Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases that make it difficult to breathe. 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 (Proair HFA, Ventolin HFA)
  • levalbuterol (Xopenex)
  • ipratropium (Atrovent HFA)
  • albuterol/ipratropium (Combivent Respimat)

Short-acting bronchodilators can cause side effects such as dry mouth, headache, or cough. These effects should go away over time. Other side effects include tremors (shaking), nervousness, 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. They’re usually prescribed in combination with a long-acting COPD drug.

Other corticosteroids are injected or taken by mouth. These forms are used on a short-term basis 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 twice daily. Side effects can include headache, sore throat, voice changes, nausea, cold-like symptoms, and thrush.
  • Budesonide (Pulmicort), which comes as a handheld inhaler or for use in a nebulizer. Side effects can include colds or thrush.
  • Prednisolone, which comes as a pill, liquid, or shot. It’s usually given for emergency rescue treatment. Side effects can include headache, 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, headache, and trouble sleeping.

Long-acting bronchodilators are medications that are used to treat COPD over a longer period of time. They’re usually taken once or twice daily using inhalers or nebulizers.

Because these drugs work gradually to help ease breathing, they don’t work as quickly as rescue medication. They’re not meant to be used in an emergency situation.

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
  • dizziness
  • tremors
  • runny nose
  • irritated or scratchy throat
  • upset stomach

More serious side effects include blurry vision, rapid or irregular heart rate, and an allergic reaction with rash or swelling.

Several COPD drugs come as combination medications. These are mainly combinations of either two long-acting bronchodilators or 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. It comes as a pill you take once per day.

Roflumilast 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
  • diarrhea
  • headache
  • nausea
  • cramps
  • tremors
  • insomnia

You should also tell your doctor if you have liver problems or depression 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?
  • What should I do if I have a sudden worsening of symptoms?
  • How can I prevent side effects?
Warnings for COPD medications Whatever medication your doctor prescribes, be sure to take it according to your doctor’s instructions. If you have serious side effects, such as an allergic reaction with rash or swelling, call your doctor right away. If you have difficulty breathing or swelling of the mouth, tongue, or throat, call 911 or your local emergency medical services. Because some COPD medications can affect your cardiovascular system, be sure to tell your doctor if you have an irregular heartbeat or cardiovascular problems.