Understanding COPD inhalers and bronchodilators

COPD inhalers can be confusing and many people with COPD may have more than 1 inhaler.² Different inhalers fill different functions. There are 2 main types of inhalers:

• Controller inhalers, also known as maintenance inhalers, prevent and control symptoms and are used on a daily basis as prescribed.
• Rescue inhalers relieve sudden shortness of breath and are used as needed.

Common medications in prescribed inhalers

Inhalers may include 1 or more of the following types of medications:

• Bronchodilators: These open up the bronchial tubes and increase airflow to your lungs.
• Corticosteroids: These reduce inflammation in your airways, making it easier to breathe.

Inhalers may also contain multiple types of bronchodilators or a combination of 1 or more bronchodilators and a corticosteroid.³

Remember, only your healthcare provider or a pulmonologist can prescribe these medications. You should not use any type of inhaler or medicine without first consulting your doctor.

What are bronchodilators?

Bronchodilators are medications frequently prescribed to help treat COPD symptoms. This medicine is usually taken through an inhaler. Bronchodilators fall into 2 categories: short-acting and long-acting.⁴

Short-acting bronchodilators

Short-acting bronchodilators work quickly, often helping to ease symptoms in just a few minutes. However, they are typically only effective for a few hours. Some short-acting bronchodilators are frequently used in rescue inhalers, but they may also be prescribed for maintenance/controller inhalers.⁵

Long-acting bronchodilators

Long-acting bronchodilators are often used for maintenance therapy. They typically work best when the medicine is regularly present in someone’s body to steadily treat COPD symptoms.⁶

Common inhalers types used to treat COPD

Besides the rescue and controller type, inhaler devices come in a variety of styles, which may work differently. Below are some of the most common variations.

Metered dose inhalers

These devices are handheld and have a pressurized canister and a plastic mouthpiece. They either work by pushing a button that releases a specific dosage of medicine, or they detect when you inhale and release an appropriate amount of medicine. Some of these inhalers are very simple but they can be modified to make them easier to use, or they can be combined with an app to keep track of how much medicine you’ve used.⁷

Dry powder inhalers

As the name implies, dry powder inhalers contain dry, powderized medicine instead of liquid. Rather than using a pressurized canister, these inhalers usually release medicine when the user breathes in with a fast, deep breath. Dry powder inhalers can come in single dose, multi-dose, and reloadable devices that use a new capsule for each use.⁸

Soft mist inhalers

Soft mist inhalers typically do not use propellant. They slowly release a mist that can be inhaled over a longer period of time. They can be modified with valves, chambers or even facemasks.⁹