What Medicine Works Best For You?

Inhalation devices help people live better and longer with COPD. These devices include both inhalers and nebulizer solutions. There are many options to choose from. So, how do you know which ones work best for you? Here’s what to know.

The COPD guidelines and medication choice

A good place to start here is with the guidelines. COPD experts from around the world got together to create the Global Initiative for Chronic Obstructive Lung Disease (GOLD). They created COPD guidelines that are well respected by the medical community worldwide.

These guidelines were updated in 2018. Here’s what the guidelines say about the choice of medicine.

"Each pharmacologic treatment regimen should be individualized and guided by the severity of symptoms, risk of exacerbations, side effects, comorbidities, drug availability, and cost, and the patient’s response, preference and ability to use various drug delivery devices." ¹

You can’t word it better than that.

An individualized treatment approach

Let’s break that paragraph down. Each treatment regimen should be individualized. This makes sense because every person is unique. So, a treatment program should be tailored to meet each person’s unique COPD needs.

Treatment choices for COPD patients should be based on:

Symptoms

If you have minimal symptoms, you may only need one inhaler. As your symptoms increase, you and your doctor may need to step-up treatment. You may need more than one medicine to control your COPD.

Risk

What is your risk of having flare-ups? How severe have your flare-ups been? Have you been admitted to the hospital within the past year? If so, your doctor may want to step up treatment. Controlling your COPD may entail more than one medicine. If you have a low risk, then you may only require one medicine.

Side effects

All medicines have side effects. Thankfully, the side effects of most inhaled medicines are minimal. Still, some people may experience side effects to medicine while others do not. If an inhaler works well with negligible side effects, then that may be the best medicine for you. But, if a medicine causes unwanted side effects, then you and your doctor may decide to try another medicinal option.

Comorbidities

These are other diseases secondary to COPD. These are those diseases that sometimes go hand in hand with COPD. These “comorbidities” may impact what medicines you can take.

Drug availability

Some insurances only cover certain medicines. It’s just the way it is. Some pharmacies only carry certain medicines. So, what medicines are available may depend on where you live or work. It may depend on what insurance you have.

Drug cost

Some insurance companies may sign contracts so they pay less for certain medicines. With my insurance, that’s the case with Symbicort. My copay for Symbicort is $50. So, this is the medicine I use. This is despite the fact that I prefer Advair. But, my copay for Advair $100. So, unfortunately, the cost does have an impact on what medicine you will use. Advair and Symbicort are both nice medicines. Don't’ get me wrong. Just, for me, I prefer Advair.

Patient response

You can have two similar medicines like Advair and Symbicort. You might respond well to one and not so much the other. This is a testament to how different we all are. So, if one medicine works better for you, then that’s the one you might prefer. And this brings us to...

Personal preference

As noted above, my personal preference is to use Advair. So, if the cost wasn’t a factor, I’d be taking Advair every day instead of Symbicort. In your case, you might prefer Symbicort.

What to make of this?
Basically, there are many factors that determine what medicines work best for you. And, finding what medicine(s) work best is often a matter of trial and error. Plus, what works best for one person may not work best for another.