COPD Medication Guidelines

You have the right and responsibility to know what medications are being prescribed for you. The more you know about your medications and how they work, the easier it will be for you to control your symptoms.

You and your doctor are partners in developing, adjusting, and following an effective medication plan. Make sure that you understand and share the same treatment goals as your doctor. Talk about what you expect from medications so you can know if your treatment plan is working.

The type and dose of medications you need might change with the season, your location, or other factors. Your medications will also vary with different triggers such as viral infections, allergens, pollution, cold air, and exercise. For most people with COPD, it takes from several weeks to several months to work out a treatment plan that leads to excellent symptom control.

General medication guidelines

• Before any medication is prescribed, tell your doctor if you have any allergies. Also tell your doctor about all other medications you are taking including over-the-counter medications, vitamins, and herbal products.
• Know the names of your medications and what they do. Know the generic and brand names, dosages, and side effects of your medications. Always keep a list of your medications with you, as well as the dosages and frequency of use.
• Know what side effects to expect from your medications. Call your doctor if you experience unexpected or troubling side effects.
• Take your medications exactly as prescribed, at the same time(s) every day. Do not stop taking or change your medications unless you first talk with your doctor. Even if you feel good, continue to take your medications. Stopping some medications suddenly might make your condition worse.
• Have a routine for taking your medications. Consider getting a pill box that is marked with the days of the week. Fill the pillbox at the beginning of each week to make it easier for you to remember.
• Keep a medicine calendar and note every time you take a dose. Your prescription label tells you how much to take at each dose, but your doctor might change your dosage periodically, depending on your response to the medication. On your medication calendar, you can list any changes in your medication dosages as prescribed by your doctor.
• Wash your hands before preparing or taking medications.
• Take your time. Double check the names and dosages of all your medications before using them.
• Regularly fill your prescriptions and ask your pharmacist any questions you have about refilling your prescription. Know your pharmacy phone number, prescription number, medication name, and dose so you can easily call for refills. Try to fill all your prescriptions at the same pharmacy, so the pharmacist can monitor for interactions and provide proper dosing and refills. If your refill medication does not look right, ask your pharmacist to verify that you have received the correct prescription.
• Do not wait until you are completely out of medication before filling your prescriptions. Call the pharmacy or doctor's office at least two business days before running out. If you have trouble getting to the pharmacy, have financial concerns, or have other problems that make it difficult for you to get your medications, let your doctor know. A social worker might be available to help you.
• If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take two doses at the same time to make up for the dose you missed, unless you are instructed to do so.
• Do not decrease your medication dosage to save money. You must take the full amount to get the full benefits. Talk with your doctor about ways you can reduce the costs of your medications.
• If you have prescription coverage, make sure you know the terms of your policy. Remind your doctor about the type of insurance coverage you have.
• Do not stop taking your medication. Talk to your doctor if you have concerns about your medication and how it is working.
• Keep medications stored in their original containers. Store according to the instructions given with the prescription.
• Check liquid medications often. If they have changed color or formed crystals, throw them away and get new ones.
• Do not take any over-the-counter drugs or herbal therapies unless you ask your doctor first.
• When traveling, keep your medications with you so you can take them as scheduled. On longer trips, take an extra week's supply of medications and copies of your prescriptions, in case you need to get a refill.

Helpful facts and tips

• COPD medications are used to improve your symptoms, but they cannot cure COPD.
• Most people need to take more than one type of medication. Not everyone with COPD takes the same medication.
• There are many different COPD medications, and they come in many forms: pills, vapors, powder, liquids, and injections.
• COPD medications are generally very safe. However, side effects can occur and vary depending on the medication and dose. Ask your doctor to describe medication side effects.
• The way the body responds to medications might change over time, so your medications might need to be adjusted. Tell your doctor if you notice a difference in how well the treatment plan is working.

Types of COPD medications

• Oxygen might be prescribed if your lungs are not getting enough oxygen to your blood. Breathing prescribed oxygen increases the amount of oxygen in your blood, reduces the extra work of the heart, and usually decreases shortness of breath.
• Bronchodilators relax the muscle bands that tighten around the airways. This action opens the airways, letting more air in and out of the lungs, and improving breathing. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can, therefore, be coughed out more easily.
• Anticholinergics relax the muscle bands that tighten around the airways. This action opens the airways, letting more air in and out of the lungs to improve breathing. Anticholinergics also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can therefore be coughed out more easily. Anticholinergics work differently and more slowly than fast-acting bronchodilators.
• Leukotriene modifiers might be used. Leukotrienes are chemicals that occur naturally in our bodies and cause tightening of airway muscles, and production of mucus and fluid. These newer drugs work by blocking the chemicals and decreasing these reactions. These medications help improve airflow and reduce symptoms in some people.
• Anti-inflammatories reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers. These need to be taken daily for several weeks before they will begin to control symptoms. Anti-inflammatories lead to fewer symptoms, better airflow, less-sensitive airways, and less airway damage.
• Expectorants thin mucus in the airways so it can be coughed out more easily. Take these medications with about a cup of water.
• Antihistamines relieve stuffy head, watery eyes, and sneezing. Although effective at relieving these symptoms, antihistamines can dry the air passages, making breathing difficult, as well as causing difficulty when coughing up excess mucus. Take these medications with food to reduce upset stomach.
• Antibiotics might be prescribed to treat infections or help you recover from an illness. To help clear up your infection completely or to help you recover more quickly from an illness, it is important to take antibiotics for the full time of treatment, even if your symptoms have improved.
• Antivirals might be prescribed to treat or prevent illnesses caused by viruses, most frequently to treat or prevent influenza (the flu). Influenza is particularly dangerous for people who have COPD.