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COPD - control drugs

Control medicines for chronic obstructive pulmonary disease (COPD) are drugs you take to control or prevent symptoms of COPD. You must use these medicines every day for them to work well.

These medicines are not used to treat flare-ups. Flare-ups are treated with quick-relief (rescue) drugs.

Depending on the medicine, control drugs help you breathe easier by:

  • Relaxing the muscles in your airways
  • Reducing any swelling in your airways
  • Helping the lungs work better

You and your health care provider can make a plan for the control drugs that you should use. This plan will include when you should take them and how much you should take.

You may need to take these drugs for at least a month before you start to feel better. Take them even when you feel OK.

Ask your provider about the side effects of any medicines you are prescribed. Be sure you know which side effects are serious enough that you need to call your provider right away.

Follow instructions on how to use your medicines the right way.

Make sure you get your medicine refilled before you run out.

Anticholinergic Inhalers

Anticholinergic inhalers include:

  • Aclidinium (Tudorza Pressair)
  • Glycopyrronium (Seebri Neohaler)
  • Ipratropium (Atrovent)
  • Tiotropium (Spiriva)
  • Umeclidinium (Incruse Ellipta)
  • Revefenacin (Yupelri)

Use your anticholinergic inhalers every day, even if you do not have symptoms.

Beta-agonist Inhalers

Beta-agonist inhalers include:

  • Arformoterol (Brovana)
  • Formoterol (Foradil; Perforomist)
  • Indacaterol (Arcapta Neohaler)
  • Salmeterol (Serevent)
  • Olodaterol (Striverdi Respimat)

Do not use a spacer with beta-agonist inhalers.

Inhaled Corticosteroids

Inhaled corticosteroids include:

  • Beclomethasone (Qvar)
  • Fluticasone (Flovent)
  • Ciclesonide (Alvesco)
  • Mometasone (Asmanex)
  • Budesonide (Pulmicort)
  • Flunisolide (Aerobid)

After you use these drugs, rinse your mouth with water, gargle, and spit.

Combination Inhaled Medicines

Combination medicines combine two or three drugs and are inhaled. They include (list is not complete):

  • Albuterol and ipratropium (Combivent Respimat; Duoneb)
  • Budesonide and formoterol (Symbicort)
  • Fluticasone and salmeterol (Advair)
  • Fluticasone and vilanterol (Breo Ellipta)
  • Formoterol and mometasone (Dulera)
  • Tiotropium and olodaterol (Stiolto Respimat)
  • Umeclidinium and vilanterol (Anoro Ellipta)
  • Glycopyrrolate and formoterol (Bevespi Aerosphere)
  • Indacaterol and glycopyrrolate (Utibron Neohaler)
  • Fluticasone and umeclidinium and vilanterol (Trelegy Ellipta)
  • Budesonide and glycopyrrolate and formoterol (Breztri Aerosphere)

For all these medicines, some generic brands have just become or will become available in the near future, thus different names might also exist.

Phosphodiesterase Inhibitor

Roflumilast (Daliresp) is a tablet that is swallowed.

Antibiotics

Azithromycin is a tablet that is swallowed.

Alternative Names

Chronic obstructive pulmonary disease - control drugs; Bronchodilators - COPD - control drugs; Beta agonist inhaler - COPD - control drugs; Anticholinergic inhaler - COPD - control drugs; Long-acting inhaler - COPD - control drugs; Corticosteroid inhaler - COPD - control drugs

References

Anderson B, Brown H, Bruhl E, et al. Institute for Clinical Systems Improvement website. Health Care Guideline: Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). 10th edition. www.healthquality.va.gov/guidelines/CD/copd/VADoDCOPDCPGFinal508.pdf. Updated January 2016. Accessed May 27, 2022.

Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report. goldcopd.org/2023-gold-report-2/. Accessed January 11, 2023.

Han MK, Lazarus SC. COPD: clinical diagnosis and management. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 64.

Waller DG. Asthma and chronic obstructive pulmonary disease. In: Waller DG, ed. Medical Pharmacology and Therapeutics. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 12.

Review Date 1/20/2022

Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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