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COPD - control drugs

Anticholinergic inhaled medicines include:

• Aclidinium (Tudorza Pressair)
• Glycopyrronium (Seebri Breezhaler)
• Tiotropium (Spiriva)
• Umeclidinium (Incruse Ellipta)
• Revefenacin (Yupelri) is a long acting nebulized medicine

Use your anticholinergic inhalers every day, even if you do not have symptoms.

Beta-agonist inhaled medicines include:

• Arformoterol (Brovana used with a nebulizer)
• Salmeterol (Serevent)
• Olodaterol (Striverdi Respimat)

Do not use a spacer with beta-agonist inhalers.

Inhaled corticosteroids include:

• Beclomethasone (Qvar)
• Ciclesonide (Alvesco)
• Mometasone (Asmanex)
• Budesonide (Pulmicort can be used in an inhaler or as a nebulized solution)

After you use these medicines, rinse your mouth with water, gargle, and spit.

Combination medicines combine two or three drugs and are inhaled. They include (list is not complete):

• Albuterol and ipratropium (Combivent Respimat; Duoneb)
• Budesonide and formoterol (Symbicort)
• Fluticasone and salmeterol (Advair)
• Fluticasone and vilanterol (Breo Ellipta)
• Formoterol and mometasone (Dulera)
• Tiotropium and olodaterol (Stiolto Respimat)
• Umeclidinium and vilanterol (Anoro Ellipta)
• Glycopyrrolate and formoterol (Bevespi Aerosphere)
• Fluticasone and umeclidinium and vilanterol (Trelegy Ellipta)
• Budesonide and glycopyrrolate and formoterol (Breztri Aerosphere)

For all these medicines, some generic forms have just become or will become available in the near future, thus different names might also exist.

Roflumilast (Daliresp) is a tablet that is swallowed.

Azithromycin is a tablet that is swallowed.

Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. goldcopd.org/2024-gold-report/. Accessed May 16, 2024.

Han MK, Lazarus SC. COPD: clinical diagnosis and management. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 64.

Reilly J. Chronic obstructive pulmonary disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 76.

US Department of Veterans Affairs website. VA/DoD Clinical Practice Guideline for The Management Of Chronic Obstructive Pulmonary Disease, Version 3.0, April 2021. www.healthquality.va.gov/guidelines/CD/copd/VADoDCOPDCPGFinal508.pdf. Accessed May 16, 2024.

Waller DG. Asthma and chronic obstructive pulmonary disease. In: Waller DG, ed. Medical Pharmacology and Therapeutics. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 12.

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