Medications for COPD
Although COPD is currently not curable, it can be managed. Medications are often part of a COPD treatment plan that may also include infection prevention, oxygen therapy and pulmonary rehabilitation.
Understanding what each medication is used for and when to take it can help you manage your symptoms, but with all the classifications of meds out there, it can get confusing. Below are the most common types of COPD medications prescribed and information on how they can help.
1. Long-Acting Control Medications
Long-acting control medications include long-acting bronchodilators, which open the airways to make breathing easier.
These bronchodilators are either classified as beta-2 agonists or anticholinergics. Beta-2 agonists bind to certain receptors that relax the muscle lining of the airways. Anticholinergics block a chemical called acetylcholine that causes the airways to narrow. Anticholinergics may also reduce mucus production.
Most long-acting bronchodilators are taken once or twice a day depending on the specific medication prescribed. It’s important to understand that long-acting bronchodilators are taken daily even if symptoms are not present. They work slowly and last longer than a fast-acting bronchodilator.
Long-acting bronchodilators may be taken via a metered dose inhaler, Respimat or dry powder inhaler. Some long-acting medications are also administered through a nebulizer and an inhaler.
Side effects of beta-2 agonists long-acting bronchodilators include shakiness and increased heart rate. Anticholinergics typically do not cause as many side effects as beta-2 agonists, but they may cause urine retention and dry mouth.
Common long-acting bronchodilators include:
- Tiotropium.
- Salmeterol.
- Olodaterol.
- Arformoterol.
2. Short-Acting Bronchodilators
Short-acting bronchodilators are also referred to as fast-acting or rescue medications.
These type of bronchodilators work fast, usually within about 20 minutes to reduce symptoms of COPD, such as shortness of breath, chest tightness and wheezing. While fast-acting bronchodilators work quickly, they do not stay in your system as long as long-acting medications.
Similar to long-acting bronchodilators, short-acting bronchodilators are also classified as either anticholinergics or beta-2 agonists. Fast-acting bronchodilators can be taken via a nebulizer, metered dose inhaler or Respimat.
Typical side effects of short-acting bronchodilators include tremors, increased heart rate and lightheadedness. Because of the possible cardiovascular side effects, people with heart problems should always discuss the benefits versus the potential risks of bronchodilators with their doctor.
Common short-acting bronchodilators include:
- Albuterol.
- Ipratropium.
- levalbuterol.
3. Corticosteroids
Recently, there has been a shift away from routinely prescribing corticosteroids for COPD treatment. However, in some cases, they are still recommended, especially for people who have frequent exacerbations despite using long-acting bronchodilators.
Corticosteroids treat COPD by decreasing inflammation in the lungs. They are not a fast-acting or rescue medication. Instead, they are often taken once or twice a day to minimize symptoms.
Corticosteroids may be taken via a nebulizer, dry powder inhaler and a metered dose inhaler. Side effects can include upset stomach, oral thrush and voice changes.
Common corticosteroids include:
- Budesonide.
- Fluticasone.
- Beclomethasone dipropionate.
4. Oral Medication
In some cases, oral medications may be prescribed to treat COPD. Roflumilast is a drug that inhibits the enzyme phosphodiesterase-4, which has an anti-inflammatory effect. It is available in pill form and taken once a day.
By reducing inflammation in the lungs, it makes breathing easier. Side effects can include nausea, weight loss and diarrhea. Cramps, tremors and insomnia can also develop.
5. Combination COPD Medications
Combination medications are also available to treat COPD.
Medications may combine two types of COPD drugs, such as a long-acting bronchodilator and a corticosteroid. Other types of drugs combine two long-acting bronchodilators, including a beta-2 agonist and an anticholinergic. Combination medications are often taken once or twice a day. Side effects depend on the combination of medication used.
Common combination medications include:
- Olodaterol combined with tiotropium.
- Salmeterol combined with fluticasone propionate.
Medication Tips
In addition to understanding what each COPD medication is for, it is also important to consider a few other factors. Consider the following tips:
- Follow all medication directions. Always only take medication as directed by your doctor. If you use an inhaler, it is essential to breathe in the medications correctly. Read directions before taking it. Some inhalers require a quick inhalation while others require a slow inhalation.
- Prime your inhaler as directed. Inhalers may also need to be primed before taking. Priming involves dispensing a dose or a few doses, which gets your inhaler ready to use. Priming helps make sure you get the correct dose of medication delivered to your lungs. Different inhalers have different priming directions. Inhalers should be primed the first time they are used.
- Use a spacer with a metered dose inhaler (MDI). If you are taking a COPD medication via a metered dose inhaler, use a spacer. Without a spacer, an MDI can be difficult to coordinate and not all the medication gets into the lungs where it is needed. Instead, some medication is left on the back of the throat. A spacer is a device that makes using an MDI more effective and easier.
- Talk to your doctor about side effects. Similar to most medications, COPD medications can have side effects. If side effects are bothersome, talk to your doctor before stopping any respiratory medication.