Table of ContentsView AllTable of ContentsClasses of InhalersPossible ConcernsSafe or Unsafe?
Table of ContentsView All
View All
Table of Contents
Classes of Inhalers
Possible Concerns
Safe or Unsafe?
Most people withchronic obstructive pulmonary disease (COPD)use an inhaler every day to control shortness of breath and other symptoms of this progressive lung disease.
There are many differentkinds of inhalers. Some are used once or twice a day to manage COPD and prevent acute exacerbations (attacks). Others are used as needed when an exacerbation occurs. As a result, most people with COPD useseveral different inhalersas part of the treatment plan.
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This article describes some of the concerns related to the use of different inhaler medications. It also lists the inhalers that should not be used together as well as several that may be OK.
Classes of COPD Inhaler Medications
There are different classes of inhaled medications used in the treatment of COPD.
Among them:
Although more than one inhaler may be prescribed to treat COPD, they can’t all be used together. In fact, using some together can pose health risks.
Possible concerns include:
Combinations That Are Safe or Unsafe
There are certain inhalers that can be used together and others that cannot. Here are some you need to watch out for if you or someone you love is being treated for COPD:
Antimuscarinic Inhalers
Controller medications are those used to control symptoms of COPD and prevent exacerbations. Antimuscarinic drugs are controller medications used once or twice daily.
Beta-Agonists
Beta-2 adrenergic agonists (also known as beta-agonists) are a mainstay treatment for COPD. There are short-acting versions used as rescue inhalers and long-acting versions that are used to control COPD.
Inhaled Steroids
Inhaled glucocorticoids (also known as inhaled steroids) are commonly used in combination with other inhaled drugs to control COPD. They are mainly used in people with a history of exacerbations.
ClassConsiderationReasonAdvair (fluticasone/ salmeterol)Inhaled steroid and LABAOK to take with SABAsN/ASymbicort (budesonide/formoterol)Inhaled steroid and LABAOK to take with SABAsN/AFluticasone (generic)Inhaled steroidDo not use with Advair or Symbicort as they contain similar steroidsIncreased risk of hypokalemia and heart rhythm problemsQVAR (beclomethasone)Inhaled steroidDo not use with Advair or Symbicort as they contain similar steroidsIncreased risk of hypokalemia and heart rhythm problemsBreo Ellipta (fluticasone/vilanterol)Inhaled steroid and LABAOK to take with SABAsN/ASummaryPeople with COPD are commonly treated with more than one inhaler. Some are used as controller medications and others are used as “rescue inhalers” when you have a COPD attack. As effective as these drugs are, not all can be used together.While it is common to use more than one inhaler for COPD, problems can occur if you use two drugs of the same class. Doing so can expose you to double the medication, leading to overdosing and an increased risk of side effects. Other drugs are known to interact, causing severe drops in blood potassium and heart rhythm problems.A Word From VerywellTo 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 or pharmacist to review your prescriptions.
Summary
People with COPD are commonly treated with more than one inhaler. Some are used as controller medications and others are used as “rescue inhalers” when you have a COPD attack. As effective as these drugs are, not all can be used together.
While it is common to use more than one inhaler for COPD, problems can occur if you use two drugs of the same class. Doing so can expose you to double the medication, leading to overdosing and an increased risk of side effects. Other drugs are known to interact, causing severe drops in blood potassium and heart rhythm problems.
A Word From Verywell
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 or pharmacist to review your prescriptions.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Global Initiative for Chronic Obstructive Lung Disease.Global strategy for prevention, diagnosis and management of COPD: 2023 report.Ajimura CM, Jagan N, Morrow LE, Malesker MA.Drug interactions with oral inhaled medications.J Pharm Technol. 2018;34(6):273-280. doi:10.1177/8755122518788809UpToDate.Stable COPD: initial pharmacologic management.National Library of Medicine, DailyMed.Advair Diskus- fluticasone propionate and salmeterol powder[drug label].National Library of Medicine, DailyMed.Symbicort- budesonide and formoterol fumarate dihydrate aerosol[drug label].Drugs.com.Drug interaction report: Flovent (fluticasone), Symbicort (budesonide / formoterol).Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Flovent (fluticasone).Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Qvar RediHaler (beclomethasone).Drugs.com.Drug interaction report: Qvar RediHaler (beclomethasone), Symbicort (budesonide / formoterol).National Library of Medicine: DailyMed.Breo Ellipta—fluticasone furoate and vilanterol trifenatate powder[drug label].
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Global Initiative for Chronic Obstructive Lung Disease.Global strategy for prevention, diagnosis and management of COPD: 2023 report.Ajimura CM, Jagan N, Morrow LE, Malesker MA.Drug interactions with oral inhaled medications.J Pharm Technol. 2018;34(6):273-280. doi:10.1177/8755122518788809UpToDate.Stable COPD: initial pharmacologic management.National Library of Medicine, DailyMed.Advair Diskus- fluticasone propionate and salmeterol powder[drug label].National Library of Medicine, DailyMed.Symbicort- budesonide and formoterol fumarate dihydrate aerosol[drug label].Drugs.com.Drug interaction report: Flovent (fluticasone), Symbicort (budesonide / formoterol).Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Flovent (fluticasone).Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Qvar RediHaler (beclomethasone).Drugs.com.Drug interaction report: Qvar RediHaler (beclomethasone), Symbicort (budesonide / formoterol).National Library of Medicine: DailyMed.Breo Ellipta—fluticasone furoate and vilanterol trifenatate powder[drug label].
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Global Initiative for Chronic Obstructive Lung Disease.Global strategy for prevention, diagnosis and management of COPD: 2023 report.Ajimura CM, Jagan N, Morrow LE, Malesker MA.Drug interactions with oral inhaled medications.J Pharm Technol. 2018;34(6):273-280. doi:10.1177/8755122518788809UpToDate.Stable COPD: initial pharmacologic management.National Library of Medicine, DailyMed.Advair Diskus- fluticasone propionate and salmeterol powder[drug label].National Library of Medicine, DailyMed.Symbicort- budesonide and formoterol fumarate dihydrate aerosol[drug label].Drugs.com.Drug interaction report: Flovent (fluticasone), Symbicort (budesonide / formoterol).Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Flovent (fluticasone).Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Qvar RediHaler (beclomethasone).Drugs.com.Drug interaction report: Qvar RediHaler (beclomethasone), Symbicort (budesonide / formoterol).National Library of Medicine: DailyMed.Breo Ellipta—fluticasone furoate and vilanterol trifenatate powder[drug label].
Global Initiative for Chronic Obstructive Lung Disease.Global strategy for prevention, diagnosis and management of COPD: 2023 report.
Ajimura CM, Jagan N, Morrow LE, Malesker MA.Drug interactions with oral inhaled medications.J Pharm Technol. 2018;34(6):273-280. doi:10.1177/8755122518788809
UpToDate.Stable COPD: initial pharmacologic management.
National Library of Medicine, DailyMed.Advair Diskus- fluticasone propionate and salmeterol powder[drug label].
National Library of Medicine, DailyMed.Symbicort- budesonide and formoterol fumarate dihydrate aerosol[drug label].
Drugs.com.Drug interaction report: Flovent (fluticasone), Symbicort (budesonide / formoterol).
Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Flovent (fluticasone).
Drugs.com.Drug interaction report: Advair Diskus (fluticasone / salmeterol), Qvar RediHaler (beclomethasone).
Drugs.com.Drug interaction report: Qvar RediHaler (beclomethasone), Symbicort (budesonide / formoterol).
National Library of Medicine: DailyMed.Breo Ellipta—fluticasone furoate and vilanterol trifenatate powder[drug label].
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