COPD medicines

Medicines for chronic obstructive pulmonary disease (COPD)

Key points about COPD medications

  • There are many different types of COPD (chronic obstructive pulmonary disease) medicines.
  • Depending on how bad your COPD symptoms are, you may have to take more than one medicine.
  • Find out how they are used or taken and possible side effects.
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Most COPD medicines are available as an inhaler (puffer) and some of them may be used with a spacer. These are used alongside self-care measures to help you breathe more easily and lessen the chance of a flare-up or exacerbation (your symptoms suddenly getting worse). Learn more about COPD.

It can also help to have a COPD action plan(external link) to advise you on how to manage your condition day-to-day, when and how to take your medicines and what to do when your symptoms get worse.

  • Reliever inhalers improve symptoms quickly because they deliver medicine directly to your airways, causing the muscles of your airways to relax and open up. They usually start working within minutes and their effect lasts for a few hours.
  • They are also called rescue inhalers or short-acting bronchodilators.
  • A single type of quick reliever may be used, or you may be given a combination of them.

Examples of quick-relievers (also called rescue inhalers)

The use of reliever medicine will be different for different people:

  • People with mild symptoms use a reliever inhaler just when they need it for breathlessness.
  • People with more severe COPD use a reliever inhaler regularly, up to 4 times a day.
  • If you use an inhaler regularly to prevent symptoms, you may also be given a reliever inhaler to use only when you need it for breathlessness (trouble with breathing).
  • Many quick relievers can be used with a spacer so ask your healthcare provider or pharmacist.

Tip: Carry your quick-relief medicine with you at all times.

  • Maintenance inhalers are used regularly to control your symptoms and prevent flare-ups. 
  • Maintenance inhalers include long-acting bronchodilators OR a combination of a steroid inhaler with 1 or 2 long-acting bronchodilators.
  • Maintenance inhalers must be used regularly every day, not just when you are breathless. 

Inhalers with long-acting bronchodilators

Examples of maintenance medicine (also called long-acting bronchodilator inhalers)

Maintenance inhalers relax the muscles of your airways causing them to open up. Some of these medicines may also decrease the amount of mucus made in the airways of your lung. Most maintenance inhalers take a little longer than relievers to start working but their effects last much longer. This means you only need to use them 1 or 2 times a day.

Inhalers with steroids

These inhalers are a combination of a steroid plus a long-acting bronchodilator in a single inhaler. They help to reduce the number of flare-ups by lessening the inflammation that causes swelling and mucus production in your airways. These inhalers are usually prescribed if you have:

  • moderate to severe COPD and have had 2 or more flare-ups over the previous year that required you to stay in hospital
  • both asthma and COPD
  • certain white blood cells (eosinophils) of more than 0.3 x 109/L. 

Examples of long-acting bronchodilator inhalers with steroids

After using inhalers with steroids, it's important to rinse your mouth to avoid getting thrush.

A COPD flare-up is when your COPD symptoms become worse suddenly and are particularly severe. A flare-up is also called an exacerbation. A flare-up might be triggered by an infection or there may be no apparent reason for it. Read more about what a COPD flare-up is and how to treat it

Most COPD medicines are available as inhalers, which come in different shapes and sizes. They include:

  • metered dose inhalers (MDIs) which can usually be used with a spacer – ask your healthcare provider or pharmacist.
  • Turbuhaler
  • Accuhaler
  • Handihaler
  • Respimat
  • Ellipta inhaler
  • Breezhaler.

You can decide on the inhaler that suits you best by talking with your doctor or asthma educator. You may want to try a range of inhalers before choosing the one you are most comfortable with. 

To get the most benefit from your inhaler, you need to use the correct technique and take it at the right time. Your doctor, nurse or pharmacist may check your technique with you from time to time. Read more about inhalers and things to consider when choosing an inhaler. 

A spacer is a clear plastic tube with a mouthpiece or mask at one end and a hole for your inhaler at the other. A spacer is attached to the end of your inhaler to make it easier to use. It also makes the medicine in the inhaler more effective, because more of it can get into your lungs.

Spacers are good if you have trouble working your inhaler or when you get so breathless that you have trouble breathing in the medicine from your inhaler. Talk to your healthcare provider or pharmacist about how to get a free spacer. Ask them to show you how to use it correctly and how to keep it clean. Read more about spacers.

A nebuliser is a machine that turns liquid medicine into a fine mist that you can easily breathe into your lungs. The machine has a mouthpiece or face mask that you use to breathe in the medicine for 3–10 minutes.

Nebulisers may be used to help you take your reliever medicine when your COPD is so bad that you can’t use your inhaler as you usually do. These are usually used during a flare-up or exacerbation of your COPD, particularly in the hospital. Read more about nebulisers.

Many people think oxygen is given to treat shortness of breath, but this is not the case. Being short of breath, or feeling like you can’t get enough air into your lungs, doesn't necessarily mean you're short of oxygen. If your doctor thinks your oxygen levels are low they will arrange for you to have a special blood test. You may need to be seen by a respiratory doctor as well. If your body has low oxygen levels for long periods it can put a strain on your heart and lead to heart problems. Oxygen is given to prevent strain on your heart, and your doctor will decide if you need it. 

The tubes from the machine that delivers oxygen to your lungs are very long, so you can move around your home while connected. Portable oxygen tanks are also available.

You must not smoke while you're taking oxygen, because of the high risk of fire.

Read more about home oxygen therapy

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Art Nahill, Consultant General Physician and Clinical Educator

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