What combination agents are used to treat COPD?

Combination agents used to treat COPD are Combivent®, Advair®, Symbicort®, Dulera®, DuoNeb®, BREO® ELLIPTA®, Stiolto® Respimat®, Bevespi® Aerosphere®, Utribron® Neohaler®, and ANORA® ELLPTA®.

What do these combination agents do?

Anoro, Bevespi, Stiolto, Utibron

These combination drugs relax airway muscles, which makes the airways wider and makes it easier to breathe.

Advair, Dulera, Symbicort, BREO

Products that combine long-acting beta2-agonists (B2-agonists) and inhaled corticosteroids relax airway muscles, making airways wider and making it easier to breathe. They also reduce and prevent inflammation in the airways. They reduce sensitivity of the airways and prevent shortness of breath. After using these products, you should rinse your mouth to prevent side effects.

Do not use these products as rescue inhalers for quick relief. Do not stop taking them without speaking to your doctor.

In the case of BREO, there is an increased risk of getting pneumonia when you are on this medication. Speak with your doctor.

Potential side effects for these drugs include:

  • Dizziness, headache, muscle cramps
  • Dry mouth, nausea, vomiting
  • Nervousness, tremor, palpitations, rapid heartbeat, increased blood pressure
  • Cough, increased wheezing
  • Thrush (a mouth infection), sore throat and/or hoarseness
  • Increased risk of infection

Side effects for BREO also include headache, high blood pressure, abnormal heartbeat, infection, stomach discomfort, and pneumonia.

Combivent and DuoNeb

These products combine a short-acting B2 agonist and an anticholinergic. They open up large and small airways. They help decrease coughing, wheezing, and shortness of breath by increasing airflow into the lungs.

Do not use these products as rescue inhalers for quick relief. Do not stop taking them without speaking to your doctor.

For Combivent: Tell your doctor if you are allergic to soy, lecithin, soybean protein, or peanuts.

Note: For all of these medicines, the side effects listed are the most common. Always contact your healthcare provider if you have questions about your personal situation.

Care at Cleveland Clinic

Last reviewed by a Cleveland Clinic medical professional on 09/14/2018.

References

  • Expert knowledge and experience of healthcare providers at Cleveland Clinic.
  • Ulrik CS. Clinical benefit of fixed-dose dual bronchodilation with glycopyrronium and indacaterol once daily in patients with chronic obstructive pulmonary disease: a systematic review. Int J Chron Obstruct Pulmon Dis. 2014;9:331-8.
  • Worth H, Buhl R, Criée CP, Kardos P, Lossi NS, Vogelmeier CF. GOLD 2017 treatment pathways in 'real life': An analysis of the DACCORD observational study. Respir Med. 2017;131:77-84.

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