COPD

What Are the Treatments for COPD?

Written by Stephanie Watson
Medically Reviewed by Zilpah Sheikh, MD on May 14, 2025
11 min read

Chronic obstructive pulmonary disease (COPD) makes it hard to breathe. Narrowed airways can make you cough, wheeze, and feel short of breath. It can affect how you exercise, work, and do other daily activities.

The goals of COPD treatment are to reduce symptoms and symptom flare-ups. "This can be done through a combination of lifestyle changes and treatment options in consultation with your doctor," says Surya Bhatt, MD, MSPH, director of the Center for Lung Analytics and Imaging Research (CLAIR) and professor of airways disease at the University of Alabama at Birmingham. 

Remember, COPD treatment is a long-term journey with many facets, and each case is different. For example, you might be great at keeping up with your medications and doctor appointments but not so good with following a nutritious diet and exercising. A dietitian and physical therapist might be able to help.

Or maybe you're good at both but still feel depressed because you can't do as much as you used to or feel worried about your health. In that case, the American Lung Association and other organizations have resources and support groups that can help. 

In addition, symptoms and drug therapy for COPD can change quite a bit as the disease gets worse, so it's good to stay vigilant and check in with your doctor regularly. Wherever you are on your journey with COPD and whatever your frustrations may be, don't be afraid to reach out for the help you need to get the most out of your daily life.

Often the first treatment for COPD is a long-acting bronchodilator. Adding an inhaled steroid can help reduce flare-ups.

Bronchodilators

These meds for COPD work quickly to relax the muscles around your airways and ease symptoms such as coughing and shortness of breath. You take them through an inhaler. 

Short-acting bronchodilators.They can help if you have symptoms only from time to time. The effects of these COPD medications last about four to six hours. You use them only when you have symptoms or before you exercise. These medicines include:

You can get dry mouth and headaches from these medications. Other side effects include:

Long-acting bronchodilators. They also relax the muscles around your airways, but their effects last up to 24 hours. You take them with an inhaler every day to prevent symptoms. They include:

Side effects include:

Steroids

These medicines bring down swelling in your airways. You usually breathe them in through an inhaler. Inhaled steroids can help if you have many COPD flare-ups. You might take steroids as a pill if your symptoms get worse.

Examples of inhaled steroids are:

  • Budesonide (Pulmicort)
  • Fluticasone (Cutivate, Flovent HFA)

Some medicines combine one or more bronchodilators and an inhaled steroid. Some examples are:

Side effects of steroid medicines depend on how long you take them. You may gain weight or bruise easily. Other possible side effects include:

  • Coughing
  • Higher chance of infections
  • Infections of the mouth
  • Hoarse voice
  • Sore mouth or throat
  • Weak bones

Phosphodiesterase-4 (PDE4) inhibitors

A drug called roflumilast (Daliresp) can help with severe COPD symptoms. It blocks an enzyme called PDE4 to reduce inflammation in your body. Daliresp brings down swelling in the lungs and opens your airways. You might take it with a long-acting bronchodilator. Side effects include diarrhea and weight loss. Rarely, roflumilast can cause neuropsychiatric side effects, such as suicidal thoughts, in some people. 

Ensifentrine (Ohtuvayre) combines a PDE4 inhibitor with a PDE3 inhibitor — a medicine that blocks a different enzyme. It's approved for COPD maintenance.

Theophylline

This medicine works like a bronchodilator, but it's less expensive. Theophylline can help your lungs work better, but it may not control all of your symptoms. Because this medicine can cause side effects such as an upset stomach and irregular heartbeat, doctors don't prescribe it as often as they do bronchodilators.

Biologics

Even with bronchodilator and steroid treatment, many people with COPD continue to have symptom flare-ups. "For some of these patients, treatment with a biologic may offer a promising option," Bhatt says.

Dupilumab (Dupixent) is the first biologic drug approved for COPD. Dupixent is added to treatment for people with the eosinophilic type of COPD that isn't well controlled. You take this medicine by injection. 

Antibiotics

An infection can make your COPD symptoms worse. Your doctor will give you antibiotics to kill the bacteria and treat the infection.

Take all the medicine you're prescribed. If you stop taking the antibiotics too early, the infection could come back.

Pulmonary rehab is a COPD management program. It can ease shortness of breath, help you exercise more easily, and improve your quality of life. At a hospital or clinic, you'll work with a team of doctors, nurses, dietitians, physical therapists, and respiratory therapists.

Typically, pulmonary rehab includes:

Breathing exercises. A respiratory therapist will show you specific ways of breathing and how to measure your progress with a device called a spirometer that you can use at home. These techniques, combined with a physical exercise program, can help lessen breathlessness and increase stamina. Your doctor or a breathing therapist can help design a program for you.

Nutritional therapy. This includes advice on what to eat and how much to eat. Nutritional therapy may differ, depending on where you are in your COPD journey. For example, in the early stages, you may need to lose weight. In the later stages, you may need to gain weight. Your doctor or nutritionist can help design a diet that works for your weight, health, and activity level.

Exercise. This is also important when you have COPD. It increases stamina and strengthens the muscles that help you breathe. Your doctor or physical therapist can help you design a fitness program that's safe for you. 

Smoking counseling. "The main culprit in COPD and the source of damage to the lung is cigarette smoke," says Shervin Takyar, MD, PhD, a pulmonologist and associate professor at Yale School of Medicine. Your pulmonary rehab team can offer advice and methods such as medications and behavioral changes to help you quit.

Tracking. Your rehab team may suggest you keep a journal of your daily symptoms and check them against an action plan. Here's one example of a COPD action plan from the American Lung Association. It's a good idea to fill the plan out with your doctor, and update it on each visit.

COPD action plans offer guidance on:

  • When and how to take your medication
  • How well your drug therapy for COPD is working
  • When to call your health care provider
  • When to get emergency care
  • How you feel from day to day
  • Health changes to discuss with your doctor 

 

Severe COPD can prevent you from getting enough air into your lungs. As a result, oxygen levels in your blood can get too low. Oxygen therapy increases these levels to help you stay active and healthy.

During this chronic obstructive pulmonary disease treatment, you breathe in oxygen through a mask or prongs in your nose. The oxygen can come from a big home unit or a small tank you carry around with you. You might need oxygen all the time or only when you're active.

This typically means a CPAP or BiPAP machine.

CPAP stands for continuous positive airway pressure. Light air pressure from the CPAP machine helps make sure your airway doesn't close and interrupt your breathing as you sleep.

The CPAP machine has a small motor that blows air into a tube. The tube connects to a mask that covers your nose and mouth or, in some cases, just your nose.

The BiPAP machine works in a very similar way. The "Bi" in BiPAP stands for "bilevel." It means there are two levels of pressure — a normal one that helps you breathe in and a lower one that makes it easier for you to breathe out. Many people find this more comfortable than the constant airflow from a CPAP machine. 

If you have moderate to severe COPD, you might use one of these machines at the hospital to help with sudden, intense symptoms. Or you could use it at home to help you sleep, keep your blood oxygen levels up, and remove carbon dioxide from your blood.

Just remember that regular use of these machines isn't always helpful for COPD. Your doctor can tell you whether you're a good candidate for a breathing machine.

If your symptoms are serious enough, you may need mechanical help to breathe. This involves tracheal intubation and a ventilator.

If your symptoms don't improve with other treatments within a certain amount of time — one hour is a common guideline — intubation and mechanical ventilation is the next treatment offered.

You'll have a breathing tube (also called a tracheal tube) put into your mouth and down into your windpipe (trachea). The tube is connected to the ventilator, a machine that pushes air into your lungs.

You'll get medicine to make this treatment more comfortable.

While the machine keeps you breathing, your respiratory system — which has been struggling to work very hard — can rest. Doctors also will do tests to identify and treat any other problems, such as pneumonia, that may have caused the flare-up.

"It's important to stay up to date with vaccinations to reduce the risk of lung infections," says Bhatt. Get a yearly flu shot to reduce the number of COPD flare-ups you have. Ask your doctor whether you should also get a pneumonia vaccine.

If other COPD therapies don't work and your COPD is severe, you might need one of these surgeries to treat it:

Bullectomy. Air sacs are the tiny pouches in your lungs where oxygen travels into your blood vessels. COPD destroys the walls of these air sacs. When the walls come down, they create large spaces in your lungs called bullae. These bullae make it hard to breathe. Bullectomy is surgery to remove these air spaces and improve the flow of air in your lungs.

Lung volume reduction surgery. The surgeon removes small pieces of your lungs that COPD has damaged. Removing the damaged parts helps the healthy parts of your lungs expand so they can take in more oxygen.

Lung transplant. If you have severe lung damage, your doctor can remove your lung and replace it with a healthy one from a donor. This surgery has risks, and you will need to take medicines for the rest of your life to prevent your body from rejecting the new organ.

 

Treatment from your doctor is just one part of COPD care. A few changes to your daily life can also help you breathe easier.

Quit smoking

Cigarette smoke is the leading cause of COPD, and it can make the disease worse. People with COPD who stop smoking improve their breathing capacity, health, and overall quality of life. It may not be easy for you to quit, but there are many methods to help. Ask your doctor about nicotine replacement, medicine, and counseling. Once you've quit smoking, try to stay away from anyone else who smokes. 

Make changes to your diet

Breathing takes more effort when you have COPD. Your muscles require 10 times more energy than those of someone without this condition. Get those calories from healthy sources such as:

  • Lean protein from eggs, chicken, fish, lean meat, nuts, and beans
  • Complex carbs such as fruits, vegetables, and whole grains
  • Monounsaturated and polyunsaturated fats such as canola and safflower oil 

Your doctor might recommend that you eat fewer carbohydrates. When your body breaks down carbs, it produces carbon dioxide, which can make it harder to breathe. 

Prevent weight loss

Maintaining weight is a problem for some people with COPD. If you don't get enough calories from your diet, your body will start to break down fat and muscle for energy. You'll lose weight and muscle mass. 

Ask your doctor how many calories you should eat each day to maintain your weight — or to gain weight if you're underweight. A dietitian in your pulmonary rehabilitation program can help you plan meals.

Avoid environmental exposures

Try to stay away from any substances that could make your COPD worse, including smoke and outdoor pollutants. If you're exposed to irritating chemicals or dust at work, wear a mask or ask your manager if you can move to a safer environment. Avoid using gas ovens or fireplaces at home.

Balance activity with rest

Try not to overdo it, as you could wear yourself out. Plan a small number of activities each day. Prioritize the most important tasks and leave the less important ones for later. Break activities into short segments, and rest in between.

Exercise

Aerobic exercise strengthens your heart muscle, helps your body use oxygen more efficiently, and preserves lung function. Gentle exercises, such as walking or pedalling a recumbent bicycle, are safest when you have COPD. Try to get 20-30 minutes of exercise, three to four days a week. 

Talk to your doctor before starting a new exercise program, to make sure it's safe for you. And ease into it slowly to get your body used to the new movements.

Chronic obstructive pulmonary disease (COPD) causes swelling in the lungs that makes it hard to breathe. COPD management includes short- and long-acting bronchodilators and other medicines that reduce inflammation in your lungs and help you breathe more easily. Quitting smoking will prevent COPD from getting worse.

What is the best medicine for COPD?

The COPD medicines most often prescribed today combine a bronchodilator to open up the airways and steroids to reduce inflammation. "There is no best medicine," says Takyar. "The most effective intervention for COPD is smoking cessation."

Is there a cure for COPD?

COPD isn't curable, but you can breathe more easily and reduce flare-ups by taking medicine, quitting smoking, doing pulmonary rehabilitation, and avoiding exposure to irritants in the environment. Work with your doctor to find the options that will help you manage your disease and its symptoms.

How can I stop COPD from progressing?

The most important way to prevent COPD from worsening is to stop smoking. Though you can't undo the damage that's already been done to your lungs, you can prevent new damage from happening.

Does exercise help COPD?

Exercising with COPD might seem difficult, especially if you can't catch your breath. But regular physical activity improves breathing and reduces other COPD symptoms. Only exercise to your ability, and check with your doctor before you start any new fitness program.