Nebulizer Treatments for COPD: What To Know

Medically reviewed by Allen J. Blaivas, D.O.

Written by Kate Harrison

Posted on August 7, 2026

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Key Takeaways

Nebulizers are devices that turn liquid medication into a fine mist, making it easier for people with COPD to get their medication directly into their lungs.

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Inhaled medications can open the airways, reduce inflammation, and ease symptoms in people with chronic obstructive pulmonary disease (COPD). These treatments are usually given through inhalers to ease wheezing and shortness of breath.

However, COPD medication can also be delivered through a nebulizer. If you have trouble using inhalers, a nebulizer may be a better way for you to take your COPD medications. To get the most out of your nebulizer, you should know how to properly use, clean, and care for it.

Here’s what you need to know about nebulizers, including what they are, the types of medications they can deliver, and how to use them.

🗳️ Do you use a nebulizer for chronic obstructive pulmonary disease (COPD) symptoms?

Yes, regularly

Yes, occasionally

No, but I use inhalers.

What Is a Nebulizer?

A nebulizer turns liquid medication into a fine mist. You breathe the mist into your lungs through a mouthpiece or face mask.

Nebulizers can deliver medicines that open the airways, ease breathing problems, reduce chest tightness, and loosen mucus. You can breathe normally during treatment.

There are three main types of nebulizers:

Jet nebulizer — Uses an air compressor that forces air into liquid medicine, turning it into mist
Ultrasonic nebulizer — Creates mist by vibrating the liquid medicine at a high frequency
Vibrating mesh nebulizer — Pumps liquid medicine through a mesh membrane containing very small holes, turning it into mist

Nebulizers are often easier to use than dry powder inhalers and metered-dose inhalers, usually just called inhalers. Inhalers tend to require special techniques, such as forceful breaths or perfectly timed puffs, which can make them challenging to use correctly.

People who have trouble taking a deep breath, can’t easily coordinate their breathing, or otherwise can’t use an inhaler correctly may not get the full benefit of their medication.

Studies show that 80 percent of people with COPD make at least one major inhaler mistake. This can make treatment less effective and raise the risk of flare-ups.

Because nebulizers are easier to use, they may be recommended for people with COPD who have trouble using inhalers.

Types of COPD Medications Used in Nebulizers

Many medications for COPD can be delivered through a nebulizer. The type of COPD medication you need depends on how often you have symptoms and how severe they are. Your doctor can help you find the right treatment plan to manage your COPD.

Bronchodilators

Tight airway muscles can limit airflow. Bronchodilators help relax the muscles around your airways. By allowing airways to open wider, these medications can help air move in and out of your lungs more easily.

Bronchodilators used in nebulizers include beta-agonists and anticholinergics, which may be short- or long-acting.

Short-Acting Beta-Agonists

These medications work quickly to relieve sudden symptoms, such as wheezing and shortness of breath. They’re sometimes called rescue medications. Two short-acting beta-agonists (SABAs), albuterol and levalbuterol (Xopenex), can be used with a nebulizer.

Short-Acting Anticholinergics

Ipratropium bromide is a short-acting anticholinergic that can also be delivered through a nebulizer. A nebulized medication that combines ipratropium bromide and albuterol is also available.

Long-Acting Beta-Agonists

These are used to better manage COPD symptoms, some people may also need long-acting beta-2 agonists (LABAs). These medications help keep the airways relaxed over time but don’t provide quick relief during a sudden breathing problem.

LABAs that can be used with nebulizers include arformoterol (Brovana) and formoterol fumarate (Perforomist).

Long-Acting Anticholinergics

These medications also help relax the muscles around the airways over the long term. They work by blocking a chemical the body naturally makes called acetylcholine, which causes airways to narrow and can contribute to excess mucus.

A long-acting anticholinergic that can be given through a nebulizer is revefenacin (Yupelri).

Ensifentrine

Ensifentrine (Ohtuvayre) is a nebulized medication used for the ongoing treatment of COPD in adults. It blocks two enzymes involved in airway tightening and inflammation. It’s usually taken twice a day and isn’t meant to relieve sudden symptoms.

Steroids

Inhaled corticosteroids (also called steroids) help reduce airway swelling and irritation. They may help prevent COPD exacerbations, but they don’t provide fast relief. They must be used regularly as prescribed.

Inhaled steroids aren’t used alone to treat COPD. Instead, they’re used with one or more long-acting bronchodilators when appropriate. Doctors may prescribe them for people who continue to have exacerbations and are likely to benefit from this treatment.

Most medications that include steroids are only available as inhalers. Budesonide can be delivered through a nebulizer.

However, nebulized budesonide is approved by the U.S. Food and Drug Administration (FDA) for asthma, not COPD. A doctor may sometimes prescribe it off-label for COPD. Off-label means a medication is used for a condition or in a way that the FDA hasn’t specifically approved.

Mucolytics

Mucolytics are medications that help thin and loosen mucus, making it easier to cough up. They may be helpful for people with COPD who have thick mucus or frequent flare-ups related to mucus buildup.

These medications aren’t part of routine COPD treatment for everyone. Acetylcysteine can be given through a nebulizer to help loosen unusually thick mucus. It may irritate the airways or cause bronchospasm, which is a tightening of the airways.

How To Use Your Nebulizer

Taking your COPD medications the right way is an essential part of managing your condition. Knowing how to use your nebulizer properly helps you get the most from your medication.

Nebulizers differ by model. Follow the instructions provided with your device and medication. A pharmacist, nurse, or respiratory therapist can also show you how to use it correctly.

Following are the general steps for using a nebulizer:

Wash your hands with soap and water.
Place the prescribed medication in the medicine cup exactly as directed. Use only medications and doses prescribed for your nebulizer.
Attach the medicine cup to either the face mask or mouthpiece. Attach one end of the hose to the medicine cup and the other to the compressor (air machine).
If you have a mask, fit it securely over your nose and mouth. If you have a mouthpiece, place it between your teeth, sealing your lips around it.
Switch on the air compressor.
Breathe in slowly and normally through your mouth. Make sure to keep the nebulizer in an upright position.
Continue treatment for the prescribed time or until the nebulizer begins sputtering and produces little or no mist, according to the device instructions. Then turn off the device and remove the mask or mouthpiece.

Nebulizer compressors usually plug into an electrical outlet. Some models also work with car adapters or batteries.

How To Care for Your Nebulizer

Cleaning and caring for your device properly are important. By keeping your nebulizer clean, you can help lower your risk of infection and keep your device working well.

Cleaning and disinfecting instructions vary by nebulizer. Follow the manufacturer’s directions for how often and how to clean each reusable part.

How to clean your nebulizer after each use:

Separate the hose from your nebulizer. Set the hose aside and make sure to keep it away from water.
Take apart the other pieces of your device.
Wash the medicine cup, top piece, and face mask or mouthpiece in warm, soapy water, making sure to rinse each piece thoroughly. You may be able to wash these parts in the dishwasher if the manufacturer’s instructions say they’re dishwasher-safe.
If you aren’t using a dishwasher, shake the pieces to remove excess water and place them in a cool, dry area to air-dry.

To disinfect your nebulizer:

Take apart your device. Set aside the hose and keep it away from water.
Disinfect the reusable parts using only the method recommended by the manufacturer. Not every nebulizer part can be safely soaked in vinegar.
Rinse the parts only if the manufacturer’s disinfection instructions call for rinsing, then allow them to air-dry completely.
Wipe the outside of the compressor and tubing with a clean, damp cloth or another method recommended by the manufacturer. Don’t place the compressor or hose in water.

If your compressor has a replaceable filter, check and replace it according to the manufacturer’s instructions. Replace it sooner if it becomes wet, dirty, discolored, or damaged.

Nebulizers can make COPD medications easier to take, especially if you have trouble using an inhaler. Several types of medicine can be delivered this way, but not every treatment is right for everyone.

Work with your doctor to choose the medication and device that best fit your symptoms, abilities, and treatment plan. Using and cleaning your nebulizer correctly can help you get the full dose of medicine and lower your risk of infection.