COPD treatment

Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that causes breathing difficulties. COPD gradually gets worse over time, but effective treatment can help you manage the condition.

COPD develops when the lungs and airways become damaged and inflamed, usually due to long-term exposure to harmful substances, such as cigarette smoke. Smoking is the main cause of COPD.

COPD includes 2 main conditions:

1. Emphysema – damage to the air sacs (alveoli) in the lungs, making the airways in your lungs collapse, so it becomes hard to breathe out.
2. Chronic bronchitis – long-term inflammation of the airways (bronchial tubes), which causes them to narrow and become blocked with mucus made by the lungs, making it harder to breathe.

Common symptoms of COPD include:

• a persistent cough with phlegm (mucus)
• shortness of breath, particularly during activity
• persistent wheezing
• frequent chest infections

COPD is a common condition in the UK, with around 1.2 million people diagnosed in England alone. It’s estimated that a further 2 million people may be living with undiagnosed COPD. The condition mainly affects middle-aged or older adults, especially those who are long-term smokers.

COPD is a chronic condition that tends to get worse over time and cannot be cured, but with the right treatment and lifestyle changes, it can be effectively managed, helping you breathe easier and improve your quality of life.

It can be difficult to know if you need COPD treatment. Symptoms can often be mistaken for ageing or lack of fitness, so many people live with the condition without realising they have it.

But COPD does have some distinct warning signs to look out for. You may have COPD if you:

• often feel short of breath
• have a cough that does not go away or keeps coming back
• feel like you can’t get enough air into your lungs

If you have any of these, especially if you smoke or used to smoke, it’s important to get assessed. A doctor can help determine if you have COPD and offer a treatment plan.

Common COPD symptoms

The common symptoms of COPD include:

• a persistent cough that does not go away, often with phlegm (mucus)
• shortness of breath, especially during physical activity
• persistent wheezing
• a feeling of tightness in the chest
• frequent, recurring chest infections
• fatigue, feeling tired or lacking energy

Getting diagnosed and starting treatment for COPD early can help slow the condition’s progression, improve your symptoms, and protect your lungs from further damage.

There are different treatments available to help you manage COPD symptoms and reduce flare-ups. The most appropriate treatment option for you will depend on your symptoms, how severe your condition is, and any other health concerns you might have.

Following a COPD diagnosis and consultation, the main treatment options you may be offered include:

Inhalers

Most people with COPD are prescribed inhalers. At ZAVA, we can prescribe the following COPD inhalers:

• salbutamol
• Spiolto Respimat
• Spiriva Respimat
• Serevent Evohaler

How do inhalers work?

The main types of inhalers prescribed for COPD are:

• bronchodilator inhalers which help to relax and open up your airways, making it easier to breathe, and these can be short-acting or long-acting
• steroid inhalers that reduce inflammation and swelling in the lungs, helping to keep your airways open
• combination inhalers, these inhalers combine both steroid and bronchodilator medications in 1 device, making them easier and more convenient to use

How effective are inhalers?

When used correctly, inhalers (bronchodilators and inhaled steroids) can significantly lower the risk of COPD flare-ups. According to a review of multiple clinical trials, all types of inhalers reduced flare-up risk compared to no treatment.

Long-acting inhalers targeting muscles in the airways reduced flare-ups by about 30% compared to no treatment. Adding a steroid inhaler may help even more for people with severe COPD.

How long do inhalers take to work?

Reliever inhalers start to work immediately and can ease symptoms like breathlessness and coughing in minutes. Maintenance inhalers may take a few days or weeks to show full effects.

Use your inhaler as prescribed. A doctor or nurse will show you how to use your inhaler correctly during your consultation.

COPD tablets

Some people may be prescribed tablets alongside inhalers or antibiotics. At ZAVA, we can prescribe the following combination treatments if you have a chest infection and COPD:

• prednisolone (a steroid treatment) in combination with the antibiotic amoxicillin
• prednisolone in combination with the antibiotic doxycycline

How do COPD tablets work?

COPD tablets that we offer at ZAVA like prednisolone in combination with antibiotic amoxicillin or doxycycline work to relieve symptoms of COPD by reducing inflammation and clearing infection.

Prednisolone is a corticosteroid which means it works to reduce inflammation, clear mucus and open up your airways which can make it easier for you to breathe.

The antibiotics prescribed alongside prednisolone like amoxicillin and doxycycline work help kill the bacteria which started the flare-up or infection. Whether your doctor prescribes amoxicillin or doxycycline will depend on your health needs and symptoms.

Different types of COPD tablets and how they work include:

• mucolytic tablets, which help thin and loosen mucus, making it easier to clear from your chest so you can breathe more comfortably
• theophylline tablets, a type of bronchodilator that helps relax airway muscles and may also reduce inflammation, making it easier to breathe
• antibiotics, which may be prescribed if you have a chest infection to kill the bacteria causing it, as infections often trigger or worsen COPD symptoms
• steroid tablets, which may be used during flare-ups to reduce inflammation in the lungs and help you recover faster

How effective are COPD tablets?

Oral medications (antibiotics and steroids) can be highly effective for treating COPD flare-ups, especially when symptoms are caused by infection. Steroids can quickly reduce swelling in the lungs and improve breathing levels, while antibiotics help clear the infection, often shortening recovery time and reducing the risk of hospitalisation.

How long do COPD tablets take to work?

Oral medications for COPD flare-ups may start to improve symptoms in a few days, but you must complete the full course of tablets, even if your symptoms improve beforehand. Tablets and capsules should be swallowed with water, ideally at the same time each day.

Other COPD treatments

Oxygen therapy

People with advanced COPD often have lower-than-normal oxygen levels in their blood. For this, extra oxygen can be given at home through a mask or nasal tubes to help improve breathing and energy levels.

Lifestyle changes

Making changes to your lifestyle is an important part of treating COPD, alongside medical treatment. For this, your doctor may recommend:

• quitting smoking – this can help slow down damage to your lungs
• staying active – regular and gentle exercise can help your breathing
• eating well – a healthy, balanced diet supports your general health
• maintaining a healthy weight – losing excess weight can ease pressure on the lungs
• attending regular check-ups to monitor your condition
• getting yearly flu-jabs can help prevent serious chest infections
• getting the anti-pneumococcal vaccination, an injection that will protect you against pneumonia

​​These changes, along with medical treatments, can help you breathe easier and live more comfortably with COPD.

How long does it take for COPD treatment to work?

Some COPD treatments, like inhalers, start working within minutes to ease symptoms like breathlessness. Others, such as daily maintenance inhalers or tablets, may take weeks of regular use to help reduce inflammation, prevent flare-ups, and improve your breathing over time.

Staying consistent with your treatment plan is key to seeing the best results. Long-term benefits develop gradually with consistent treatment and lifestyle changes.

Can COPD come back after treatment?

Yes, none of these treatments can completely cure COPD because it is a chronic (ongoing) condition. Your symptoms may flare up from time to time. Flare-ups are more likely if you are not consistent with treatment and if you continue smoking.

Consistent treatment and monitoring can prevent flare-ups and improve your symptoms, but COPD cannot be cured.

What’s the best treatment for COPD?

The best or most effective COPD treatment for you will depend on the severity of your symptoms, how frequently you experience flare-ups and any other health conditions or concerns you may have.

Sometimes, there can be multiple treatment options, and your doctor will prescribe the best option based on your preferences and any potential risks. In most cases, inhalers are the first choice and most effective treatment, especially when used consistently.

Aside from medical treatment, your healthcare provider will discuss with you how to manage your COPD. The best treatment for COPD focuses on managing symptoms, slowing the progression of the disease, which usually involves a combination of lifestyle changes and medication.

Other multi-disciplinary team members at your local health clinic can advise if your doctor recommends further support from chest physiotherapists, occupational therapists, psychologists and dieticians. Depending on what you need, you can discuss the next steps and what is best for you.

Stopping smoking, losing excess weight, and doing regular exercise can all help improve COPD symptoms and your quality of life. While there is no cure for COPD, these approaches can make a big difference to how you feel.

There are several ways to buy or access treatment for COPD, as long as you have a diagnosis and prescription from your doctor.

Can I buy COPD treatment online?

Yes, you can buy some COPD treatments online using safe and regulated online doctor services, like ZAVA. You will need a COPD diagnosis and a prescription from your doctor to get your treatment. We don’t currently offer a diagnosis service, but if you’re already being treated for COPD, ZAVA can make it easy to get your medication delivered directly to you.

You can request COPD treatment from ZAVA by:

1. Completing a short online health questionnaire.
2. One of our doctors will review your responses to decide if your treatment request is suitable for you.
3. If approved, your medication will be sent to your home address in plain, discreet packaging.

Never buy inhalers or medicines from unverified sources, as they may be potentially unsafe or ineffective.

Can I get COPD treatment over the counter?

No, COPD treatments, such as inhalers, steroids, and antibiotics, are prescription-only and cannot be bought over the counter.

However, some non-prescription treatments or therapies may be available over-the-counter. You may be able to buy oxygen masks to help with breathlessness.

Can I get COPD treatment on the NHS?

Yes, COPD treatment is widely available on the NHS. Your doctor can prescribe inhalers, oral medications, and any other treatments as needed, as well as provide lifestyle support, such as help with stopping smoking.

Like all medications, COPD treatments can cause some side effects, though not everyone will experience them.

Common side effects (inhalers)

There are a few common side effects from inhalers used for COPD, which include:

• throat irritation or sore throat
• dry mouth
• hoarseness
• fungal infections in the mouth (thrush) – though this is more from steroid inhalers

How long do side effects last?

Most side effects will improve as you adjust to the treatment. With inhaler use, you can try to ease or avoid symptoms like oral thrush by rinsing your mouth with water after use.You can also use a spacer device which can also help with this.

What to do if you get side effects:

If you experience side effects from using an inhaler and they become unbearable or do not go away, talk to your doctor or pharmacist. Don’t suddenly stop using your inhaler without speaking to a doctor first.

Seek urgent medical attention if you experience signs of an allergic reaction, such as:

• difficulty breathing, an increase in wheezing and shortness of breath immediately after dosing
• itching, rashes, or reddened skin
• swelling of the face, lips, or throat

Common side effects (oral medications)

Oral medications, like steroids, antibiotics or a combination of both, can be prescribed during flare-ups and chest infections.

Most people will not experience troublesome side effects with short courses of COPD oral medications, sometimes called ‘rescue packs’ like prednisolone 5mg and amoxicillin 500mg or prednisolone 5mg and doxycycline 100mg. You should always review your medications with your doctor after experiencing a flare up of your COPD.

These medications are designed to be taken short-term to avoid causing side effects, such as:

• mood swings
• weight gain
• osteoporosis

For more information on side effects specific to your particular medication, always check the patient information leaflet included in the packaging with your medication. If you’re worried about any side effects, contact your GP or community pharmacist.

Certain COPD treatments may not be suitable for everyone. Some medications may interact with other medications you might take, making them potentially unsafe or less effective. Certain medical conditions may also make COPD treatments inappropriate for you.

When diagnosing COPD, your doctor will assess your personal needs and health information carefully to make sure any treatment prescribed is safe and appropriate for you.

In general, you may not be able to take certain COPD treatments if you:

• are under 18 years old, because most COPD treatments are only recommended for adults over 18
• are pregnant or breastfeeding, as some treatments may be unsafe and alternatives may be recommended
• have certain health conditions, such as severe heart problems or neuromuscular diseases
• are allergic to any ingredients in COPD treatments
• are taking drugs that may interact with COPD treatment

Your doctor or healthcare provider will check for any risks before prescribing COPD treatment to help you find the safest and most effective option. Your COPD treatment will be personalised to suit your needs, taking into account your age, health, lifestyle, and the severity of your condition. You’ll also have regular check-ups so your healthcare provider can see how you’re doing and make any changes if needed.

Never start or stop COPD treatment without getting medical advice.