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5 Signs You Need to Talk to Your Doctor About Your COPD Meds
By By Becky Upham. Medically Reviewed by David Mannino, MD,
1 days ago
Struggling with COPD symptoms? Learn the signs that indicate it's time to discuss medication changes with your doctor. Phanie/Alamy According to the American Lung Association, about 11.7 million people in the United States have chronic obstructive pulmonary disease (COPD) , a group of lung conditions that block airflow and cause breathing problems. While there is no cure for COPD, certain drugs can ease symptoms, reduce the severity and number of exacerbations, and help improve your ability to move and exercise.
However, COPD medications , including bronchodilators, steroids, combination medications, phosphodiesterase-4 inhibitors, and antibiotics, may lose their effectiveness over time. Here are some signs that you should talk to your doctor about your COPD medication.
1. Your Symptoms Get Worse
The biggest indicators that your COPD is getting worse would be increased shortness of breath, less activity, or a reduced ability to move, climb stairs, or walk up a slight incline, says Robert A. Wise, MD , the medical director of the pulmonary function laboratory at the Johns Hopkins Asthma and Allergy Center in Baltimore. "A worsening cough, wheezing or chest tightening, and a change in phlegm - either in consistency, volume, or color - are other signs that your condition is getting worse," says Dr. Wise.
Symptoms can also get worse if you're not taking your medication correctly, which is relatively common, says Wise. "Most people with COPD should periodically ask their healthcare provider to make sure that they're using their inhaler properly," he says. A number of how-to videos are available online, including a guide from the American Lung Association.
Doctors prescribe a dozen different types of inhalers , and it's quite common for people to use their inhaler in a less-than-optimal fashion. "Very often, if someone is worsening, it's not a matter of changing their medication, but rather ensuring that they are using their inhaler properly," he says.
2. Your Blood Pressure, Pulse Rate, or Other Vital Signs Change
"Sometimes, if a person is taking the wrong dose of their COPD medication, it can affect [their] blood pressure, pulse rate, or even their electrolytes ," says Wise. "A person can get low potassium sometimes from certain types of inhalers." Your doctor should routinely monitor your vital signs and electrolytes to ensure your body is processing the medication appropriately.
3. Your Medication Is No Longer Effective
In general, Wise says that even if you've been on your COPD medication for a long time, you shouldn't have to increase your dose to get the same benefit.
If you aren't getting the same benefit from your medication, you should check in with your healthcare provider and make sure you are using your inhaler correctly, says Wise.
"Sometimes in asthma, if people overuse their rescue inhaler, it can have less and less efficacy; but that's usually a sign that their asthma is getting worse rather than that they're developing [a tolerance] to the medication," he says.
4. You Have Thrush, or Candida Infection, in Your Mouth
"If you have more irritation or soreness of the mouth or you notice whitish patches on the tongue or the inside of the mouth, it could signal the presence of thrush , or a candida infection, of the mouth," says Wise.
This can develop after using inhalers for COPD, particularly inhaled steroids, which can make the mouth and throat's immune defenses weaker. You should contact your doctor if you suspect you have thrush so they can prescribe treatment for the infection. This will generally involve applying an antifungal gel such as clotrimazole , miconazole, or nystatin inside the mouth for one or two weeks.
5. You Experience Medication Side Effects
The most common side effects of some of the oral medications prescribed for COPD, are GI upset, such as nausea, diarrhea, and weight loss, says Wise. He adds that this typically happens when you begin taking the medicine.
Look out for the following side effects of COPD medications, and speak to a physician if they become problematic:
Inhaled Steroids Bruising, oral infections, and hoarseness
Oral Steroids Weight gain, diabetes, osteoporosis, cataracts, and more frequent infections
Phosphodiesterase-4 Inhibitors ( Roflumilast ) Diarrhea, nausea, and weight loss
Theophylline Nausea, headaches, fast heartbeat, and tremors
The Takeaway
COPD medications can support easier breathing and improved quality of life. However, if symptoms get worse or new symptoms develop, discuss your current medication regimen with your doctor.
If you begin to experience side effects such as thrush after regular inhaler use, or gastrointestinal upset, it might be time to change the medication, delivery system, or dosage.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
How to Use a Metered-Dose Inhaler without a Valved Holding Chamber. American Lung Association . June 7, 2024.
Khijmatgar S, Belur G, Venkataram R, et al. Oral Candidal Load and Oral Health Status in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Case-Cohort Study. BioMed Research International . September 11, 2021.
David Mannino, MD, is the chief medical officer at the COPD Foundation . He has a long history of research and engagement in respiratory health.
After completing medical training as a pulmonary care specialist, Dr. Mannino joined the Centers for Disease Control and Prevention (CDC) Air Pollution and Respiratory Health Branch. While at CDC, he helped to develop the National Asthma Program and led efforts on the Surveillance Reports that described the U.S. burden of asthma (1998) and COPD (2002).
After his retirement from CDC in 2004, Mannino joined the faculty at the University of Kentucky, where he was involved both clinically in the College of Medicine and as a teacher, researcher, and administrator in the College of Public Health. He served as professor and chair in the department of preventive medicine and environmental health from 2012 to 2017, with a joint appointment in the department of epidemiology.
In 2004, Mannino helped to launch the COPD Foundation, where he served as a board member from 2004 through 2015, chairman of the Medical and Scientific Advisory Committee from 2010 through 2015, and chief scientific officer from 2015 to 2017.
Mannino has over 350 publications and serves as an associate editor or editorial board member for the following journals: American Journal of Respiratory and Critical Care Medicine , Chest , Thorax , European Respiratory Journal , and the Journal of the COPD Foundation . He was also a coauthor of the Surgeon General's Report on Tobacco in 2008 and 2014.
Becky Upham has been professionally involved in health and wellness for almost 20 years. She's been a race director, a recruiter for Team in Training for the Leukemia & Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.
She majored in English at the University of North Carolina and has a master's in English writing from Hollins University.
Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.
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