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COPD - quick-relief drugs

Quick-relief medicines for chronic obstructive pulmonary disease (COPD) work quickly to help you breathe better. You take them when you are coughing, wheezing, or having trouble breathing, such as during a flare-up. For this reason, they are also called rescue drugs.

The medical name of these drugs is bronchodilators, meaning medicines that open the airways (bronchi). They relax the muscles of your airways and open them up for easier breathing. You and your health care provider can make a plan for the quick-relief drugs that work for you. This plan will include when you should take your medicine and how much you should take.

Follow instructions on how to use your medicines the right way.

Make sure you get your medicine refilled before you run out.

Quick-relief Beta-agonist Inhalers

Quick-relief beta-agonists help you breathe better by relaxing the muscles of your airways. They are short-acting, which means they stay in your system only for a short time.

Some people take them just before exercising. Ask your provider if you should do this.

If you need to use these drugs more than 3 times a week, or if you use more than one canister a month, your COPD probably is not under control. You should call your provider.

Kinds of Quick-relief Beta-agonists

Quick-relief beta-agonists inhalers include:

  • Albuterol (ProAir HFA; Proventil HFA; Ventolin HFA)
  • Levalbuterol (Xopenex HFA)
  • Albuterol and ipratropium (Combivent)

Most of the time, these medicines are used as metered dose inhalers (MDI) with a spacer. Sometimes, especially if you have a flare-up, they are used with a nebulizer.

Side effects might include:

  • Anxiety.
  • Tremor.
  • Restlessness.
  • Headache.
  • Fast or irregular heartbeats. Call your provider right away if you have this side effect.

Some of these medicines also exist in pills, but the side effects are a lot more significant, so they are very rarely used that way.

Quick relief Muscarinic antagonists (anti-cholinergics)

There is one medicine, ipratropium (Atrovent), which works slower than beta-agonists, but faster than other long-acting medicines.

Oral Steroids

Oral steroids (also called corticosteroids) are medicines you take by mouth, as pills, capsules, or liquids. They are not quick-relief medicines, but are often given for 7 to 14 days when your symptoms flare-up. Sometimes you might have to take them for longer.

Oral steroids include:

  • Methylprednisolone
  • Prednisone
  • Prednisolone

Alternative Names

COPD - quick-relief drugs; Chronic obstructive pulmonary disease - control drugs; Chronic obstructive airways disease - quick-relief drugs; Chronic obstructive lung disease - quick-relief drugs; Chronic bronchitis - quick-relief drugs; Emphysema - quick-relief drugs; Bronchitis - chronic - quick-relief drugs; Chronic respiratory failure - quick-relief drugs; Bronchodilators - COPD - quick-relief drugs; COPD - short-acting beta agonist inhaler

References

Anderson B, Brown H, Bruhl E, et al. Institute for Clinical Systems Improvement website. Health Care Guideline: Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). 10th edition. www.healthquality.va.gov/guidelines/CD/copd/VADoDCOPDCPGFinal508.pdf. Updated January 2016. Accessed May 27, 2022.

Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report. goldcopd.org/2023-gold-report-2/. Accessed January 11, 2023.

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.

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

Review Date 1/20/2022

Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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