Inhalers for chronic obstructive pulmonary disease (COPD) are a mainstay of treatment.
These medications are inhaled through your mouth so they can directly reach your lungs.
Some contain bronchodilators to open your airways or deliver a glucocorticoid (steroid) to reduce inflammation.
Laura Porter / Verywell
Other inhalers offer a combination of drugs.
These medications work in different ways, and some inhalers contain combinations of different types of medications.
Whats better for COPD, a long-acting or short-acting inhaler?
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
They are each used for different reasons.
Your healthcare provider may recommend that you use them both.
Different choices may be considered if a person has a history of asthma or other medical concerns.
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
Advair
Advair is one of the most commonly used inhalers for the maintenance treatment of COPD.
It is a combination of fluticasone, a corticosteroid, and salmeterol, a long-acting bronchodilator.
Advair is available as Advair Diskus, an inhaled powder, or Advair HFA, an aerosol inhaler.
The dose is represented with two microgram (mcg) numbers and written as fluticasone mcg/salmeterol mcg per puff.
Keep in mind that there are other dosing combinations for this medication as well.
The out-of-pocket cost of one canister of Advair HFA is about $400.
There is no generic version of this form available.
It contains albuterol, a short-acting beta-agonist.
Albuterolhelps immediately relax the airways, making it easier to breathe.
This inhaler can be used about 15 to 30 minutes prior to exercise to prevent exercise-induced symptoms.
Because you might not use albuterol on a regular basis, it is recommended that you prime the inhaler.
Generic albuterol costs approximately $25 for the same supply of 200 doses.
Atrovent HFA
Atrovent HFA (ipratropium) is an anticholinergic bronchodilator.
It’s used in the maintenance treatment of chronic COPD, including bronchospasm, emphysema, and chronic bronchitis.
It can be taken as two inhalations of 17 mcg each.
It is typically used three or four times per day.
Atrovent HFA is supplied in a 12.9 g canister containing 200 doses.
Side effects of Atrovent HFA include bronchitis, COPD exacerbation, shortness of breath, and headaches.
The out-of-pocket cost of a canister containing a one-month supply is approximately $400 and there is no generic.
Bevespi Aerosphere
Bevespi Aerosphere is a combination of two long-acting bronchodilators, glycopyrrolate and formoterol.
Bevespi Aerosphere is not a rescue inhaler and is not used to treat sudden COPD symptoms.
The most common side effects include urinary tract infection and cough.
The pressurized metered-dose inhaler contains a one-month supply of the medication and costs approximately $350, without insurance.
There is no generic version.
The medication comes in two double-foil blister strips of powder formulation for oral inhalation.
Each contains blisters that have either fluticasone furoate 100 mcg or vilanterol 25 mcg.
It is taken in doses of 25 mcg vilanterol/100 mcg fluticasone once daily.
Side effects include upper respiratory infections, headaches, and fungal mouth infection.
This inhaler should be taken as two puffs twice a day.
A 30-day supply of this medication costs $645.14.There is no generic version available.
Is there a new inhaler for COPD?
Breztri is one of the newer COPD inhalers to come on the market.
It was approved by the FDA in 2020.
Brovana
Brovana (arformoterol) is a long-acting beta-agonist bronchodilator.
It should be taken twice a day, in the morning and in the evening.
Brovana is not a rescue inhaler, nor does it treat asthma.
A standard package contains a two-month supply and costs approximately $1,000, or more, out-of-pocket.
There is no generic version of Brovana.
Combivent Respimat
Combivent contains albuterol, a short-acting beta-agonist, and ipratropium, an anticholinergic.
It is used in COPD as a second inhaler when symptoms are not controlled with a regular aerosol bronchodilator.
It can be taken three or four times per day.
A standard inhaler generally includes a month supply and is expected to cost approximately $450.
It is available in a solution for inhalation at a dose of 20 mcg/2 mL.
The solution is used with a standard jet nebulizer with a facemask or mouthpiece connected to an air compressor.
The inhalation solution should always be stored in the foil pouch and removed right before you will use it.
Pulmicort is used in the maintenance treatment of COPD.
It is usually taken twice per day.
The price of a one-month supply is approximately $40, and there is no generic version.
Spiriva
Spiriva contains tiotropium, an anticholinergic bronchodilator.
It opens and relaxes the airways, making it easier to breathe.
It is considered preventative for COPD exacerbations.
Side effects include upper respiratory infection, cough, dry mouth, urinary tract infection, and heartburn.
The cost of a one-month supply is about $450, and there is no generic version.
Symbicort
Symbicortcontains formoterol, a long-acting bronchodilator, and budesonide, a corticosteroid.
The dose is represented as budesonide mcg/formoterol mcg and it is available in doses of 80/4.5 and 160/4.5.
A one-month supply can range from $303$346, without insurance.
A generic version is also available.
It is intended to open your airways, reduce inflammation, and improve lung function.
It is used for chronic COPD with bronchospasm.
Like the other long-acting bronchodilators, it is not used as a rescue inhaler.
It is available as a dry powder metered-dose inhaler that delivers 400 mcg aclidinium bromide per inhalation.
Side effects include headaches, upper respiratory infection, and cough.
The cost of a 24-day supply is about $24 for generic and $75 for the brand version.
Inhalers may work to prevent symptoms or to treat symptoms when they occur.
Some inhalers contain metered doses of liquid medication while others contain dry powder medication.
Your healthcare provider will recommend an inhaler for you based on factors such as your symptoms and spirometry.
If you have co-existing conditions, these may also factor into which COPD inhaler is right for you.
Food and Drug Administration.Advair Discus label.
Food and Drug Administration.Ventolin.
GSK.Ventolin HFA Prescribing Information.
Food and Drug Administration.Bevespi Aerosphere.
Food and Drug Administration.Brio Ellipta.
Breztri Aerosphere.Change starts with Breztri.
Breztri.Cost assistance with Breztri.
AstraZeneca.Breztri Aerosphere approved in the US for the maintenance treatment of COPD.
Food and Drug Administration.Brovana.
Food and Drug Administration.Combivent Respimat label.
Food and Drug Administration.Perforomist label.
Food and Drug Administration.Pulmicort label.
Food and Drug Administration.Spiriva Respimat.
Food and Drug Administration.Spiriva HandiHaler.
Food and Drug Administration.Symbicort label.
Food and Drug Administration.Trelegy Ellipta.
Food and Drug Administration.Tudorza Pressair.
Food and Drug Administration.Xopenex HFA.
