A robust treatment plan for chronic obstructive pulmonary disease (COPD) often includes a combination of prescription medication, pulmonary therapies, and healthy lifestyle changes.

While there’s no known cure for COPD, certain treatments can help to relieve your symptoms and slow its progress.

COPD treatments include:

  • medication
  • oxygen therapy
  • pulmonary rehabilitation
  • surgery
  • healthy lifestyle changes

Many people with COPD use a variety of prescription medications to help manage the disease, treat associated complications, or target specific symptoms. The ultimate goal is to improve your overall quality of life.

Bronchodilators

Bronchodilators usually come in an inhaler or nebulized form. Inhaling the medication delivers it directly to your lungs and airways. These medications help to open constricted (narrowed) airways so you can breathe more easily.

There are two classes of bronchodilators: beta-agonists and anticholinergics.

Beta-agonists work to relax the tightened muscles around your airways. This opens the airway and makes breathing easier. Beta-agonists may be short-acting (e.g., albuterol) or long-acting (e.g., salmeterol).

Short-acting beta-agonists are often referred to as “rescue medications” because they can be used to improve breathing during a COPD flare. Long-acting beta-agonists, used twice daily, are a part of maintenance therapy.

Anticholinergic medications, such as Atrovent, also come in inhalers and can be used every 4–6 hours (short-acting) or once a day (long-acting).

Anticholinergic medications work by blocking the chemical acetylcholine, which causes your airways to constrict. They may also play a role in decreasing mucus production and secretions.

Corticosteroids

Corticosteroids, such as prednisone, reduce irritation and swelling in your airways. Corticosteroids can be delivered by:

  • inhaler
  • nebulizer
  • tablet
  • injection

Keep in mind that corticosteroids can cause unpleasant side effects for some people. When taken in tablet form, corticosteroids can cause:

  • weight gain
  • water retention
  • elevated blood sugar levels

Long-term use of corticosteroid tablets can cause weakening of the bones and may depress the immune system.

Inhaled forms of corticosteroids have fewer side effects and may be used for maintenance, especially for people with asthma. They may also be useful in people with COPD who have frequent exacerbations.

Antibiotics

If you have a respiratory infection, which is often the case when symptoms suddenly worsen, a healthcare professional may prescribe antibiotics.

Antibiotics kill bacteria, but they do not kill viruses. A healthcare professional may order tests to determine the type of infection you have and what kind of antibiotic will be most effective.

Anti-anxiety drugs (anxiolytics)

As COPD progresses, you may have difficulty breathing. This can cause anxiety.

Treating anxiety symptoms is key to decreasing the discomfort that often accompanies shortness of breath.

Pain relievers (opioids)

Opioids, also known as narcotic medications or pain relievers, work by depressing the central nervous system. Opioid medication can help ease that feeling of “air hunger.”

Opioids are commonly prescribed as a liquid that’s swallowed and absorbed through the membranes in the mouth. They may also be prescribed as a patch placed on the skin.

Most people with COPD first notice symptoms around the age of 40. Supplemental oxygen and pulmonary rehabilitation may be especially beneficial for this age group.

Oxygen therapy

Because COPD interferes with your ability to breathe, you’re not inhaling enough oxygen, so you won’t have enough oxygen in your blood.

Medical devices are available that can deliver oxygen to your lungs. Many of these devices are small and portable, so you can take them with you wherever you go.

A healthcare professional may suggest that you use oxygen therapy all the time. Or you may only need to use the device while you’re sleeping or during certain activities.

Oxygen therapy can help you:

  • stay active with fewer symptoms
  • protect your heart and other organs from further damage caused by oxygen deprivation
  • sleep better and be more alert during waking hours
  • live longer

Pulmonary rehabilitation

Pulmonary rehabilitation often involves a team of doctors and specialists. The primary goal is to help you stay active through increased stamina.

Rehab typically includes breathing techniques, exercise, education, and mental health support. It also provides social support, which can be especially helpful for older adults.

Surgery may be beneficial for a small percentage of people with COPD and is usually only an option in severe cases.

Bullectomy

When the walls of the air sacs in your lungs are destroyed, large air spaces can form. These are called bullae. These open spaces can interfere with your breathing.

In a bullectomy, some of these spaces are removed. This can help your lungs function better.

Lung volume reduction surgery (LVRS)

Removing sections of damaged lung tissue may improve your overall lung function. However, LVRS may not always be effective and carries significant risks.

Lung transplant

In severe cases, a damaged lung may be removed and replaced with a healthy lung from a donor. Lung transplants have many risks, though. You may develop an infection, or your body might reject the new lung.

If either of these things occur, it can be fatal. But a successful lung transplant can improve lung function and your quality of life.

Bronchial rheoplasty

A new method of treating COPD is a minimally invasive procedure called bronchial rheoplasty. It’s currently being tested and may reduce the number of mucus-producing cells in the lungs.

During the procedure, electrical bursts destroy the cells that produce too much mucus, paving the way for new, healthy cells to grow.

For some people with COPD or severe asthma, failure to respond to the anti-inflammatory effects of corticosteroids can be a major barrier to effective treatment.

According to the American Journal of Respiratory and Critical Care Medicine, drugs to reverse corticosteroid resistance may be developed in the future.

Some large clinical trials are already underway with low dose oral theophylline.

The National Heart, Lung, and Blood Institute (NHLBI) leads and sponsors studies on COPD. To learn more about clinical trials, visit the NIH Clinical Center website.

Cut back or quit smoking tobacco products

People who quit smoking can improve their health and overall quality of life.

Many doctors offer nicotine replacement therapy (NRT) to help ease cravings and reduce the symptoms of withdrawal. NRT can be done with:

  • chewing gum
  • inhalers
  • topical skin patches

Certain antidepressants may also help reduce or eliminate nicotine cravings.

Minimize exposure to air pollution

Do your best to reduce air pollution in your environment as much as possible. Try to avoid secondhand smoke and stay away from places with dust, fumes, and other toxic substances you might inhale.

Ensure adequate nutrition

The fatigue and breathing difficulty that comes with COPD might make it difficult to eat. Eating smaller meals more frequently may help.

Your healthcare professional might suggest nutritional supplements. It may also be helpful to rest before meals.

Develop a movement practice

Exercise is important, but it may be difficult for some. Physical activity can strengthen the muscles that help you breathe.

Consult with a healthcare professional about the physical activities that are best suited for you.

Complementary treatments that have been shown to reduce anxiety include:

  • pulmonary rehabilitation
  • guided muscle relaxation
  • yoga
  • tai chi
  • behavioral therapy
  • singing groups

Other examples of complementary treatment methods that have produced positive results include:

  • Identifying the situations, places, or people that might trigger anxiety: When you know what causes your stressors and anxiety, it can help you avoid or manage them.
  • Limiting work, chores, and activities: If you have a job, learn how to manage your workload to avoid feeling overwhelmed.
  • Following your treatment plan closely: When your illness is managed well, you’ll have more energy to enjoy life.
  • Talking with someone about how you feel: Relieve anxiety by sharing your feelings with a trusted friend, family member, or religious leader. You may also want to seek therapy.

Finding a doctor specializing in palliative care or hospice can help you prioritize comfort during the late stages of the disease.

Effective end-of-life care involves:

  • pain and symptom management
  • provisions of spiritual, psychological, social, and practical support
  • an active partnership of care involving you, your loved ones, and your team of healthcare professionals
  • a compassionate approach to care that ensures respect for and dignity of you and your loved ones
  • advanced care planning according to your preferences

Even with treatment, symptoms can worsen. This is especially true if you develop a lung infection or a heart condition related to lung damage.

Seek immediate medical attention if your regular treatments aren’t helping with the following symptoms:

  • unusual difficulty walking or talking
  • fast or irregular heart rate
  • new or worsening chest pain
  • blue lips or fingernails
  • hard and fast breathing