Chronic Obstructive Pulmonary Disease (COPD)

Medication

You can prevent or ease your COPD symptoms, like shortness of breath, cough, mucus build-up and tiredness by taking your prescribed medication. Different types of medications treat different symptoms. Sometimes, you may have a flare-up where your symptoms get worse and your doctor may prescribe extra medications to help you feel better. To get the full benefit from your medication, you must follow the doctor’s instructions and take the medications exactly as prescribed. Some medications need to be taken only when you need them, like a quick-relief bronchodilator. Others need to be taken regularly. If you are unsure when or how to take your medications or use your devices, ask your doctor, respiratory educator, pharmacist or other healthcare provider.


Keep a list of all of the medications you take and show it to your doctor and pharmacist, so they can check for drug interactions.

Types of Medications

There are many types of medications and treatments available to make your life with COPD easier. These include both inhaled and oral (taken by mouth) medications:

  • Bronchodilators to relieve shortness of breath
  • Combination bronchodilators and antiinflammatories to relieve shortness of breath and to prevent flare-ups
  • Antibiotics to fight infections
  • Supplemental oxygen (oxygen tank) to help with low oxygen and energy levels
  • Vaccines for flu and pneumonia to help prevent infections

Inhalers

The main medication treatment for COPD comes in inhalers (sometimes, these are called puffers). There are many types of inhalers and devices.

Bronchodilator Inhalers


Bronchodilators open up the airways in the lungs, making it easier to breathe. There are two main groups of bronchodilators: beta2-agonists and anticholinergics.
Beta2-agonists relieve breathlessness. They can be taken for prevention or providing a quick relief. They are inhaled medicines that can be short-acting or long-acting. Short-acting beta2-agonists are often used as a “rescue” or quick-relief medicine to open airways quickly. Long-acting beta2-agonists may also be taken regularly to prevent breathlessness.
Anticholinergics relieve breathlessness, but in a different way than beta2-agonists. They are also inhaled medicines that are effective in treating COPD, especially when they are taken on a regular
basis. There are short-acting and long-acting anticholinergics.


Here is a list of short-acting bronchodilators you may be prescribed:

 

  • Atrovent® MDI
  • Airomir® MDI
  • Bricanyl® Turbuhaler®
  • Ventolin® Diskus®
  • Ventolin® MDI

Here is a list of long-acting bronchodilators you may be prescribed:

 

  • Incruse™ Ellipta®
  • Seebri® Breezhaler®
  • Spiriva® Handihaler®
  • Spiriva® Respimat®
  • Tudorza® Genuair®
  • Foradil® Aerolizer®
  • Onbrez® Breezhaler®
  • Serevent® Diskus®
  • Striverdi® Respimat® (available in Canada only in combination)

Combination Inhalers


If you have on-going breathing problems, your doctor may prescribe a combination medicine. Combination inhalers are “preventer” medicines that need to be taken every day. There are many different medication combinations available and may contain some of the short and long-acting bronchodilators listed above. The most common combinations contain two or three medicines in one inhaler.

Here is a list of combination inhalers you may be prescribed:

 

  • Short-acting beta2-agonist and short-acting anticholinergic
    • Combivent Respimat®
  • Long-acting beta2-agonist and corticosteroid
    • Advair® Diskus®
    • Breo™ Ellipta®
    • Symbicort® Turbuhaler®
  • Long-acting beta2-agonist and long-acting anticholinergic
    • Anoro® Ellipta®
    • Duaklir® Genuair®
    • Inspiolto™ Respimat®
    • Ultibro® Breezhaler®
  • Long-acting beta2-agonist, long-acting anticholinergic and corticosteroid
    • Trelegy™ Ellipta®


Long-acting bronchodilators will help relieve shortness of breath for longer periods of time, and if combined with an inhaled corticosteroid, will also bring down the swelling in your airways. Don’t
worry - these are not the same steroids as those taken by some bodybuilders to build muscle. Over time, combination medicines can help prevent COPD flareups. Combination medicines may not help right away.
If you need immediate help, take your quick-relief bronchodilator medicine.

Nebulizer Medication

Nebulizer is a device that turns medication into fine mist and delivers it into your airways, using a mouthpiece or a mask. Nebulizers can be used for those patients who have a difficult time using inhalers.

Oral Medications

Corticosteroid Pills


Corticosteroids also come as pills, most often known as prednisone. Corticosteroid pills have more side effects than the inhaled corticosteroids that are in combination medicines. Corticosteroid pills are often used for short periods of time - usually when you have a COPD flare-up. If you need to take corticosteroid pills on a regular basis, your healthcare provider will work to keep you on the lowest dose necessary. You can talk with your healthcare provider about side effects of your medication.

Antibiotics


Bacterial infections in your airways may cause some of your COPD flare-ups. Antibiotics can help in these cases. However, antibiotics will not work if your flare-up was caused by a viral infection. Sometimes people may be experiencing both bacterial and viral infections at the same time. Prednisone is often prescribed along with antibiotics. Sometimes antibiotics are prescribed on a regular basis for those patients with frequent flare-ups. Your respirologist or family doctor will monitor you closely for improvements and side effects.

Working with your COPD team on a COPD action plan will ensure you have clear directions on what to do and what medicine to take if you have a flare-up.

Phosphodiesterase-4 Inhibitors


Phosphodiesterase-4 Inhibitors (PDE-4) medications are a type of oral medication that decreases inflammation in the lungs. This pill is used for patients with a history of frequent flare-ups and
chronic cough with mucus (phlegm). It can prevent flare-ups and should be used along with regular inhalers.

Mucolytics


Mucolytics help to remove secretions (unwanted contents like phlegm) from the lung by thinning mucus so it is easier to cough up. These medications are for patients with frequent flare-ups.

Mucomyst

(N-acetylcysteine – NAC), may prevent flare-ups.

References: 

This page was updated November 2019.

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Page Last Updated: 21/11/2019