Long-acting beta2-agonist and corticosteroid combination
Short-acting beta2-agonist and anticholinergic combination
Beta2-agonists are available in metered-dose
nebulizer, pill, injected, and syrup forms. Some
beta2-agonists may be available in multiple forms. Your doctor will help you
decide which form is best for you.
There are two types of
beta2-agonists: short-acting and long-acting. The short-acting type relieves
symptoms and the long-acting type helps prevent breathing problems.
Short-acting beta2-agonists are used for treating stable COPD in a person whose
symptoms come and go (intermittent symptoms). Long-acting beta2-agonists are
effective and convenient for preventing and treating COPD in a person whose
symptoms do not go away (persistent symptoms).
bronchodilators. This means that they relax and
enlarge (dilate) the airways in the lungs, making breathing easier.
Beta2-agonists are considered
first-line therapy for the treatment of stable
chronic obstructive pulmonary disease (COPD) with
symptoms that come and go (intermittent symptoms). They are used for both
short- and long-term relief of symptoms.
Beta2-agonists also may
be used before exercise to reduce breathing difficulties.
Arformoterol, formoterol, or salmeterol may be taken to prevent shortness
of breath or coughing that may keep you from exercising.
Studies show that inhaled
beta2-agonists are effective in treating symptoms of COPD and improving lung
function as measured by tests (spirometry).1 They also reduce the
Results vary from one person to the next. For some people
with COPD, beta2-agonist medicines make breathing much easier. For others, they
do not help.
Combining medicines may help your lung function.
Using a beta2-agonist:
Combining medicines also may reduce the risk of side effects compared to increasing the dose of one medicine.6
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor right away if:
Common side effects of these medicines include:
Side effects are much more likely to
occur when you take this medicine as a pill or injection than when you use the
See Drug Reference for a full list of side
effects. (Drug Reference is not available in all systems.)
While short-acting beta2-agonists
may be the first choice for treating symptoms of mild COPD that come and go
(intermittent symptoms), anticholinergics typically are regarded as the
first-line treatment for persistent symptoms, in most cases of COPD.
Inhalation is the preferred method of taking beta2-agonists. This method
reduces the chance of side effects and makes the medicine more effective. Pills
and injections are reserved for those who cannot use a metered-dose inhaler
(MDI) or nebulizer.
Nebulizers normally are no better at
delivering beta2-agonists deep into the lungs than a properly used metered-dose
inhaler. Sometimes your doctor may prescribe a nebulizer. Although a nebulizer
can deliver a very large dose of medicine, it also may increase side effects of
Most doctors recommend that everyone using an
inhaler also use a
spacer. Use of a spacer is especially important when
using an inhaler containing a steroid medicine. But you should not use a dry
powder inhaler (DPI) with a spacer.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
CitationsCelli BR, et al. (2008). Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: Results from the TORCH study. American Journal of Respiratory and Critical Care Medicine, 178(4): 332–338.Stoller JK (2002). Acute exacerbations of chronic
obstructive pulmonary disease. New England Journal of Medicine, 346(13): 987–994.McIvor RA, et al. (2011). COPD, search date April 2010. Online version of BMJ Clinical Evidence: http://www.clinical
evidence.com.Calverley PM, et al. (2007). Salmeterol and
fluticasone propionate and survival in chronic obstructive pulmonary disease.
New England Journal of Medicine, 356(8):
775–789.Hanania NA, et al. (2003). The efficacy and safety of
fluticasone propionate (250 micrograms)/salmeterol (50 micrograms) combined in
the Diskus Inhaler for the treatment of COPD. Chest,
124: 834–843.Global Initiative for Chronic Obstructive Lung Disease
(2010). In Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Available online:
November 29, 2011
E. Gregory Thompson, MD - Internal Medicine & Ken Y. Yoneda, MD - Pulmonology
How this information was developed to help you make better health decisions.
To learn more visit Healthwise.org
© 1995-2013 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.