How medicines fit in

The most effective treatment for COPD is to stop smoking, which has been shown to put off the development of symptoms and disability, and prolong life.

But there are also many choices of medical treatments for COPD. None of these can cure COPD but the medications available today can reduce or even abolish symptoms and flare-ups, allowing you to carry on with your normal daily activities.

As it's a long-term (chronic) illness, your treatments are likely to be long term too. There are two main types of medicines that work together to help control your COPD - maintenance and rescue. Your doctor may prescribe one of each. Here's how they work together:

Maintenance and rescue medicine

Maintenance inhalers

Work over time and keep you breathing better for longer.

Taken every day to help maintain control over your COPD
Work over time and last up to 24 hours
Must be taken every day for full, long-term benefits

Rescue inhalers

Taken in times of emergency to help you catch your breath when symptoms suddenly get worse.

Taken as needed to help you catch your breath
Help you breathe better quickly, but last only 4-6 hours

Maintenance and rescue therapy

Maintenance therapy

Maintenance medicines help keep your airways open so you can breathe better all day. You need to take these medicines every day for them to work properly.

Rescue therapy

Rescue therapy is a medicine that you take just when you need it - for example, when your shortness of breath suddenly becomes worse. They work quickly to help you to breathe, but unlike maintenance therapy their effects don't last all day.

The effectiveness of treatment for COPD can vary from person to person. If the first type of treatment your doctor suggests doesn't improve your symptoms there are others to try.

Treatments available

Inhalers

These are devices that you can use to deliver a ‘puff’ of medicine directly to your lungs to relieve your shortness of breath. It’s possible that you’ll have one inhaler for your maintenance medication and another inhaler for your rescue medication.
Short-acting bronchodilator

Bronchodilators are medications that cause the muscles in your airways to relax and open up. Short-acting bronchodilator inhalers deliver a small dose of medicine to your lungs, and your doctor may prescribe this as rescue medication if you have mild COPD symptoms. For you, using one of these inhalers just when you feel breathless may be all you need to relieve your symptoms. Other people may need to use their inhalers more often.
Long-acting bronchodilator

Used as maintenance treatment, these last for at least 12 hours per dose, and your doctor may suggest you use one if the short-acting bronchodilator has failed to relieve your symptoms.
Corticosteroids

You may be prescribed a corticosteroid as maintenance treatment if you have moderate or severe COPD. Corticosteroids work by reducing the inflammation in your airways. Examples of corticosteroids are beclometasone and budesonide.
Nebulisers

Used as a rescue for severe COPD, the nebuliser is a device that allows a larger dose of the inhaled medicines to be delivered through a mouthpiece or a face mask.
Tablets

Theophylline may be used if your symptoms are not being controlled by the bronchodilator therapy. Theophylline works by helping you to breathe more strongly and allows you to clear phlegm from your lungs more quickly. Steroids You may be prescribed a short course of steroids if you have a flare-up, in which you become suddenly more short of breath. Mucolytics, given as tablets or capsules, make the mucus and phlegm easier to cough up. They may be recommended if you have moderate and severe COPD. If your phlegm changes colour, becomes stickier, or there is more of it, you may have a chest infection. Your doctor may give you a course of antibiotics.(ref)
A flu vaccination

If you have COPD, you’re at greater risk of catching infections such as ‘flu’. As flu is a trigger for flare-ups, having the flu jab every autumn is important for you.
Oxygen Therapy

If your COPD is severe, you may need to have oxygen therapy so that you can get more oxygen into your blood. Oxygen is delivered by a machine through nasal tubes or through a mask. You may need to be connected to this machine for 15 hours or more a day, but during this time you’ll still be able to move around your house.
Treating flare-ups

If you have a flare-up of your COPD when your symptoms are particularly bad, you may need to have a spell in hospital. During this time doctors and nurses will monitor your condition while you receive your medication.
Stick with it

Many people let their COPD go untreated, or they’ll take their treatment off and on. Some may have doubts about their diagnosis and the need for treatment. Others forget. But if you don’t take your treatment consistently as your doctor has advised, you miss out on the full benefits of managing your condition: being able to breathe better all day, every day. Maintenance medicines work over time and their effects are long-lasting. This is why you may not "feel" them working right away. These medicines help keep your airways open. You need to take them every day, even when you’re breathing better, so that you can keep breathing better. You feel their full benefits over time.