Medications for Chronic Obstructive Pulmonary Disease (COPD)

Short-acting inhaled bronchodilators include:

• Beta2-agonists
  • Albuterol
  • Terbutaline
  • Fenoterol
• Anticholinergics
  • Ipatropium
  • Oxitropium

Long-acting inhaled bronchodilators include:

• Beta2-agonists
  • Salmeterol
  • Formoterol
  • Arformoterol
  • Indacaterol
  • Olodaterol
• Anticholinergics
  • Tiotropium
  • Aclidinium
  • Umeclidinium
  • Glycopyrronium

These drugs work by relaxing the muscles of the airways. This will help them to open more fully and make breathing easier.

Problems may be:

• Fast heartbeat
• Nervousness, shaking
• Heartburn
• Nausea
• Insomnia
• Constipation
• Problems passing urine
• Dry mouth
• Sore throat

Common names are:

• Beclomethasone
• Triamcinolone
• Budesonide
• Flunisolide
• Fluticasone

Corticosteroids ease airway inflammation. They are used in people who are not helped by bronchodilators. They are usually inhaled into the lungs, which results in fewer side effects.

Some problems from inhaled medicines may be:

• Dry throat or mouth
• Hoarseness
• Fungal infection in the mouth or throat— thrush

Corticosteroids taken by mouth or given by IV may be used to treat a sudden worsening of the disease. Long term use of these medicines may cause serious side effects.

Common names are:

• Roflumilast

PDE4 inhibitors are used by mouth in people with severe COPD. They ease inflamed lungs by blocking the effects of inflammatory substances in the body. It also makes mucus easier to clear from the lungs and eases the number of COPD flare ups.

Problems may be:

• Nausea
• Diarrhea
• Weight loss
• Headache
• Insomnia

Side effects that affect mental health may include new or worsening depression or anxiety. These drugs may raise the risk of suicidal thoughts or actions.

Oxygen may be given in the hospital or used at home. It may be delivered through the nose or a mask. The oxygen will raise low blood oxygen levels in the body. This will make it easier to exercise and improve mental function. It will also help the heart to work as it should and lower the risk of heart problems from the disease. It may be used only during the day or at all times. All sources of flame will need to be avoided as oxygen is highly flammable.

• Tetracycline
• Doxycycline
• Ampicillin
• Amoxicillin
• Trimethoprim-sulfamethoxazole
• Clarithromycin
• Azithromycin
• Erythromycin
• Cephalosporins
• Quinolones

Antibiotics are used to treat bacterial infections that could cause more breathing problems. They are often given at the first sign of a respiratory infection. They are usually given for a week, but they may need to be taken longer to prevent flare ups.

Problems may be:

• Diarrhea
• Belly pain
• Sore mouth or tongue
• Vaginal itching due to growth of fungus or yeast
• Sensitivity to sunlight with tetracycline
• Rash

Common names are:

• Acetylcysteine
• Ambroxol
• Carbocysteine

Mucolytics are given by mouth, inhaler, or IV. Some require a prescription. They are used to dissolve, break up, and loosen excess mucus in the chest. This makes it easier to cough it up and out of the lungs. These drugs can help also lower the number of flare ups a person has.

Problems may be:

• Itching, rash, or hives
• Nausea or vomiting
• Fever
• Gastrointestinal bleeding (with carbocysteine)

Ambroxol should not be taken by people in their first trimester of pregnancy.