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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. As such, ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor. Make sure to follow the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Numerous medications may be prescribed to treat COPD. These medications may be taken by mouth or inhaled into the lungs. Some work by opening the airways. Others are designed to reduce inflammation, or eliminate infections. The list below is a sample of some of these medications. Doctors may often choose drugs closely related to those listed. They may also choose combinations of drugs.

Prescription Medications
Bronchodilators

Short-acting inhaled bronchodilators include:

  • Albuterol
  • Terbutaline
  • Ipatropium

Long-acting inhaled bronchodilators include:

  • Salmeterol
  • Formoterol
  • Arformoterol
  • Tiotropium

These drugs work by relaxing the smooth muscles of the respiratory tract. This allows the bronchial passages to open, which makes breathing easier.

Possible side effects include:

  • Fast heartbeat
  • Nervousness, trembling
  • Heartburn or nausea
  • Insomnia
  • Constipation
  • Difficulty urinating
  • Dry mouth
  • Sore throat
Corticosteroids

Common names include:

  • Beclomethasone
  • Triamcinolone
  • Budesonide
  • Flunisolide
  • Fluticasone

Corticosteroids reduce inflammation in the airway walls. They are frequently used if airway obstruction cannot be kept under control with bronchodilators. Corticosteroids are often provided in an inhaled form. This allows them to work directly on inflamed lung tissue. Few serious side effects are associated with their use if inhaled.

Possible side effects from inhalation therapy include:

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

Systemic corticosteroids, taken by mouth or by IV, may also be used to treat COPD exacerbations. However, long-term use in COPD is not usually recommended.

Oxygen Therapy

Supplemental oxygen may be given in the hospital or as home oxygen therapy. There are several of oxygen delivery. A nasal cannula is a two-pronged device inserted in the nostrils. It is connected to a tube carrying the oxygen. The tube can rest on the ears, or be attached to the frame of eyeglasses. People who need a high flow of oxygen may use a mask.

Oxygen therapy raises low blood oxygen levels. This enhances your ability to tolerate exercise, and improves mental function. It also improves heart function and helps to prevent some of the heart complications of COPD. You may require oxygen only during waking hours, or you may need it at all times throughout the day. Make sure that you understand how many hours a day you should be using oxygen. It is important to follow the prescription closely.

If you are using supplemental oxygen, it is extremely important that you do not smoke cigarettes. You should also avoid all other sources of fire or flame, such as candles or gas stoves. These could produce an explosive reaction. You should also avoid drinking alcohol or sedatives, since these can slow your breathing rate.

While on supplemental oxygen therapy, contact your doctor if:

  • You develop a headache, blue lips, confusion, or agitation
  • Your breathing becomes very shallow
  • You are still very tired following slight exertion
Antibiotics
  • Tetracycline
  • Doxycycline
  • Ampicillin
  • Amoxicillin
  • Trimethoprim-sulfamethoxazole
  • Clarithromycin
  • Azithromycin
  • Erythromycin
  • Cephalosporins
  • Quinolones

Antibiotics are used to treat bacterial infections that could further limit breathing. They are frequently prescribed at the first sign of a respiratory infection, such as increased production of green or yellow sputum or fever. Usually, they are taken for 3-7 days. Your doctor may advise you to take them for a longer period to prevent flare-ups. Some are taken with food or on an empty stomach. It is usually best to avoid alcohol while taking antibiotics.

Some of the more likely side effects include:

  • Diarrhea
  • Stomach ache
  • Sore mouth or tongue
  • Vaginal itching due to growth of fungus or yeast
  • Increased sensitivity to sunlight with tetracycline
  • Rash
Special Considerations

Talk to your doctor before using any over-the-counter medications if you have COPD.

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Know what side effects could occur. Discuss them with your doctor.
  • Talk to your doctor before you stop taking the medication.
  • Plan ahead for refills if you need them.
  • Do not share your medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.
When to Contact Your Doctor

Contact your doctor if you:

  • Have serious side effects, such as increased shortness of breath or signs of an allergic reaction, including swelling of the face, lips, or eyelids
  • Have prolonged nausea, vomiting, or diarrhea
  • Develop white spots in your mouth
  • Develop vaginal itching
  • Have severe or prolonged muscle cramps or heart palpitations

References:

COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 20, 2014. Accessed February 24, 2014.

COPD medications. American Lung Association website. Available at: http://www.lung.org/lung-disease/copd/living-with-copd/copd-medications.html. Accessed February 24, 2014.

How is COPD treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd/treatment.html. Updated July 31, 2013. Accessed February 24, 2014.

Inhaled corticosteroids for COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 20, 2014. Accessed February 24, 2014.

Supplemental oxygen. American Lung Association website. Available at: http://www.lung.org/lung-disease/copd/living-with-copd/supplemental-oxygen.html. Accessed February 24, 2014.

What you can do about a lung disease called COPD. Global Initiative for Chronic Obstructive Lung Disease website. Available at: http://www.goldcopd.org/uploads/users/files/GOLD_Patient_RevJan10.pdf. Accessed February 24, 2014.

9/14/2006 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Appleton S, Poole P, Smith B, et al. Long-acting beta2-agonists for poorly reversible chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006;3:CD001104.

7/6/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Yang IA, Fong KM, Sim EHA, Black PN, Lasserson TJ. Inhaled corticosteroids for stable chronic obstructive pulmonary disease [review]. Cochrane Database of Systematic Reviews. 2007;2:CD002991.

6/4/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. Abstract Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008;63:415-422.

1/13/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Herath SC, Poole P. Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2013;11:CD009764.



Last reviewed February 2014 by Peter J. Lucas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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