COPD Treatment Don't Combine These COPD Medicines Check this table to make sure you can use your COPD inhalers together By Lauren Van Scoy, MD facebook twitter Lauren Van Scoy, MD, is a board-certified physician in internal medicine, pulmonary medicine, and critical care. Learn about our editorial process Lauren Van Scoy, MD Medically reviewed by Medically reviewed by Sanja Jelic, MD on May 12, 2020 Sanja Jelic, MD is board-certified in pulmonary disease, sleep medicine, critical care medicine, and internal medicine. She is an assistant professor and attending physician at Columbia University College of Physicians and Surgeons in New York, NY. Learn about our Medical Review Board Sanja Jelic, MD on May 12, 2020 Print COPD Overview Symptoms Causes Diagnosis Treatment Coping Caregiving Cultura RM/JPM/Getty Images Most patients with COPD should be taking an inhaler every day to control their symptoms of shortness of breath. While there are many kinds of inhalers, there are some inhalers meant to be taken once or twice a day regardless of symptoms (eg. Spiriva) and some inhalers meant to be taken "as needed", for instance, whenever you have symptom or right before exercise (albuterol, Combivent, Ventolin, etc). As a result, most patients with COPD use several different inhalers. Sometimes this can be very confusing, especially because inhalers are often changed due to clinician preference, insurance coverage, or other reasons. Thus, sometimes, patients may end up using inhalers inappropriately or in combination with medications they should not be. Below is our attempt to help understand which inhalers can and should be used together, and which ones should not be used together. Different classes of medications can be used in combination (for example, combining a beta agonist with an anti-muscarinic inhaler), but in most cases, patients should not take the same class of medicine in more than one inhaler. The following chart helps explain this: Controller Medications How often it is taken Class of Medication Important to note Spiriva (tiotropium) Daily Anti-muscarinic Note this medication should not be taken with Combivent Turdoza Twice daily Anti-muscarinic Note this medication should not be taken with Combivent As Needed Inhalers (or Nebulizers) How often it is taken Class of Medication Important to note Albuterol (Ventolin, pro air, others) As needed Short-acting beta-agonist Note that it is OK to take this with long-acting beta agonists Combivent, Duoneb As needed Beta-agonist and anti-muscarinic Note these medications should not be taken with Spiriva. Inhaled Steroids How often it is taken Class of Medication Important to note Advair, Symbicort inhaled glucocorticoid and long-acting beta agonist Note that it is OK to take this with short-acting beta agonists Flovent, Q-Var inhaled glucocorticoid Note that sometimes, in severe COPD, patients may use this inhaler in addition to Advair or Symbicort To make sure your inhalers are OK to take together, look at the class of medications. If you notice that you take more than one medicine in the same class, ask your physician to review your prescriptions. It is really important to know that the information on this site is meant to be 'in general' and that there are always exceptions to every "rule"– especially in medicine. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Chronic obstructive pulmonary disease (COPD): Medication for COPD. 2015 Aug 12 [Updated 2019 Mar 14]