In fact, many people with COPD have mild forms of the disease for which little therapy is needed other than smoking cessation.
For more advanced stages, there are several effective therapies that can relieve symptoms, slow the decline of lung function, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.
Prescription Medications for COPD
There are a number of prescription medications available to manage COPD. Talk to your doctor about which options might be best for you.
Bronchodilators
Bronchodilators relax the muscles that tighten around the airways. This allows the airways to expand, making it easier to breathe and alleviating coughing and shortness of breath. Most bronchodilators are delivered through an inhaler or can be nebulized so you breathe the medicine straight into your lungs.
Short-Acting Beta-Agonists This type of bronchodilator is used as a “rescue inhaler” for sudden bouts of shortness of breath, such as exercising.
Long-Acting Beta-Agonists This type of bronchodilator is taken every 12 to 24 hours to consistently manage symptoms. These medications provide relief for many hours, but may take longer to start working. They include:
Short-Acting Anticholinergics Anticholinergics block a chemical that causes the airways to contract and can be either short-acting or long-acting. The medication lasts for four to six hours and starts working 15 minutes after using an inhaler.
Long-Acting Anticholinergics These starts working about 20 minutes after taking it and lasts between 12 and 24 hours, depending on the medication.
Theophylline
Not commonly used in the United States, theophylline is a bronchodilator in pill form. It requires blood level monitoring to make sure the drug level is high enough to be effective, but not high enough to cause serious side effects. Shakiness is a common side effect, but serious side effects may include severe nausea, vomiting, irregular heart beat, and seizures.
Corticosteroids (Steroids)
These drugs help reduce swelling and mucus production in the airways, making it easier to breathe. Steroids usually involve an inhaler device but can also be taken as a pill for short periods of time if your symptoms are more severe. Long-term use can cause other health problems, including diabetes, weight gain, osteoporosis, cataracts, and making people more susceptible to infections.
Combination Medicines
Sometimes COPD treatment involves an inhaler or nebulizer with a combination of bronchodilators and steroids, or more than one type of bronchodilator. For some individuals, a combination inhaler can act to both control current symptoms and prevent future symptoms.
Bronchodilator plus inhaled steroid:
Multiple bronchodilators:
Phosphodiesterase-4 (PDE-4) Inhibitors
This oral medication reduces airway inflammation and is used to prevent worsening COPD symptoms. Roflumilast (Daliresp) is approved in the United States for people with severe COPD and symptoms of chronic bronchitis. Side effects may include diarrhea, weight loss, stomach pain, headache, and dizziness.
Ensifentrine (Ohtuvayre), approved by the U.S. Food and Drug Administration (FDA) in 2024 as a maintenance therapy for COPD, is designed to work as both a bronchodilator and an anti-inflammatory to ease breathing while also helping to clear mucus from the lungs. Ensifentrine accomplishes this by acting on two enzymes in the lungs — phosphodiesterase 3 and phosphodiesterase 4 — that play a role in managing airway inflammation and muscle movements in the lungs. The medication is delivered directly to the lungs through a standard jet nebulizer. Some common side effects included colds, elevated blood pressure, and back pain.
Antibiotics
Bacterial or viral infections can lead to COPD symptom exacerbations, like intensified coughing, mucus production, and shortness of breath. Antibiotics, like azithromycin (Zithromax), can help treat those infections, but side effects and antibiotic resistance may limit their use.
Mucolytics
Mucolytics are used to break up mucus in the lungs, making it easier to cough up. It comes in oral, intravenous (IV), and nebulizer forms. Examples include:
