What should I know about medications for chronic obstructive pulmonary disease (COPD)?

You have the right and responsibility to know what medications are being prescribed for you. The more you know about your medications and how they work, the easier it will be for you to control your symptoms.

You and your healthcare provider are partners in developing an effective medication plan. Make sure that you understand and share the same treatment goals as your provider. Talk about what you expect from medications so you can know if your treatment plan is working.

The type and dose of medications you need might change with the season, your location or different triggers. These might include viral infections, allergens, pollution, cold air and exercise. For most people with COPD, it takes weeks to months to find a treatment plan that provides excellent symptom control.

What types of medications are prescribed for COPD?

If you have COPD, you may have more than one type of medication. Different types of medications work in different ways to help treat different symptoms. Also, you might have different ways of taking your medications. You might get tablets or you might have inhalers or nebulizers that will let you breathe in your medications. Here are some kinds of COPD medications:

Bronchodilators

Bronchodilators relax the bands of muscle that have tightened around the airways. This action opens the airways, letting more air in and out of the lungs, and improving breathing. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can therefore be coughed out more easily.

Broncho­dilators, such as beta2-agonists and anticholinergics, have different mechanisms of action, but both loosen muscle tightness and help to remove mucus through coughing. There are long-acting bronchodilators and short-acting bronchodilators.

Long-acting bronchodilators take a longer time to start helping you, but their effects last 12 to 24 hours. These long-acting medicines are also called maintenance or controller medications. The short-acting bronchodilators, often called rescue or reliever medications, start working within minutes but only last four to six hours.

Anti-inflammatory medications

Anti-inflammatories reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers. Though some may give some relief quickly, others may need to be taken daily for several weeks before they will begin to fully control symptoms. Anti-inflammatories lead to fewer symptoms, better airflow, less-sensitive airways, and less airway damage.

Corticosteroids are the most commonly used type of anti-inflammatory medicines that treat COPD. Steroids come as both pills and inhalers. The pills are mostly used for times when you are having a COPD exacerbation, or when it is getting worse, because they can work more quickly. Inhaled steroids are primarily used in combination with other medications and are used over time to help control symptoms.

Leukotriene modifiers are another class of drugs that affect muscle tightness and may decrease inflammation. Leukotrienes are chemicals that occur naturally in our bodies that cause airway muscles to tighten up and increase the production of mucus and fluid. Leukotriene modifiers, used primarily for asthma, work by blocking the chemicals and decreasing these reactions. These medications can also help improve airflow and reduce symptoms in some people with COPD.

Combination medications for COPD

Your doctor might suggest a combination medicine to treat your COPD. These drugs usually combine different kinds of bronchodilator medications or pair a steroid with a bronchodilator. Each drug in the combination works in their own way to manage COPD symptoms to give you better control over the disease. Combination medications for COPD are generally available as an inhaler.

Other medications for COPD

Antihistamines relieve stuffy heads, watery eyes, and sneezing by drying up secretions. Although effective at relieving these symptoms, antihistamines can dry the air passages too much, making breathing difficult, as well as causing difficulty coughing up excess mucus. Take these medications with food to reduce upset stomach if needed.

Antibiotics might be prescribed to treat infections or help you recover from an illness. To help clear up your infection completely or to help you recover more quickly from an illness, it is important to take antibiotics for the full time of treatment, even if your symptoms have improved.

Expectorants help hydrate the airways, which helps thin mucus so it can be coughed out more easily. Take these medications with at least 8 ounces of water, and drink water regularly to help break up the mucus.

Antivirals might be prescribed to treat or prevent illnesses caused by viruses, most frequently to treat or prevent influenza ("the flu"). Influenza is particularly dangerous for people who have COPD.

Vaccines are important to prevent infections, especially flu shots and pneumococcal pneumonia shots. You need to get a flu shot every autumn, but the pneumonia vaccine is needed only once after age 65. If you got one before the age of 65, you would need to get another one after the age of 65, but at least 5 years after the first.

A note from Cleveland Clinic

COPD medications are used to improve your symptoms, but they cannot cure COPD. You’ll probably need to take more than one type of medication. These medicines are generally safe, but if you have side effects that concern you, talk to your healthcare team or pharmacist. It is a good idea to keep a list of the medications with you all of the time, either on a wallet card or a special app for your phone. Treating COPD is likely to involve a combination of therapies that may go beyond medications. For instance, your provider might prescribe oxygen if your lungs aren’t working well enough to get oxygen into your blood or they might ask you to consider pulmonary rehabilitation.