Key takeaways

  • COPD can be managed with medications like bronchodilators and corticosteroids, which reduce airway inflammation and open airways for easier breathing.
  • Vaccines for the flu, pneumonia, shingles, RSV, and COVID-19 are important for people with COPD to prevent infections and complications.
  • Combination therapies, which include two long-acting bronchodilators or an inhaled corticosteroid and a long-acting bronchodilator, are recommended for those experiencing shortness of breath.

There is currently no cure for chronic obstructive pulmonary disease (COPD), but the right treatment can help keep symptoms under control and improve your quality of life.

The main goals of COPD treatment are to relieve your daily symptoms, such as shortness of breath and coughing, and to reduce the risk of flare-ups or exacerbations, which are periods when symptoms suddenly worsen.

This article explains COPD medications and what they do.

Questions to ask your doctor

Managing COPD is a team effort between you and your healthcare providers. Screenshot these questions to ask your doctor at your next appointment.

  • 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 help relieve my COPD symptoms?
  • What should I do if I have a sudden worsening of symptoms?
  • How can I prevent side effects?

Bronchodilators are the most common medications for COPD. They work by relaxing the muscles around your airways, helping them open wider so air can flow more easily. Most are taken using an inhaler or a nebulizer

Short-acting bronchodilators

A doctor may prescribe short-acting bronchodilators for an emergency situation or for quick relief as needed. They’re often called rescue inhalers. They typically start working within minutes and last for 4 to 6 hours.

Examples include:

Short-acting bronchodilators may cause short-term side effects, such as:

If you have a heart condition, tell a doctor before taking a short-acting bronchodilator.

Long-acting bronchodilators

Long-acting bronchodilators are taken once or twice daily to provide steady control of your breathing.

Current global guidelines recommend using a combination of two different types of long-acting bronchodilators, LABAs and LAMAs, as the first-line treatment for people who have significant symptoms or frequent flare-ups.

Long-acting beta-2 agonists (LABA) include:

Long-acting muscarinic agonists (LAMA) include:

  • tiotropium (Spiriva)
  • aclidinium (Tudorza)
  • glycopyrrolate (Seebri Neohaler, Lonhala Magnair)

Side effects of long-acting bronchodilators may include:

  • fine tremors, particularly in the hands
  • headache
  • muscle cramps
  • rapid heart rate
  • low potassium (hypokalemia)

LABA/LAMA combinations

Sometimes, COPD medications are a combination of two drugs. If you experience shortness of breath or trouble breathing during exercise, the American Thoracic Society (ATS) strongly recommends a LABA combined with a LAMA.

Recommended LABA/LAMA combination bronchodilator therapies include:

With COPD, your airways can become inflamed, swollen, and irritated. Inhaled corticosteroids (ICS) are a type of medication that reduces inflammation in the body, making airflow easier in the lungs.

In COPD, steroids should almost never be used by themselves. They are usually prescribed as part of a combination inhaler.

Examples of an ICS and a long-acting bronchodilator include:

Triple therapy, a combination of an ICS and two long-acting bronchodilators, is recommended for those who continue to have shortness of breath or trouble breathing and are currently using LABA and LAMA combination therapy.

A common triple therapy combination includes fluticasone/vilanterol/umeclidinium (Trelegy Ellipta).

Corticosteroids may have potential side effects, such as:

Take your COPD medication exactly as your doctor prescribes it.

If you have serious side effects, such as an allergic reaction with rash or swelling, call a doctor right away.

If you have difficulty breathing or swelling of the mouth, tongue, or throat, call 911 or your local emergency medical services.

Be sure to tell a doctor if you have an irregular heartbeat or cardiovascular problems.

Roflumilast (Daliresp) is a phosphodiesterase-4 (PDE4) inhibitor. It comes as a pill you take once per day.

Roflumilast is for people with severe COPD and chronic bronchitis who still have frequent flare-ups despite using inhalers. It helps reduce inflammation and can improve airflow.

Side effects of roflumilast may include:

Let a doctor know if you have liver problems or depression before taking this medication.

COPD flare-ups can cause thick mucus to build up in the lungs.

Mucoactive drugs help reduce mucus or thin it so you can more easily cough it up. They typically come in pill form and include:

  • carbocysteine
  • erdosteine
  • N-acetylcysteine

A 2019 study suggests that these medications may help reduce flare-ups and disability from COPD.

Potential side effects of these medications may include:

  • nausea
  • vomiting
  • stomach pain

Preventing and treating infections is a major part of managing COPD, as even a simple cold or flu can lead to a serious lung infection.

Vaccines

A doctor may also recommend getting the following vaccines:

Antibiotics

Doctors prescribe antibiotics during COPD flare-ups if there are signs of a bacterial infection, such as changes in mucus, or if a patient needs a breathing machine.

During exacerbations, doctors usually recommend short treatments of 5 to 7 days to prevent bacteria from becoming harder to kill (resistant) in the future.

Taking certain antibiotics long-term can reduce the number of flare-ups a person has each year, but it also increases the risk of side effects such as hearing loss and bacterial resistance.

Biologics are a newer type of precision medication that targets specific proteins in the body to stop inflammation. Biologic drugs are created from living cells.

Research shows that the biologic drugs dupilumab (Dupixent) and mepolizumab (Nucala) can significantly reduce flare-ups and improve lung function in people with COPD who have a high eosinophil count. Eosinophils are a type of white blood cell.

Here are three things you can do right now to take control of your lung health:

  • Get help to quit smoking: Ask your doctor about coaching or medications that can help you quit.
  • Work on your inhaler technique: Ask your doctor or pharmacist to watch you use your inhaler to make sure you are getting the full dose.
  • Check your vaccine status: Talk to your doctor to ensure you are up to date on shots for the flu, pneumonia, COVID-19, shingles, and RSV.

Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.