More Details on Drugs for COPD
Sometimes, oral or IV steroids (such as prednisone) are necessary to help control a temporary worsening of COPD. Steroids work by decreasing inflammation of the airways, which helps improve breathing. Some people also benefit from using an inhaled steroid on a daily basis. These inhaled steroids include:
- Beclomethasone (Qvar®)
- Budesonide (Pulmicort®)
- Ciclesonide inhaler (Alvesco®)
- Flunisolide (Aerobid®, Aerospan®)
- Fluticasone (Flovent®)
- Mometasone (Asmanex®)
- Triamcinolone (Azmacort®).
Inhaled steroids are not fast-acting medications for rapid relief of symptoms. You must take them on a daily basis in order to obtain the full benefit. A few medications combine a bronchodilator medication with an inhaled steroid. These medications include:
- Fluticasone and salmeterol (Advair)
- Budesonide and formoterol (Symbicort)
- Fluticasone and vilanterol (Breo Ellipta).
People with COPD are prone to frequent and severe lung infections, such as bronchitis. As a result, antibiotics are often used in the treatment of COPD. In general, antibiotics are reserved for use only when an infection occurs. However, sometimes antibiotics are used on a continuous basis to help prevent infections, although this type of use is a little controversial.
There is one phosphodiesterase type-4 inhibitor approved for treating COPD -- Daliresp™ (roflumilast). Unlike most COPD medications, Daliresp is a tablet, not an inhaler, and is taken just once a day. Daliresp is specifically approved to prevent exacerbations in people with severe COPD associated with chronic bronchitis and a history of exacerbations.
Daliresp is not a "rescue medication" and should not be used to replace a rescue medication, such as a bronchodilator. Some of the most significant side effects noted with the drug include weight loss and, rarely, psychiatric problems such as depression, anxiety, and suicidal thoughts or actions.
People with COPD are typically advised to receive a pneumococcal vaccine (pneumonia vaccine) and a yearly flu shot, as this condition may predispose people to pneumonia or the flu. Usually, the pneumococcal vaccine is a one-time vaccine, although there are a few situations when a booster vaccine may be required.