Medication Overview

Medications are a key part of any treatment plan for chronic obstructive pulmonary disease (COPD). Patients and their healthcare providers work together to find the right combination of medicines to treat different aspects of the individual’s disease, in the best way possible.

Some drugs for COPD are called maintenance medicines. This means that they are used to help control and prevent the symptoms of stable COPD, which are symptoms the person has all or most of the time. Some medicines are used to treat symptoms that suddenly get worse during COPD flare-ups, or exacerbations. Others are not used to treat the symptoms of the disease itself, but to treat related conditions that people with COPD often have.

These types of medicines can all play a role in a COPD treatment plan:

What are bronchodilators?

Bronchodilators are a central part of the treatment plan for most people with COPD. During a bronchospasm, the muscles that surround the airways tighten up and make the airways too narrow for enough air to pass through. This can make it hard to breathe.

Bronchodilators are inhaled drugs that can help to relieve and prevent bronchospasms by helping the muscles around the airways to relax. This opens up the airways and makes breathing easier.

There are several types of bronchodilator medicines:

  • Short-acting beta-agonist bronchodilators (SABAs), which may be called “rescue” inhalers, because they can provide very quick relief for sudden or severe breathing symptoms
  • Long-acting beta-agonist bronchodilators (LABAs)
  • Short-acting antimuscarinic (anticholinergic) bronchodilators (SAMAs)
  • Long-acting anticholinergic bronchodilators (LAMAs)1

What are corticosteroids?

Corticosteroids are another type of medicine commonly used to help control COPD symptoms. They work by helping to reduce the amount of swelling in the airways and make it easier for a patient to breathe. Corticosteroids can be inhaled, or they can be taken orally in a tablet or liquid.

Corticosteroids are used daily as part of COPD maintenance therapy for some people, especially those with more severe disease. In other cases, corticosteroids are used to help treat a COPD flare-up and keep it from getting worse.1,2

What are combination therapies?

Combination therapies for COPD contain two different types of medicines delivered in a single dose. For many patients, the combined drugs are an effective and convenient way to manage their symptoms.1

What are phosphodiesterase-4 inhibitors?

Phosphodiesterase-4 (PDE4) inhibitors are a treatment option for certain patients with COPD. PDE4 is an enzyme that is involved in the inflammatory process, and blocking this enzyme seems to decrease the number of flare-ups from COPD.1

What are methylxanthines?

Methylxanthines are an older type of bronchodilator for treating COPD. They work by reducing swelling in the airways and relaxing the muscles that surround them. Methylxanthines are not used as often as other types of bronchodilators, because they can cause serious side effects. The most common type of methylxanthine is called theophylline.1

What are antibiotics?

For COPD patients, antibiotics are frequently used to treat respiratory infections that are caused by bacteria. Respiratory infections very often cause COPD flare-ups, so it is important to treat the infection with antibiotics as quickly as possible.1,2

What are mucolytic drugs?

Some COPD patients use mucolytic drugs to help thin and loosen the mucus produced by their lungs. When the mucus produced by the lungs is too thick, it can clog the airways and become hard to clear out by coughing. Mucolytic drugs can make it easier to cough up the mucus, which clears the airways and makes breathing easier.1

What are opioids?

Opioid medicines are a type of very strong pain reliever. For some patients with very severe COPD, opioids can provide some relief for severe breathlessness as well. Common opioids include morphine, oxycodone, and hydrocodone.3

What medications can help a person stop smoking?

Two types of medications are available that can help a patient with COPD to stop smoking: nicotine replacement products and prescription medications. Nicotine replacement products deliver a small amount of nicotine into the body that can help make it easier to quit smoking. These include gum, patches, inhalers, and lozenges. Prescription medicines can decrease a person’s urge to smoke without delivering any nicotine at all.1

What are antidepressants and anti-anxiety medicines?

Many COPD patients will experience anxiety or depression (or both) at some point during the disease. Antidepressants and anti-anxiety medicines can be helpful in treating these conditions and improving a patient’s quality of life.

Written by: Anna Nicholson and Emily Downward | Last reviewed: April 2018.
View References
  1. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease, 2018 Report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Available at http://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed 4/3/18.
  2. Medicines used to treat COPD. American Thoracic Society. Available at https://www.thoracic.org/patients/patient-resources/resources/copd-medicines.pdf. Accessed 4/3/18.
  3. Ekström M, Nilsson F, Abernethy AA, Currow DC. Effects of opioids on breathlessness and exercise capacity in chronic obstructive pulmonary disease. A systematic review. Ann Am Thorac Soc. 2015 Jul;12(7):1079-92. doi: 10.1513/AnnalsATS.201501-034OC.