-613.
  • Hitt, E. (5 May 2011). “Long-acting beta-agonists lower COPD mortality in elderly.” Medscape Today. Retrieved from http://www.medscape.com/viewarticle/742115
  • Jackson, D.J. & Elkin, S.L. (2008). “Palliative care and end-of-life issues.” In O.M. Kon, T.T. Hansel & P.J. Barnes (Eds.) Chronic Obstructive Pulmonary Disease (COPD) (101-110). Oxford: Oxford University Press.
  • Mayo Clinic. (15 March 2011). “COPD: Treatment and drugs.” Retrieved from http://www.mayoclinic.com/health/copd/DS00916/DSECTION=treatments-and-drugs        

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