Although there isn’t yet a cure for chronic obstructive pulmonary disease (COPD), there are effective treatments. Studies have shown the current treatments for COPD can:

• Improve your symptoms
• Prevent exacerbations (flares)
• Slow the progression of your disease
• Help you stay active

You can work with your health care team to find the best treatment for you based on the stage of your lung disease, the type of COPD you have, your age and overall health, and any other health conditions you have or medications you’re taking.

The most important thing people with COPD can do to slow the disease and prevent worsening of lung function is to stop smoking. This article will help you understand the other treatment options that are available to you.

Medicines for COPD

Your health care provider may prescribe a combination of quick-relief medications and long-acting medications. Quick-relief medications can provide rapid relief for your symptoms. Long-acting medications are taken daily to prevent breathlessness and other symptoms. Many people with COPD are prescribed multiple medications that work together to better control symptoms and prevent flares.

Bronchodilators

Bronchodilators help to relax the muscles that surround your airways, opening them and making it easier to breathe. Some bronchodilators are short-acting and can be used as a quick-relief medication, while others are long-acting. You can take bronchodilators using an inhaler or nebulizer.

Short-Acting Bronchodilators

Short-acting bronchodilators begin working almost immediately and are used as rescue medications in case of sudden asthma attacks. There are two types of short-acting bronchodilators — beta-2 agonists and anticholinergics.

Beta-2 agonists cause the muscles in your airway to relax. The short-acting type of beta-2 agonists are known as short-acting beta-agonists (SABAs). These medications start working in just a few minutes and last between four and six hours. Examples of SABAs include:

• Albuterol (sold under brand names including Ventolin HFA and Proventil HFA)
• Levalbuterol (Xopenex HFA)

SABA side effects may include:

• Feeling jittery
• Difficulty sleeping
• Upset stomach
• Rapid heart rate
• Hyperactivity

Anticholinergics work by preventing muscles in your airway from tightening. The short-acting type of anticholinergics are known as short-acting muscarinic antagonists (SAMAs). An example of a SAMA is ipratropium (Atrovent).

SAMA side effects may include:

• Upset stomach
• Blurry vision
• Dryness in your throat, eyes, or nose
• A strange taste in your mouth

Long-Acting Bronchodilators

Long-acting bronchodilators are used daily as a maintenance treatment to prevent COPD flare-ups. Long-acting bronchodilators are not effective immediately and can’t be used as rescue medications in the event of an attack. There are long-acting beta-2 agonists (LABAs) and anticholinergics called long-acting muscarinic antagonists (LAMAs) available.

Examples of LABAs include:

• Formoterol (Perforomist)
• Salmeterol (Serevent Diskus)
• Olodaterol (Striverdi Respimat)
• Arformoterol (Brovana Neb)

Examples of LAMAs include:

• Tiotropium (Spiriva Handihaler)
• Aclidinium (Tudorza)
• Glycopyrrolate (Lonhala Magnair and Seebri Neohaler)
• Umeclidinium (Incruse Ellipta)
• Revefenacin (Yupelri)

Long-acting bronchodilators have side effects similar to those of short-acting bronchodilators.

Other Bronchodilators

Theophylline (sold under the brands Theo-24 and Elixophyllin) is a bronchodilator you take by mouth. Your health care provider may prescribe theophylline if other treatments don’t work or are too expensive. You may need blood tests to monitor the amount of theophylline in your blood while taking this medication.

Corticosteroids

Also called glucocorticosteroids or simply steroids, corticosteroids are powerful anti-inflammatory medications that help to reduce swelling and mucus production in your airways. Inhaled corticosteroids aren’t recommended as your only COPD treatment, but you may use this type of medication in combination with other types of COPD medications.

Examples of inhaled corticosteroids include:

• Budesonide (sold under the brand names Pulmicort Respules and Pulmicort Flexhaler)
• Fluticasone (sold under the brand names Armonair Respiclick, Arnuity Ellipta, and Flovent)

You may take corticosteroids orally for short periods of time if you have a COPD flare-up. Prednisone is a common corticosteroid used for COPD. The branded version of prednisone approved by the U.S. Food and Drug Administration (FDA) to treat COPD flares is called Rayos.

Inhaled steroids may cause side effects such as easy bruising, thrush (a fungal infection in your mouth), and a hoarse voice. Short courses of oral corticosteroids may have side effects such as upset stomach, mood changes, and weight gain. Long-term oral corticosteroid use can have serious side effects, including osteoporosis, cataracts, and serious metabolic disorders such as diabetes and Cushing’s syndrome.

Combination Medications

Combination medications combine two or three different types of COPD medicine into one inhaler or nebulizer treatment. Your health care provider may prescribe a combination medication to make your treatment regimen more effective and simpler.

Most types of combination medications combine two different medications, including:

• Inhaled steroid plus LABA — Such as fluticasone/salmeterol (Advair or AirDuo Respiclick), budesonide/formoterol (Symbicort), or fluticasone/vilanterol (Breo Ellipta)
• LAMA plus LABA — Such as umeclidinium/vilanterol (Anoro Ellipta), glycopyrrolate/formoterol (Bevespi Aerosphere), aclidinium/formoterol (Duaklir Pressair), or olodaterol/tiotropium (Stiolto Respimat)
• SABA plus SAMA — Such as ipratropium/albuterol (Combivent Respimat) or ipratropium/albuterol (DuoNeb)

If you have severe COPD, you may need a combination treatment with three medications (triple therapy). Triple therapy combines an inhaled steroid, a LABA, and a LAMA. Examples include fluticasone/vilanterol/umeclidinium (Trelegy Ellipta) and budesonide/glycopyrrolate/formoterol (Breztri Aerosphere).

Phosphodiesterase Inhibitors

Phosphodiesterase (PDE) inhibitors help to relax the airways and reduce airway inflammation in people with COPD. There are two types of PDE inhibitors available for COPD — PDE4 inhibitors and PDE3/PDE4 inhibitors.

Roflumilast (Daliresp) is a PDE4 inhibitor you take as a pill every day to prevent a COPD flare-up. Common side effects may include:

• Diarrhea
• Weight loss
• Loss of appetite
• Nausea
• Headache
• Back pain
• Difficulty sleeping
• Dizziness

Ensifentrine (Ohtuvayre) is a PDE3/PDE4 inhibitor you inhale every day to prevent symptoms of COPD. Common side effects include:

• Back pain
• High blood pressure
• Urinary tract infection
• Diarrhea

Other Medications

Other medications sometimes taken by people who are treating COPD include:

• Antibiotics to fight respiratory infections during flare-ups
• Vaccinations to prevent lung infections
• Guaifenesin (Mucinex) to help thin mucus and make it easier to cough up
• Dupilumab (Dupixent) as an add-on treatment for COPD with an eosinophilic phenotype to reduce inflammation and improve lung function

Talk to your health care provider to find out if you need any other medications in your COPD treatment plan.

Oxygen Therapy

Oxygen therapy helps deliver more oxygen to your lungs. You may need oxygen therapy if you have severe COPD that leads to low oxygen levels in your blood. Your health care provider will order tests to determine how much oxygen you need.

Some people only need supplemental oxygen when they’re active or sleeping, while others need it all the time. Depending on your needs, your health care provider will help you choose the right oxygen delivery device for you.

There are three main types of oxygen delivery devices: oxygen-gas cylinders, oxygen concentrators, and liquid-oxygen devices. Devices differ in portability, expense, and noise.

Surgery

If you have severe COPD with difficulty breathing all of the time, your health care provider may suggest surgery. Surgeries for COPD may include:

• Bullectomy — A surgery to remove bullae (large air pockets that can form in lungs damaged by COPD) to improve lung function
• Lung volume reduction surgery — A surgery to remove damaged portions of one or both lungs that have become overinflated due to emphysema, leaving healthier parts of the lung more room to expand

If you have lung damage that can’t be repaired, your provider may recommend a lung transplant. This is a surgery to replace part or all of your damaged lung with a healthy lung from an organ donor. There are extensive criteria for becoming a candidate for a lung transplant, in addition to the severity of your disease. Your health care provider can help you determine whether you might be a good candidate for a lung transplant.

Pulmonary Rehabilitation

Pulmonary rehabilitation programs are supervised medical programs that combine education, exercise, counseling, and nutrition. These programs can help reduce shortness of breath and fatigue and increase your ability to walk and exercise. Some people with COPD who complete a course of pulmonary rehabilitation report improved quality of life.

Healthy Lifestyle Habits

As mentioned before, smoking cessation is vital for anyone with COPD who wants to improve symptoms, slow disease progression, and prolong life.

Regular physical activity and a healthy diet can also help improve your COPD symptoms. Even though exercise may seem difficult if you have trouble breathing, regular exercise can improve your symptoms by making your breathing muscles stronger. Your health care provider can help you develop an exercise plan that’s right for you or refer you to a physical therapist or registered dietitian.

There’s no specific diet for COPD, but a well-balanced diet can help you remain strong. Talk to your health care provider about how you can improve your nutrition.

Complementary Therapies

Some people with COPD incorporate natural treatments and report relief from certain symptoms when they use complementary or alternative treatments such as acupuncture, massage, or herbal supplements. It is important to notify your doctor of any natural treatments you use because some can interact with medications in dangerous ways or make them less effective. Complementary therapies should not replace prescribed medications, which have been proven effective in clinical studies.

Clinical Studies

Researchers are working to develop new and more effective ways to treat COPD. If you’re interested in joining a clinical trial for COPD, talk to your pulmonologist about studies for which you might be eligible. As with all COPD treatments, your doctor can help you understand the potential risks and benefits of a trial and whether it might be a good option for you.

Find Support for COPD

On MyCOPDTeam, the social network for people with COPD and their loved ones, more than 120,000 members come together to ask questions, give advice, and share their stories with others who understand life with COPD.

What treatments have you tried for COPD? What has been helpful for you? Comment below or post on your Activities page.