How Chronic Obstructive Pulmonary Disease (COPD) Is Treated

Chronic obstructive pulmonary disease (COPD), an irreversible form of lung disease, is treated with prescription drugs, lifestyle changes, rehabilitation therapies, and surgery in certain cases.

The treatment plan can help you control your COPD symptoms and avoid exacerbations (flareups), including shortness of breath, wheezing, cough, chest tightness, and excess mucus production.

This article describes the various treatment options your healthcare provider may prescribe if you have COPD. It also offers tips and insights on what you can do to improve your respiratory health and better manage COPD on a day-to-day basis.

Home Remedies and Lifestyle

When you have COPD, your lifestyle has a major impact on the severity and progression of your illness. Every treatment plan should start with healthy lifestyle changes. Medications alone should not be the sole focus of treatment.

Treating COPD According to the 2020 GOLD Guide
Verywell / Catherine Song

Quit Smoking

Kicking the cigarette habit is the most important step you can take to manage COPD. Smoking is the leading cause of COPD and will invariably make COPD symptoms worse if you continue. For some people, smoking cessation is enough to help keep COPD symptoms at bay and prevent the disease from progressing.

It can be extremely difficult to quit, especially if you've been smoking for years. Treatment options include nicotine replacement therapy, including aids such as nicotine gum, inhalers, tablets, patches, or nasal sprays. Prescription medications used for smoking cessation include Wellbutrin (bupropion) and Chantix (varenicline).

Counseling or group therapy may also help by providing you with guidance, support, and accountability as you take this important step.

Regular Exercise

Getting regular exercise is always good for your overall health and wellbeing. For people with COPD, it can help optimize a person's lung function and increase their lung capacity. It can also help maintain muscle strength and endurance.

Walking is often a great way to start exercising if you have COPD. Resistance band training is also a great and affordable option. Talk to your healthcare provider about what types of exercise are best for you based on your current health and physical limitations.

Should I Exercise With Oxygen?

According to the American Lung Association, if you use supplemental oxygen, you should exercise with it. Be sure to speak to your healthcare provider first as the flow rate will likely need to be adjusted for physical activity.

Breathing Exercises

Struggling to breathe required excessive energy and exhausts your diaphragm (the large muscle below the lungs that helps enable respiration). Breathing exercises can help strengthen the diaphragm if you have COPD and improve oxygen exchange (the exchange of oxygen and carbon dioxide in each cell of the body).

Your healthcare provider, physical therapist, or respiratory therapist can teach you breathing exercises that you can perform on your own at home. These include pursed-lip breathing and diaphragmatic breathing ("belly breathing").

Get Enough Calories

Medications, fatigue, and difficulty breathing can lead to a reduced appetite and unintended weight loss. This can make your COPD symptoms worse and put you at a higher risk for infections (which, in turn, increases the risk of exacerbations).

Calorie Recommendations for COPD

According to the COPD Foundation, a person with COPD needs anywhere from 430 to 720 extra calories per day to compensate for the extra energy needed for breathing.

If you have experienced weight loss or a loss of appetite due to COPD, talk to your healthcare provider about ways to combat malnutrition.

On the other hand, if you are overweight or have obesity, it is important to shed the extra pounds. Being overweight makes it harder to breathe whether you have COPD or not.

Vaccinations

Infections, especially lung infections, can lead to a health crisis if you have COPD. While vaccines neither treat nor prevent COPD, they can prevent infections that trigger acute exacerbations and contribute to the progression of COPD.

Vaccinations commonly recommended for COPD include:

  • Pneumococcal pneumonia vaccine: This is a vaccine used to prevent pneumonia caused by a bacteria known as Streptococcus pneumoniae.
  • Flu vaccination: Annual flu shots are strongly advised for anyone with COPD irrespective of the disease severity.

Prescriptions

There are no over-the-counter (OTC) drugs used to treat COPD. While OTC inhalers like Primatene Mist can be used to treat acute exacerbations in people with asthma, they are not approved for people with COPD.

Prescription options include long-acting inhalers that are used on a regular basis to control COPD and short-acting inhalers that are used whenever symptoms flare up. Others drugs are used to treat respiratory infections.

Bronchodilators

Bronchodilators help relax the muscles in the airways. This makes it easier to breathe, reduces coughing, and improves or prevents acute dyspnea (shortness of breath).

These drugs are delivered to the lungs with an inhaler (equipped with an aerosol propellant) or a nebulizer (a machine that converts the liquid drug into a fine, inhalable mist).

There are two major categories of bronchodilators that differ by the speed of their action. You may need to u one or both of these, depending on the severity and frequency of your symptoms.

Short-acting bronchodilators work within seconds or minutes to relieve shortness of breath and provide relief for four to six hours. These include:

Long-acting bronchodilators help keep your airways open and relaxed for 12 to 24 hours. Though the effects last longer, they don't help in an emergency situation. Options include:

  • Serevent (salmeterol)
  • Arcapta (indacaterol)
  • Brovana (arformoterol)
  • Performist (formoterol)
  • Spiriva (tiotropium)
  • Tudorza Pressair (aclidinium)

Combination inhalers deliver two different long-acting agents. These are recommended for people with moderate to severe COPD who experience dyspnea and/or exercise intolerance. Examples include:

  • Bevespi Aerosphere (formoterol/glycopyrrolate)
  • Duaklir (formoterol/aclidinium)

Inhaled Corticosteroids

Your healthcare provider may also prescribe a daily inhaled corticosteroid (steroid). These medications help reduce airway inflammation as well as the frequency of exacerbations. They may be recommended for people who have one or more COPD exacerbations per year.

Inhaled corticosteroids for the treatment of COPD include:

There are also combination inhalers that deliver one or two long-acting bronchodilators with a corticosteroid. These include:

When to Stop Inhaled Corticosteroids

If you have not had a COPD exacerbation in the past year and do not have asthma, you should stop using inhaled steroids due to the increased risk of pneumonia.

Oral Corticosteroids

During a COPD exacerbation, oral corticosteroids like prednisone can shorten your recovery time, improve your lung function, and relieve low blood oxygen (hypoxemia). The drugs may also reduce the risk of relapse, increase the effectiveness of inhaled medications, and shorten hospitalization times.

Oral steroids are recommended for short-term use only. Long-term use of drugs like prednisone can lead to serious complications, including osteoporosis (porous bones), diabetes, eye problems (like glaucoma or cataracts), and an increased risk of infections.

Phosphodiesterase-4 (PDE4) Inhibitors

COPD can cause an overproduction of an enzyme called phosphodiesterase-4 (PDE4) that causes lung inflammation. PDE4 inhibitors block this enzyme and help to reduce COPD exacerbations in people with chronic bronchitis, a history of exacerbations, or severe to very severe COPD.

Daliresp (roflumilast) is currently the only PDE4 inhibitor used for the treatment of COPD. Side effects include diarrhea, weight loss, abdominal pain, disrupted sleep, nausea, loss of appetite, and headache.

Antibiotics

If you come down with a bacterial respiratory infection such as bronchitis or bacterial pneumonia, your healthcare provider may prescribe an antibiotic to clear the infection. These medications act against bacteria, not viruses.

It is now recommended that antibiotics be used for exacerbations in people with mild to moderate COPD as well as those with severe COPD. Augmentin (amoxicillin/clavulanate) is a drug of choice, able to shorten the duration of symptoms and extend the time between COPD exacerbations.

If you are prescribed a course of antibiotics, it is important to take them to completion as prescribed even if you start to feel better. Failing to do so increases your risk of antibiotic resistance (in which the drugs are less able to clear the infection).

COPD Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man

Surgeries and Specialist-Driven Procedures

A number of specialist procedures can be used to alleviate COPD symptoms or slow disease progression. While these treatments are not curative, they can enhance your respiratory function as well as your quality of life.

Pulmonary Rehabilitation

Pulmonary rehabilitation involves an assessment and an individualized program that includes physical exercise, breathing exercises, a nutrition plan, and counseling.

Your rehabilitation team may include respiratory therapists, physical therapists, occupational therapists, dietitians, and psychologists who will work cooperatively to optimize and track your breathing abilities.

Pulmonary rehabilitation can help you feel stronger and more active by increasing your level of fitness. It may even decrease the need for hospital visits.

Medicare and other forms of health insurance cover pulmonary rehabilitation for COPD if you meet certain requirements.

Oxygen Therapy

You may need supplemental oxygen therapy if you have COPD. Some people need oxygen only at night or when going out, while others need it 24 hours a day.

For some people with COPD, supplemental oxygen can improve survival times. It may also help alleviate symptoms and improve your quality of life by helping you sleep better at night, increase your alertness during the day, and improve your ability to take part in activities with fewer symptoms.

Lung Flute

The Lung Flute is a reusable handheld device that was approved by the U.S. Food and Drug Administration (FDA) in 2006 to help clear your lungs of mucus.

The Lung Flute works by creating low-frequency vibrations deep in the lungs when you blow hard through the mouthpiece. This helps break up mucus, making it easier for you to cough up.

The Lung Flute costs around $45, while the replacement reeds cost around $15. Depending on where you live, you may need a prescription to buy one.

Surgery

Surgery may be a necessary option in certain situations. it may be recommended if it can significantly improve your breathing by either removing a damaged section of a lung or reducing the volume of lungs in the chest cavity.

Depending on the extent of the lung damage, surgical resection (the partial removal of lung tissue) may not be an option. Instead, a lung transplant may be the only viable way to keep you alive.

Types of lung surgery for COPD include:

  • Bullectomy: This surgery involves the removal of bullae (large pockets of air that form when the air sacs of the lungs are damaged). Removing one or more bullae can help improve airflow.
  • Lung volume reduction surgery: In this surgery, damaged tissue is removed from the upper part of your lungs. This allows your lungs to expand further so that you can breathe more easily.
  • Lung transplant: This is a major surgery that involves the replacement of a damaged lung with a healthy lung from a deceased donor. Immunosuppressive drugs are used afterward on a daily basis to prevent organ transplant rejection.

Complementary and Alternative Medicine (CAM)

Complementary therapies are thought by some to be beneficial to people with COPD. With that said, there is little evidence that herbal remedies of any sort can help, and you should be wary of any non-prescription product that claims to do so.

Yoga and acupuncture have been evaluated in people who COPD in a number of smaller studies. While these practices do not "treat" COPD, they are safe and can improve your quality of life by alleviating stress.

Yoga

A number of small studies suggest that yoga may be beneficial for people who have COPD. One 2014 review in the Journal of Thoracic Disease reported positive effects for people with COPD who practiced yoga for at least 12 weeks as part of their treatment plan. These individuals show better lung function, less shortness of breath, and improved overall quality of life.

Acupuncture

Acupuncture is a form of traditional Chinese medicine that involves the placement of thin needles into specific parts of the body to heal.

A 2016 study published in the journal Medicine reported that people on COPD medications experienced less shortness of breath with exertion and a better quality of life after acupuncture was added to the treatment plan for a period of eight weeks.

A 2012 study in Acupuncture Medicine showed similar results after 10 weeks.

Summary

Chronic obstructive pulmonary disease (COPD) can be treated with lifestyle changes, prescription medications, and specialist procedures aimed at improving lung function.

Recommended lifestyle changes include routine exercise, quitting cigarettes, and increasing your caloric intake if underweight. Prescription drug options include short- and long-acting bronchodilators, inhaled corticosteroids, oral corticosteroids, and oral antibiotics. Pulmonary rehabilitation and devices like the Lung Flute can also be beneficial.

If these treatments are unable to provide relief due to extensive lung damage, lung surgery or a lung transplant may be advised.

A Word From Verywell

There are a variety of different treatments that are effective in managing COPD and preventing exacerbations. Even so, your treatment plan may need to be adjusted as the disease progresses, if certain medications start to lose their potency, or a drug causes intolerable side effects or toxicity.

It is for this reason that you need to see your healthcare provider regularly to have your blood tests done and your lung function monitored. By maintaining stable control of your symptoms, you will be better able to slow the progression of COPD and live a longer, more active life.

Frequently Asked Questions

  • When do you need oxygen therapy for COPD?

    Long-term oxygen therapy is needed for people with severe COPD who have extremely low blood oxygen levels. Oxygen therapy can also be used on an as-needed basis for people with moderate COPD but is less beneficial for long-term use. A 2016 study in the New England Journal of Medicine found that long-term supplemental oxygen in people with moderate COPD neither improved survival nor decreased hospitalizations.

  • Can lung damage from COPD be reversed?

    No, COPD is a progressive disease that gets worse over time, so any tissues damaged by the disease cannot be healed. However, with the appropriate treatment and lifestyle changes, you can slow the progression of COPD, improving both your symptoms and quality of life.

  • Why can't I use an over-the-counter inhaler for COPD?

    While over-the-counter inhalers like Primatene Mist and Asthmanefrin have attractive price tags, they are known to cause potentially serious side effects like tachycardia (rapid heart rate) and arrhythmia (heart rhythm problems). Given the risks—and the fact that COPD often occurs with heart disease—products like these should never be used.

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26 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Qureshi H, Sharafkhaneh A, Hanania NA. Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implicationsTher Adv Chronic Dis. 2014;5(5):212-227. doi:10.1177/2040622314532862

  2. National Heart, Lung, and Blood Institute. COPD.

  3. American Cancer Society. Prescription drugs to help you quit tobacco.

  4. American Lung Association. Physical activity and COPD.

  5. Global Initiative for Chronic Obstructive Lung Disease. Pocket guide to COPD diagnosis, management, and prevention.

  6. Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in patients with COPD and its treatmentNutrients. 2013;5(4):1316-35. doi:10.3390/nu5041316

  7. COPD Foundation. Nutrition for someone with COPD.

  8. Restrepo MI, Sibila O, Anzueto A. Pneumonia in patients with chronic obstructive pulmonary diseaseTuberc Respir Dis (Seoul). 2018;81(3):187-97. doi:10.4046/trd.2018.0030

  9. U.S. Food and Drug Administration. Primatene.

  10. Nici L, Mammen MJ, Charbek E, et al. Pharmacologic management of chronic obstructive pulmonary disease: an official American Thoracic Society clinical practice guideline. Am J Respir Criticla Care Med. 2020;201(9). doi:10.1164/rccm.202003-0625ST

  11. Rossi A, Khirani S, Cazzola M. Long-acting beta2-agonists (LABA) in chronic obstructive pulmonary disease: efficacy and safetyInt J Chron Obstruct Pulmon Dis. 2008;3(4):521-529. doi:10.2147/copd.s1353

  12. Zhang J, Zheng J, Huang K, Chen Y, Yang J, Yao W. Use of glucocorticoids in patients with COPD exacerbations in China: a retrospective observational studyTher Adv Respir Dis. 2018;12:1753466618769514, doi:10.1177/1753466618769514

  13. Asher GN, Mounsey A. Steroids for acute COPD--but for how longJ Fam Pract. 2014;63(1):29-32.

  14. Liu D, Ahmet A, Ward L, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapyAllergy Asthma Clin Immunol. 2013;9(1):30. doi:10.1186/1710-1492-9-30

  15. Nissly T, Prasad S. PURLs: should you consider antibiotics for exacerbations of mild COPD? J Fam Pract. 2014 Apr;63(4):E11–E13.

  16. American Lung Association. The basics of pulmonary rehabilitation.

  17. Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and managementJ Clin Sleep Med. 2015;11(3):259-270. doi:10.5664/jcsm.4540

  18. U.S. Food and Drug Administration. 510(k) premarket notification.

  19. Huang W, Han R, Li L, He Y. Surgery for giant emphysematous bullae: case report and a short literature reviewJ Thorac Dis. 2014;6(6):E104-E107. doi:10.3978/j.issn.2072-1439.2014.04.39

  20. Kostron A, Horn-tutic M, Franzen D, et al. Repeated lung volume reduction surgery is successful in selected patients. Eur J Cardiothorac Surg. 2015;48(5):710-715. doi:10.1093/ejcts/ezu498

  21. Rampolla R. Lung Transplantation: an overview of candidacy and outcomesOchsner J. 2014;14(4):641-8.

  22. Liu XC, Pan L, Hu Q, Dong WP, Yan JH, Dong L. Effects of yoga training in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysisJ Thorac Dis. 2014;6(6):795-802. doi:10.3978/j.issn.2072-1439.2014.06.05

  23. Feng J, Wang X, Li X, Zhao D, Xu J. Acupuncture for chronic obstructive pulmonary disease (COPD): a multicenter, randomized, sham-controlled trial. Medicine (Baltimore). 2016;95(40):e4879. doi:10.1097/MD.0000000000004879

  24. Suzuki M, Namura K, Ohno Y, et al. Combined standard medication and acupuncture for COPD: a case series. Acupunct Med. 2012;30(2):96-102. doi:10.1136/acupmed-2011-010112

  25. Long-Term Oxygen Treatment Trial Research Group, Albert RK, Au DH, et al. A randomized trial of long-term oxygen for COPD with moderate desaturationNEJM. 2016;375(17):1617-27. doi:10.1056/nejmoa1604344

  26. Rabe KF, Hurst JR, Suissa S. Cardiovascular disease and COPD: dangerous liaison? Eur Respir Rev. 2018;27:180057. doi:10.1183/16000617.5057-2018