Chronic Obstructive Pulmonary Disease (COPD)

COPD Symptoms

Common COPD symptoms may include: 

• Shortness of breath, which you may notice more with physical activity
• Chest tightness
• Wheezing
• Chronic productive cough with mucus

If symptoms suddenly worsen compared to your baseline, this may indicate a COPD exacerbation or flare-up. If this occurs, promptly contact your clinician. They can recommend next steps, such as adjusting medications to help bring symptoms back under control.

Seek immediate medical care or go to the hospital if you experience any of the following serious symptoms:

• Blue or gray lips or fingernails
• Decreased mental alertness or confusion
• Difficulty catching your breath or trouble speaking
• Little to no symptom relief from routine COPD medications
• Very fast heartbeat

COPD Risk Factors

COPD risk increases with certain environmental, genetic, and health factors.

COPD Diagnosis

COPD can be diagnosed using a combination of medical history, physical examination, lung function tests, and labs. Some diagnostics your clinician could perform include:

COPD Medication Treatments

COPD medication treatments include relief (rescue) inhalers and maintenance inhalers.

Relief Inhalers for COPD

Need more support? 

For support, call 1-800-LUNGUSA (1-800-586-4872).

Medication Treatment Details

Once you have a COPD diagnosis, your clinician will assign you to a group, depending on the severity of your symptoms and how often you experience hospitalized flare-ups.

In general, most people start with a bronchodilator, which is a medicine that opens your airways. 

Bronchodilators include:

• Short-acting beta agonist (SABA) as needed
• Short-acting muscarinic antagonist (SAMA) as needed
• Long-acting beta agonist (LABA) for daily maintenance
• Long-acting muscarinic antagonist (LAMA) for daily maintenance

If a single bronchodilator is not enough, experts recommend dual bronchodilator therapy (using both LABA and LAMA) with or without an inhaled corticosteroid (ICS) depending on your eosinophil (“eos”) count. 

• An eos count over 300 cells per microliter (cells/µL) will likely result in the addition of an ICS. 
• An eos count above 100 cells/µL may still lead to an ICS if your symptoms are not controlled with a LABA and LAMA combo. 

If you have an eos count above 100 cells/µL and continue to experience uncontrolled symptoms on a LABA/LAMA/ICS combination, your clinician may also add a 300 mg dupilumab (Dupixent) injection under the skin every 2 weeks.

As for an eos count below 100 cells/µL with uncontrolled symptoms on a LABA/LAMA combination, the next step is roflumilast tablets to start at 250 mg daily for four weeks before increasing to 500 mg daily. Roflumilast may still be used with bronchodilators. Instead of switching to roflumilast, another option is to add on azithromycin antibiotic tablets, especially for people who used to smoke. The azithromycin dosage is either 250 mg daily or 500 mg three times per week.

At all times, you will still have a rescue inhaler (SABA), with or without SAMA, on hand for rescue treatment.

Compare COPD Medication Prices

This price data is updated daily. U.S. pharmacy retail price reflects a national average of out-of-pocket cost. All other pricing reflects that of the lowest price per inhaler on PharmacyChecker.com.

*There are slight dose variations for some medications sold internationally. For inhalers, this is usually due to alternate ways of measuring the strength. Check with your clinician regarding COPD therapy equivalence.

Ordering COPD Medication Online

It's important to remain vigilant when shopping online for medications. Verify websites through trusted tools. PharmacyChecker independently verifies online pharmacies to help consumers avoid counterfeit or unsafe medications. PharmacyChecker offers the following resources to help you check whether an online pharmacy meets PharmacyChecker’s safety and quality standards:

• Public list of PharmacyChecker-accredited online pharmacies
• PharmacyChecker Verification Portal
• List of rogue online pharmacies

Pharmacist Advice on COPD Medications

1. If you are a smoker with COPD, experts strongly recommend quitting. To improve your chance of success, your clinician can discuss different cessation medications, such as varenicline (Chantix). There are also nicotine replacement therapy (NRT) options, such as patches, gums, or lozenges. For support and additional resources, call 1-800-QUIT-NOW (1-800-784-8669).

2. With so many inhaler options, there are also numerous types of devices. Appropriate use of your inhaler is important in COPD management. If you are new to a specific inhaler, become familiar with the patient information section at the bottom of the product label. The product label is a folded sheet of paper that is usually attached to the box or is inside the box of your inhaler. This section also contains information about priming and cleaning requirements. For further assistance, your clinician or pharmacist can demonstrate proper device technique with you. Referring to the relevant video links throughout this page may help as well. As mentioned, additional support is available at 1-800-LUNGUSA (1-800-586-4872).

3. If you experience sudden worsening symptoms, reach out to your clinician as soon as possible for next steps to prevent hospitalization. Seek emergency medical care right away if you have severe symptoms with little or no relief from your routine COPD medications. Severe symptoms include blue or gray lips or fingernails; trouble speaking; severe difficulty catching your breath; extremely fast heartbeat; or reduced mental alertness.

More About COPD