Chronic obstructive pulmonary disease (COPD) is a group of conditions that occur due to damage to your lungs and airways. COPD can include emphysema and chronic bronchitis. If you have COPD, you may have symptoms such as trouble breathing, cough, wheezing, and tightness in your chest. COPD is often caused by smoking, but in some cases it’s caused by breathing in toxins from the environment.
There is no cure for COPD, and the damage to the lungs and airways is permanent. However, several medications can help reduce inflammation and open your airways to help you breathe easier with COPD.
Bronchodilators help open your airways to make breathing easier. Your doctor may prescribe short-acting bronchodilators for an emergency situation or for quick relief use as needed. You take them using an inhaler or nebulizer.
Examples of short-acting bronchodilators include:
- albuterol (Vospire ER)
- levalbuterol (Xopenex)
- ipratropium (Atrovent)
- albuterol/ipratropium (Combivent)
Short-acting bronchodilators can cause side effects such as dry mouth, blurry vision, or cough. These effects should go away over time. Other side effects include tremors (shaking) and a fast heartbeat. If you have a heart condition, tell your doctor before taking a short-acting bronchodilator.
With COPD, your airways can be inflamed (swollen and irritated). Inflammation makes it harder to breathe. Corticosteroids are a type of medication that reduces inflammation in the body, making air flow easier in the lungs.
Several types of corticosteroids are available. Some are inhalable and should be used every day as directed. Other corticosteroids are injected or taken by mouth. These forms are used when your COPD suddenly gets worse.
The corticosteroids doctors most often prescribe for COPD are:
- Fluticasone (Flovent), which comes as an inhaler that you use once or twice daily. Side effects can include headache, sore throat, voice changes, and allergic reaction.
- Budesonide (Pulmicort), which comes as a powder, liquid, or in an inhaler. Side effects can include colds or thrush, which is an infection in the mouth.
- Prednisolone, which comes as a pill, liquid, or as a shot and is usually given for emergency rescue treatment. Side effects can include muscle weakness, upset stomach, and weight gain.
For some people with severe COPD, the typical first-line treatments, such as fast-acting bronchodilators and corticosteroids, don’t seem to help when used on their own. When this happens, some doctors prescribe a drug called theophylline along with a bronchodilator. Theophylline works as an anti-inflammatory drug and relaxes the muscles in the airways. Theophylline comes as a pill or liquid you take daily.
Side effects of theophylline can include nausea or vomiting, tremors, and trouble sleeping.
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 using inhalers or nebulizers. Because these drugs work gradually to help ease breathing, they don’t work well as rescue medication.
The long-acting bronchodilators available today are:
- aclidinium (Tudorza)
- arformoterol (Brovana)
- formoterol (Foradil, Perforomist)
- glycopyrrolate (Seebri Neohaler)
- indacaterol (Arcapta)
- olodaterol (Striverdi Respimat)
- salmeterol (Serevent)
- tiotropium (Spiriva)
- umeclidinium (Incruse Ellipta)
Side effects of long-acting bronchodilators can include:
- dry mouth
- runny nose
- irritated or scratchy throat
More serious side effects include blurry vision, rapid heart rate, and an allergic reaction with rash or swelling.
Several COPD drugs come as combination medications. These are mainly combinations either of two long-acting bronchodilators or of an inhaled corticosteroid and a long-acting bronchodilator.
Combinations of two long-acting bronchodilators include:
- glycopyrrolate/formoterol (Bevespi Aerosphere)
- glycopyrrolate/indacaterol (Utibron Neohaler)
- tiotropium/olodaterol (Stiolto Respimat)
- umeclidinium/vilanterol (Anoro Ellipta)
Combinations of an inhaled corticosteroid and a long-acting bronchodilator include:
- budesonide/formoterol (Symbicort)
- fluticasone/salmeterol (Advair)
- fluticasone/vilanterol (Breo Ellipta)
Roflumilast (Daliresp) is a type of drug called a phosphodiesterase-4 inhibitor. Roflumilast comes as a pill you take once per day. It helps relieve inflammation, which can improve air flow to your lungs. Your doctor will likely prescribe this drug along with a long-acting bronchodilator.
Side effects of roflumilast can include:
- weight loss
You should also tell your doctor if you have liver problems before taking this medication.
Different types of medications treat different aspects and symptoms of COPD. Your doctor will prescribe medications that will best treat your particular condition. Feel free to ask questions about your treatment plan. Your questions might include:
- How often should I use my COPD treatments?
- Am I taking any other drugs that might interact with my COPD medications?
- How long will I need to take my COPD medications?
- What’s the proper way to use my inhaler?
- What happens if I suddenly stop taking my COPD medications?
- Besides taking medication, what lifestyle changes should I make to relieve my COPD symptoms?