COPD – Medications for COPD
Bronchodilators | Corticosteroids | Antibiotics | Oxygen | Flu & pneumonia shots
COPD can’t be cured, but there are safe, effective medicines that can help control your symptoms. You’ll need a doctor’s prescription to get these medicines.
Because COPD symptoms are variable- they can change or get worse – it’s important that you know how to adjust your medicine depending on how you feel.
Ask a professional on your COPD healthcare team to explain:
What each medicine does
How to use each medicine
when to use each medicine
How to recognize warning signs of a COPD flare-up
How to adjust your medicine if you’re feeling worse
How to use the devices that deliver your COPD medicines- inhalers, nebulisers, and spacing chambers
Many people get confused by COPD medicines; they aren’t sure what to take, or when to take it. With a little bit practice, people can learn to adjust their medicine to control their symptoms.
This website explains the basics of COPD medications. It also explains how to use inhalers and nebulisers. If you have any questions, be sure to ask someone on your COPD healthcare team. It can also help to have your son, daughter, spouse or friend sit in on your appointment when the doctor is explaining your medicines. They can take notes and help you remember the details.
Common COPD medications:
Bronchodilators to open your airways
Steroids to reduce the swelling
Antibiotics if you have an infection
Flu and pneumonia shots to prevent infections
Supplemental oxygen
Bronchodilators
Bronchodilators help reduce your breathing effort. They open up the airways in your lungs to relieve or reduce shortness of breath and wheezing.
The three main groups of bronchodilators are:
beta2-agonists
anticholinergics
xanthines
Beta2-agonists work to relieve breathlessness.
They come in two varieties: short- and long-acting.
Short-acting beta2-agonists are often used as a “rescue” medication to open airways quickly. They can also be taken on a regular basis.
Examples of short-acting beta2-agonists are:
Ventolin® and Airomir® (salbutamol);
Bricanyl® (terbutaline);
Berotec® (fenoterol).
If you need many doses of a short-acting bronchodilator to control your symptoms, your doctor may also prescribe a long-acting beta2-agonist, for you to take regularilyregularly.
Examples of long-acting beta2-agonists are:
Serevent® (salmeterol);
Oxeze® & Foradil® (formoterol).
Anticholinergics also work to relieve breathlessness, but in a different way than beta2-agonists. Anticholinergics seem to be effective in treating COPD – especially if they are taken on a regular basis.
An example of an anticholinergic is:
Atrovent® (ipratropium)
A long-acting anticholinergic bronchodilator called tiotropium (Spiriva®) is also available.
A short-acting beta2-agonist and an anticholinergic can be combined in a single inhaler. For some COPD sufferers, this combination can provide better relief of breathlessness than if the drugs are used separately. For others, the effect is the same, but the combination medication is more convenient. They can be used both regularly and on an “as needed” basis.
An example of a short-acting beta2-agonist and anticholinergic combination is:
Combivent® (salbutamol and ipratropium)
Xanthines are tablets that may help relieve breathlessness.
Depending on the person, xanthines can also improve the function of breathing muscles and perhaps reduce inflammation. Your doctor will be careful about prescribing xanthines: this medication is likely to cause side-effects such as nausea and heartburn, and can also interact with food and other drugs.
Examples of xanthines are:
Theophylline;
Uniphyl®;
Theo-Dur®.
Corticosteroids (anti-inflammatories) for COPD
Anti-inflammatories are corticosteroids, usually taken in an inhaled form. Corticosteroids are not the same thing as anabolic steroids, which some athletes take to build muscles.
Corticosteroids work over the long term, to reduce cough and inflammation in your airways.
New medical evidence shows that people with COPD who take corticosteroids at the first sign of a flare-up have fewer complications than those who do not take corticostroids.
Your doctor may put you on corticosteroids for a short while as a test to see if they help your breathing. A typical trial (test) lasts two to three weeks.
Examples of inhaled corticosteroids are:
Flovent® (fluticasone);
Pulmicort® (budesonide);
Qvar® (beclomethasone).
Corticosteroids in tablet form (e.g. prednisone) are often prescibed to people with COPD flare-ups or a bad lung infection.
Corticosteroid tablets can cause more side effects than inhaled steroids. Your doctor will explain the side effects of oral corticosteroids, and explain that you have to slowly taper off this medication: you can’t quit taking corticosteroid tablets all of a sudden, or you could feel sick.
Some medications combine anti-inflammatories with long-acting beta2-agonists to reduce inflammation, relieve breathlessness and decrease the number of COPD flare-ups.
Two such combinations are:
Advair® (fluticasone and salmeterol);
Symbicort® (budesonide and formoterol).
Antibiotics for COPD
When you have COPD, your lungs’ natural defence systems are not as effective as they normally would be. You are very susceptible tohave a higher risk of lung infections.
You’ll need antibiotics to protect your lungs: even a mild infection can turn out to be very serious when your lungs cannot protect themselves.
If you notice any of the warning signs of worsening COPD. you should call your doctor. Your doctor may prescribe antibiotics. Be sure to follow the doctor’s instructions exactly, and take all the antibiotics in your prescription.
Supplemental oxygen for COPD
Oxygen is a medicine that your doctor may prescribe. Not everyone with COPD needs oxygen. Many people believe that being “put on oxygen” is a sign that they’re desperately sick. This isn’t always true. For some people, oxygen is an important part of regular therapy. For others, it may be a short-term treatment.
Generally, oxygen therapy can benefit people with:
very low blood-oxygen levels (hypoxemia)
temporary lung damage from infections (like pneumonia)
Only people who suffer from significant low blood-oxygen levels will benefit from oxygen. Ask your doctor to test to see if oxygen might help you.
Benefits of oxygen
If your doctor says oxygen is right for you, you can enjoy these benefits:
it prolongs life by preventing heart strain from low levels of oxygen
it improves the way you feel and think
it decreases shortness of breath
It helps you to tolerate exercise better
it results in fewer hospitalization days
How does oxygen therapy work? Oxygen therapy is generally delivered as a gas from an oxygen source like a cylinder or concentrator. You breathe in the oxygen through small nasal “prongs” that fit into the nostrils, or through a mask, that covers the mouth and nose. Breathing in this extra oxygen raises low blood-oxygen levels, easing the strain on your body and making breathing easier.
Because your body can’t store oxygen, the therapy works only while you use it. If you take off your oxygen mask or remove the prongs, your blood-oxygen level will drop within a few minutes.
Like any other prescription medicine, oxygen must be used carefully. You need to follow instructions and follow all the safety precautions. Your doctor will tailor your oxygen prescription to your individual needs. Be sure you get instruction on how to use your oxygen, and how to clean your equipment.
How long do people use oxygen therapy? You may be on oxygen therapy for a few weeks or months, or for the rest of your life. It all depends on why you need it.
If you have a respiratory infection, you may need to be on oxygen only until the infection clears and your blood-oxygen levels return to normal. If you have chronically low blood-oxygen levels because of lung damage from COPD, you may need to be on oxygen permanently. If you are prescribed oxygen on around-the-clock, usually you need to use the oxygen for a minimum of 15 hours a day for the best results.
More information about oxygen
You can’t use oxygen if you smoke. No one can smoke within 10 feet (3 meters) of oxygen tanks, because of the risk of fire. You can’t use oxygen anywhere near an open flame (candle, fireplace, etc).
Ask how to use the equipment. Learning how to use and care for the oxygen equipment may seem complicated. Have Ask the oxygen supply company to give you a demonstration. If you’re not clear on something, keep asking until you feel confident. For more support, have a family member or caregiver learn about your equipment as well.
Keep your equipment clean. Clean equipment works more effectively. Keeping your equipment clean also helps prevent infections. Always wash your hands before cleaning or handling your oxygen equipment.
Have your doctor check your prescription at least once each year, or if your symptoms change, to see if your oxygen prescription still meets your needs.
Ask about funding. Oxygen therapy can be expensive, especially over the long term. You may qualify for government funding for oxygen therapy – ask your doctor if you’re eligible. Funding, which varies from province to province, may cover basic oxygen needs.
You can travel with oxygen. With some extra help and planning, you can travel by car, plane, boat or train with your oxygen tank. Contact your home oxygen supply company well in advance of your trip to allow them to arrange for oxygen while traveling and at your destination.
Flu and pneumonia shots
People with COPD are very vulnerable to lung infections. A healthy person with the flu or pneumonia usually recovers in a couple of weeks. But a person with COPD who gets the flu or pneumonia can be very sick, go to the hospital, or even die.
Get your flu shot every fall. The flu shot only lasts one year. Get it every fall. In most provinces, the flu shot is free for people with COPD.
Get your pneumonia shot. You may need to take a booster every five years.
It’s important to prevent lung infections. If you already have an infection, it’s important to get it treated right away.