Many people with COPD have mild forms of the disease for which little therapy is needed other than smoking cessation. Even for more advanced stages of disease, effective therapy is available that can control symptoms, slow progression, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.

 

Quitting smoking

The most essential step in any treatment plan for COPD is to quit all smoking. Stopping smoking can keep COPD from getting worse and reducing your ability to breathe. But quitting smoking isn't easy. And this task may seem particularly daunting if you've tried to quit and have been unsuccessful.

Talk to your doctor about nicotine replacement products and medications that might help, as well as how to handle relapses. Your doctor may also recommend a support group for people who want to quit smoking. Also, avoid secondhand smoke exposure whenever possible.

 

Medications

Several kinds of medications are used to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed.

 

Bronchodilators

Bronchodilators are medications that usually come in inhalers — they relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day or both.

 

Examples of short-acting bronchodilators include:

• Albuterol (ProAir HFA, Ventolin HFA, others)

• Ipratropium (Atrovent HFA)

• Levalbuterol (Xopenex)

 

Examples of long-acting bronchodilators include:

• Aclidinium (Tudorza Pressair)

• Arformoterol (Brovana)

• Formoterol (Perforomist)

• Indacaterol (Arcapta Neoinhaler)

• Tiotropium (Spiriva)

• Salmeterol (Serevent)

• Umeclidinium (Incruse Ellipta)

 

Inhaled steroids

Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of COPD. Examples of inhaled steroids include:

• Fluticasone (Flovent HFA)

• Budesonide (Pulmicort Flexhaler)

 

Combination inhalers

Some medications combine bronchodilators and inhaled steroids. Examples of these combination inhalers include:

• Fluticasone and vilanterol (Breo Ellipta)

• Fluticasone, umeclidinium and vilanterol (Trelegy Ellipta)

• Formoterol and budesonide (Symbicort)

• Salmeterol and fluticasone (Advair HFA, AirDuo Digihaler, others)

 

Combination inhalers that include more than one type of bronchodilator also are available. Examples of these include:

• Aclidinium and formoterol (Duaklir Pressair)

• Albuterol and ipratropium (Combivent Respimat)

• Formoterol and glycopyrrolate (Bevespi Aerosphere)

• Glycopyrrolate and indacaterol (Utibron)

• Olodaterol and tiotropium (Stiolto Respimat)

• Umeclidinium and vilanterol (Anoro Ellipta)

 

Oral steroids

For people who experience periods when their COPD becomes more severe, called moderate or severe acute exacerbation, short courses (for example, five days) of oral corticosteroids may prevent further worsening of COPD. However, long-term use of these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection.

Phosphodiesterase-4 inhibitors

 

A medication approved for people with severe COPD and symptoms of chronic bronchitis is roflumilast (Daliresp), a phosphodiesterase-4 inhibitor. This drug decreases airway inflammation and relaxes the airways. Common side effects include diarrhea and weight loss.

 

Theophylline

When other treatment has been ineffective or if cost is a factor, theophylline (Elixophyllin, Theo-24, Theochron), a less expensive medication, may help improve breathing and prevent episodes of worsening COPD. Side effects are dose related and may include nausea, headache, fast heartbeat and tremor, so tests are used to monitor blood levels of the medication.

 

Antibiotics

Respiratory infections, such as acute bronchitis, pneumonia and influenza, can aggravate COPD symptoms. Antibiotics help treat episodes of worsening COPD, but they aren't generally recommended for prevention. Some studies show that certain antibiotics, such as azithromycin (Zithromax), prevent episodes of worsening COPD, but side effects and antibiotic resistance may limit their use.

 

https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685