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COPD: Medicines for Maintenance

People with chronic obstructive pulmonary disease (COPD) may need to use several types of medicines to control their symptoms. Maintenance medicines work for an extended time after you take them. For sustained benefits, such as improved control over shortness of breath or less-frequent need for quick-relief medicines, maintenance medicines must be taken on time.

Types of medicines

Each person's treatment for COPD must be tailored to that person's condition--mainly the severity of his or her symptoms. Quick-relief medicines may be enough for someone with mild COPD. If your COPD is moderate to severe, maintenance medicines may be important.

Maintenance medicines come in two types:

  • Bronchodilators. These medicines help relax the muscles around your airways so that they open up and allow more air through. Short-acting and long-acting bronchodilators are available. "Short-acting" ones work soon after taking them, but only last a few hours; "long-acting" ones take more time to work, but last longer. If you can usually breathe well without using a bronchodilator, your health care provider may give you only a short-acting version to use for quick relief when breathing problems occur. If you have ongoing breathing problems, you may need to take maintenance bronchodilators every day to breathe more easily. This could mean taking a short-acting version two to four times a day or a long-acting version once or twice a day. Bronchodilators come in three types. Depending on your symptoms, you may use just one kind or a combination:

    • Beta-agonists. These medicines signal the muscles around your small airways to relax. Most people who take these medicines use an inhaled or nebulizer form.

    • Anticholinergics. These medicines keep the muscles around your large airways from tightening. You may take them using either an inhaler or a nebulizer.

    • Theophylline. Medicines that contain theophylline help relax airway muscles and may decrease swelling in your lungs, too. They come in tablet and liquid forms. This class of COPD medications is not used as frequently now as it was a few years ago

  • Corticosteroids. This type of medicine helps reduce swelling in your airways, opening up more space through which air can travel. It takes a while--days to weeks--for inhaled steroids to work. Your health care provider may ask you to try an inhaled steroid for a few months to see whether it helps you breathe. You may also need to use steroids for a while to control symptoms that have gotten worse. The usual schedule for taking inhaled steroids is once or twice a day. Be sure to rinse and spit after using an inhaled steroid. Most people with COPD who use these take an inhaled form, but steroids also come in tablets. (An intravenous form is also made, but it's not used at home.) These medications work best for people who have asthma in addition to COPD. They must be taken on a regular basis to prevent future attacks, not just sporadically with an acute episode.

It's possible that combination medicines may be needed to help control COPD. You may need to take multiple medicines--such as one or more long-acting medicines along with a short-acting medicine. Or you may be able to take a combination medicine--one medicine that contains multiple active ingredients.

Mind your medications

To get the relief you need, it's important to take your medicines exactly the way your health care provider tells you to. Follow your schedule and get refills in time so that you don't run out..  Like many medicines, medications used to treat COPD can cause side effects. Ask your health care provider what to expect and which side effects to report. It's a good idea to review all your medicines with your health care provider at least twice a year, even if they seem to be working well for you. 

Finally, ask your doctor to work with you to develop a COPD action plan. This plan shows you actions you can take to manage your COPD. You can find an example of this plan at the American Lung Association's website