The main medication treatment for COPD comes in inhalers (sometimes, these are called puffers). There are many types of inhalers and devices.
Download the COPD Medications Brochure
Bronchodilator Inhalers
Bronchodilators open up the airways in the lungs, making it easier to breathe. Some can even help prevent flare-ups or worsening of COPD. Often people with COPD start off on short-acting inhalers and as their symptoms worsen, such as shortness of breath or cough, long-acting medications will be added. If you were to continue to experience worsening of symptoms, a second long-acting inhaler or combination inhaler would be the next step.
Bronchodilators are the main medication for COPD. There are two main groups of bronchodilators: beta2-agonists and anticholinergics.
Beta2-agonists
These medications can be taken for prevention or to provide a quick relief. They are inhaled medications that can be short-acting or long-acting. Short-acting beta2-agonists are often used as a “rescue” or quick-relief medicine to open airways quickly. Long-acting beta2-agonists may also be taken regularly to prevent breathlessness.
Short-acting beta2-agonists (SABA)
- Examples include Ventolin®, Bricanyl®
Long-acting beta2-agonist (LABA)
- Examples include Foradil®, Onbrez®, Serevent®, Striverdi®
Anticholinergics
These inhalers relieve breathlessness, but in a different way than beta2-agonists. They are also inhaled medications that are effective in treating COPD and some even prevent COPD flare-ups, especially when they are taken on a regular basis. There are short-acting and long-acting anticholinergics (aslo known as muscarinic antagonists).
Short-acting muscarinic antagonist (SAMA)
- Examples include Atrovent®
Long-acting muscarinic antagonist (LAMA)
- Examples include Incruse™, Spiriva®, Seebri®, Tudorza®
Combination bronchodilators
There are a few newer options of inhalers that have both a beta2-agonist medication and anticholinergic medication. These medications help prevent COPD symptoms and are sometimes called ‘preventers’. These medications should be taken daily. Combination bronchodilators are available as short-acting and long-acting medications.
Combination short-acting muscarinic antagonist (SAMA) and short-acting beta2-agonist (SABA)
- Examples include Combivent®
Comination long-acting muscarinic antagonist (LAMA) and long-acting beta2-agonist (LABA)
- Examples include Anoro™, Duaklir®, Inspioloto®, Ultibro®
Combination Corticosteroid and Bronchodilator Inhalers
If you experience flare-ups or continued symptoms even with the use of your combination bronchodilator inhalers, your doctor may prescribe a combination inhaler with several medications in it. These inhalers have both a corticosteroid (anti-inflammatory) medication and long-acting bronchodilator medication to help prevent future flare-ups. These inhalers are considered “preventer” medications that need to be taken every day.
Long-acting bronchodilators will help relieve shortness of breath for longer periods of time, and if combined with an inhaled corticosteroid, will also bring down the swelling in your airways. Don’t worry - these are not the same steroids as those taken by some bodybuilders to build muscle. Over time, combination medications can help prevent COPD flare-ups.
Combination medications may not help relieve symptoms right away. If you need immediate help, take your quick-relief bronchodilator medicine.
Combination inhaled corticosteroid (ICS) and long-acting beta2-agonist (LABA)
- Examples include Advair®, Breo®, Symbicort®, Wixela®
Combination inhaled corticosteroid (ICS), long-acting muscarinic antagonist (LAMA) and long-acting beta2-agonist (LABA)
- Examples include Trelegy®
How do I use my inhalers properly?
Making sure you know how to take your medications is important and will help you best manage your COPD. Did you know that up to 90% of people, including health professionals do not use inhalers correctly?
Watch these videos to learn how to use your inhaler properly, call our Lung Helpline, or speak to your pharmacist for more assistance.
Nebulizer Medication
A nebulizer is a device that turns medication into fine mist and delivers it into your airways, using a mouthpiece or a mask. Nebulizers can be used for those patients who have a difficult time using inhalers. Caution: Nebulizers can aerosolize and potentially spread different viruses and as a result inhalers may be prescribed.