Close-up of asthma inhalers

COPD Medications Combination Guide

Most patients having COPD should use an inhaler on a daily basis to cope with their shortness of breath. There are different kinds of inhalers. Some of them should be used once or twice a day regardless of symptoms and some are used “as needed”, for example, when you have symptoms. As a result, most patients suffering from COPD use different inhalers.

COPD inhalers are designed to deliver the medicine directly to the lungs. Depending on the severity of COPD symptoms, the doctor can prescribe both short-acting and prolonged drugs. Depending on the severity of COPD, the physician may also prescribe combination drugs.

Inhalers improve breathing and airway patency. Inhalers are effective for quick relief of symptoms and prevention of asthma attacks.

Inhalers for the content of drugs can be of three types:

  • with bronchodilators;
  • with glucocorticosteroids;
  • combined (bronchodilators + glucocorticosteroids).

We propose you to check the table below, which demonstrates the possibility or impossibility of the combined used of inhalers. In most cases, patients with COPD should not use the same class of medicine in more than one inhaler, but there are classes of medicines that can be combined (e.g., a combination of a beta agonist with an anti-muscarinic inhaler is possible). Make sure which COPD inhalers you can use together with the help of this table:

  Application frequency Class of Medicine Check
Daily inhalers
Turdoza Twice daily Anti-muscarinic Should not be combined with Combivent
Spiriva (tiotropium) Daily Anti-muscarinic Should not be combined with Combivent
As needed inhalers
Albuterol (pro air, Ventolin) As needed Short-acting beta-agonist Can be combined with long-acting beta agonists
Duoneb, Combivent As needed Beta-agonist and anti-muscarinic Should not be combined with Spiriva.
Inhaled Steroids
Symbicort, Advair inhaled glucocorticoid and long-acting beta agonist Can be combined with short-acting beta agonists
Q-Var, Flovent inhaled glucocorticoid In severe COPD, can be used in addition to Symbicort or Advair

If you see according to this table that you use more than one medicine of the same class, consult your doctor in order to review your prescriptions. We do not recommend mixing different medicines without the permission of a doctor, creating your own prescriptions for inhalation. It is important to understand that the information given in this table is presented ‘in general’. You know there are exceptions to every rule– especially in such a field as medicine.