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A List Of All Inhalers Part 1: The Bronchodilators

So, there are lots of new inhalers on the market. Bronchodilator inhalers are top-line COPD medicines.

They are often the first medicines doctors prescribe for COPD.1 Since there are so many of them, I thought it would be neat list them all in one place. So, here is a list of all the bronchodilator inhalers approved by the FDA.1

Short-Acting Beta Agonists (SABA)

Molecules of these medicines have a high affinity for beta-2 (B2) receptor sites lining airways. Once they attach to B2 receptors, this causes muscles wrapped around airways to loosen up. This, in effect, dilates (opens) airways. This makes breathing easier. The medicine works fast. Therefore, they are often called Rescue Inhalers. But, they only last 4-6 hours, hence the term “short-acting.”

They include:

  • ProAir HFA. It contains albuterol
  • ProAir RespiClick. It contains albuterol.
  • Proventil HFA. It contains albuterol.
  • Ventolin HFA. It contains albuterol
  • Xopenex HFA. It contains levalbuterol.

Short-Acting Muscarinic Antagonists (SABAs)

Molecules of these medicines are attracted to muscarinic receptors lining airways. A hormone called acetylcholine normally lands on these receptors. When this happens, it causes the muscles wrapped around airways to spasm. This causes the airways to become narrowed. It makes breathing difficult. SABAs prevent acetylcholine from doing its job. In this way, they dilate airways to make breathing easier. But, they only last 4-6 hours, hence the term “Short-Acting.”

  • Atrovent HFA. It contains ipatropium bromide.

Long-Acting Beta-Agonists

Molecules of these medicines also attach to B2 receptors. But, they stay attached for 12-24 hours (depending on the medicine). So, in this way, they dilate airways. Then, they keep them open long-term.

  • Arcapta Neohaler. It contains indaceterol. The dose is one inhalation once daily.3
  • Serevent Diskus. It contains salmeterol. The dose is one inhalation twice daily.4
  • Striverdi Respimat. It contains olodaterol. The dose is two inhalations once daily.5

Long-Acting Muscarinic Antagonists

These work the same as SABAs. But, they work for 24 hours, hence the term “Long-Acting.” They help to keep your airways open long term.

  • Seebri Neohaler. It contains glycopyrrolate. The dose is one inhalation twice daily.6
  • Incruse Ellipta. It contains umeclidium.
  • Spiriva HandiHaler. It contains tiotropium bromide
  • Spiriva Respimat. It contains tiotropium bromide.
  • Tudorza Pressair. It contains aclidinium bromide.

Combination Inhalers

These are inhalers that combine two medicines. These are nice when two medicines are prescribed. It’s nice as far as convenience. But, it’s also nice as far as cost, because you get two medicines for the price of one. These are all meant to prevent symptoms and control COPD. At the present time, there are 4 inhalers that combine 2 different bronchodilators.

SABA plus SAMA

  • Combivent HFA. It contains albuterol plus ipatropium bromide

LABA plus LAMA

  • Anoro Ellipta. It contains vilanterol plus umeclidinium.
  • Stiolto Respitat. It contains olodaterol plus tiotropium bromide. The dose is 2 puffs once daily.
  • Utibron Neohaler. It contains indacaterol plus glycopyrrolate. The dose is one inhalation twice daily.

What to make of this?

These are all your bronchodilator inhaler options. Most people with COPD have one or two of these on hand at all times. What about you? Are any of these on your medicine list? Let us know in the comments below.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. COPD Guidelines. Global Initiative For Chronic Obstrutive Lung Disease (GOLD), 2018, pages 46-50, https://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/, accessed 7/17/18
  2. Respiratory Inhalers At A Glance. Allergy & Asthma Network, American College of Allergy, Asthma, And Immunology, 2016, http://micmrc.org/system/files/webinars/Respiratory%20Inhalers.pdf, accessed 8/4/18
  3. Arcapta package insert, https://www.arcapta.com/Arcapta-Prescribing-Information.pdf, accessed 8/4/18
  4. Serevent package insert, https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Serevent_Diskus/pdf/SEREVENT-DISKUS-PI-MG-IFU.PDF, accessed 8/4/18
  5. Striverdi package insert, https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/203108s000lbl.pdf, accessed 8/4/18
  6. Seebri package insert, https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/207923lbl.pdf, accessed 8/4/18

Comments

  • sardonicus
    12 months ago

    Three days now I have been using Anoro Ellipta. But I am thinking about going back to Breo Ellipta only cause I am getting more side effects. The anoro was prescribed by a specialist. A horrible woman who I will never see again. The breo was prescribed by my family doctor. Any thoughts? The best one I was on was one that you did not list called something like ultibro breezhaler. My morning cough vanished, I was able to smoke in the morning (I have tried and failed twice to quit). But of course I got a terrible side effect and had to stop it I got nose bleeds. It was listed in the side effects list but I never thought it would happen to me. And why does every prescription drug out there list anxiety as a side effect. I have been suffering from clinical depression and an anxiety disorder since 2014 and its something I just dont need……sardonicus

  • Lyn Harper, RRT moderator
    12 months ago

    Hi sardonicus – I’m sorry you’re experiencing side effects with the Anoro Ellipta. You know your body, so you’re in the best position to decide what you should do. If you weren’t happy with the specialist that prescribed it, try calling your family doctor and getting their opinion. It usually takes a little more than a few days to determine if a medication is going to work, but as I said before, you know your body best.
    – Lyn (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    12 months ago

    Hi sardonicus and we appreciate your comments to our moderator/contributor, Lyn Harper. You were right to think she is a professional. Lyn has been in the field of respiratory therapy for many years and, is currently the director of a hospital respiratory therapy department in New York.
    We appreciate your posting here on COPD.net. Wishing you well, Leon (site moderator)

  • sardonicus
    12 months ago

    Thanks for your feedback. My God you look so young, I thought you had to be a professional of some kind. I long for the days when the only drugs I ever took(except for beer and grass) were the occasional aspirin.

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