While there is currently no cure for emphysema, various medications can help manage it. These may include bronchodilators, steroids, and antibiotics. They aim to manage symptoms, improve quality of life, and prevent the condition from worsening.
People with emphysema most commonly have an inflammatory reaction to an irritant, such as smoking. This destroys the air sacs in the lungs and causes symptoms such as coughing and shortness of breath. Emphysema is a form of chronic obstructive pulmonary disease (COPD).
Quitting smoking and making other lifestyle changes can help improve a person’s outlook.
Keep reading to learn more about medications that doctors may prescribe to treat emphysema, including some side effects associated with each type.
Some types of bronchodilators include:
Beta2-agonists
These medications aim to
Examples of SABAs include:
- albuterol (Ventolin)
- levosalbutamol (Xopenex HFA)
- metaproterenol
- terbutaline (Marex)
Examples of LABAs include:
- salmeterol (Serevent)
- formoterol (Perforomist)
- arformoterol (Brovana)
Some side effects people may experience include:
- headaches
- nervous tension
- trembling, especially of the hands
- muscle cramps
- heart palpitations
Antimuscarinics
These medications aim to prevent the narrowing of the airways. Antimuscarinics block the M3 muscarinic receptors responsible for contracting the smooth muscle. A person can use short-acting antimuscarinic agents (SAMA) for immediate symptom relief or long-acting antimuscarinic agents (LAMA) as maintenance therapy.
Example of antimuscarinics include:
- ipratropium bromide (Atrovent)
- oxitropium bromide (Oxident)
- aclidinium bromide/formoterol fumarate (Duaklir)
- tiotropium (Spiriva)
- glycopyrrolate (Lonhala)
Some side effects include:
- dry mouth
- tachycardia, or fast heart rate
- urinary retention
- sore throat
- agitation
- drowsiness
- blurred vision
- light sensitivity
Methylxanthines
While methylxanthines are no longer part of treatment guidelines for COPD, they may still be in use in clinical practice.
These medications
Adverse effects of these medications can be mild or severe, depending on the dose.
Doctors may prescribe theophylline (Elixophyllin) or dyphylline (Lufyllin).
Mild adverse effects usually happen with serum drug concentrations below
- headaches
- excessive urination
- nausea
- vomiting
- increased gastric acid production, leading to gastroesophageal reflux
- insomnia, or trouble sleeping
- tremors
- heart palpitations
Severe adverse effects may happen with serum concentrations higher than 20 mcg/mL. These effects include:
- irregular heart rhythm or heartbeat
- allergic skin reactions
- uncontrollable vomiting
- seizures
- cardiac arrest
Doctors may recommend inhaled corticosteroids alongside LABA and LAMA to reduce inflammation. Inhaling steroids reduces swelling in the airways, and any resulting symptoms, such as wheezing and shortness of breath. People have received a
Some drugs available include:
- budesonide (Pulmicort)
- flunisolide
- ciclesonide (Alvesco)
However, a person taking inhaled corticosteroids is at increased risk of developing pneumonia. Other potential side effects include:
- cough
- sore mouth or throat
- nosebleeds
- a hoarse, or croaky voice
- oral thrush (fungal infection in the mouth)
Systemic glucocorticoids work by reducing inflammation. Doctors may prescribe them to manage acute flare-ups of emphysema. However, they do not recommend taking these on a long-term basis as they can potentially cause
- increased blood glucose levels
- weight gain
- muscle breakdown
- bone breakdown
- infections
- osteoporosis
- adrenal insufficiency, which is when the adrenal glands struggle to make certain hormones, such as cortisol and aldosterone
- Cushing’s syndrome (characterized by abdominal and back weight gain and rounding of the face)
- slowed growth in children
- cardiovascular problems, including fluid retention, edema, weight gain, hypertension, and arrhythmia
- skin problems, including bruising, skin thinning, acne, mild hirsutism, facial rashes, stretch marks, impaired wound healing, hair thinning, and dermatitis around the mouth
- eye problems, including cataracts and glaucoma
- neuropsychiatric problems, including anxiety, depression, psychosis, sleep disturbance, and inability to stay still
Doctors may need to examine a person’s medical history and perform a physical exam before prescribing this medication. If a person has a preexisting condition — for example, diabetes — systemic glucocorticoids may not be appropriate.
Phosphodiesterase-4 (PDE4) inhibitors aim to reduce inflammation by inhibiting the breakdown of a cell signaling molecule called “cyclic AMP.”
Doctors may prescribe roflumilast (Daliresp), a PDE4 inhibitor, to reduce flare-ups in people with severe emphysema.
However, potential
- nausea
- vomiting
- gastrointestinal reactions
The antibiotic azithromycin (Zithromax) may help reduce the frequency of flare-ups in people with COPD.
People can usually take
- gastrointestinal symptoms
- prolonged QT interval, which is an irregular heart rhythm shown on an electrocardiogram
- hearing impairment
A doctor will decide what the best medication is for emphysema on an individual basis. It can depend on:
- a person’s individual disease severity
- how emphysema affects their quality of life
- whether they have experienced side effects from certain medications
- whether they have a preexisting condition
For mild flare-ups, a person may receive bronchodilators, corticosteroids, or antibiotics as an outpatient.
A person may be hospitalized for moderate to severe flare-ups, where they will likely receive oxygen and SABA (with or without SAMA) bronchodilators. They will typically receive LABA or LAMA bronchodilators once their condition stabilizes and they are ready to go home.
Other treatments, including surgery and oxygen therapy, exist for emphysema.
Learn more about other treatments for emphysema here.
If anyone has any concerns about their medications or they are experiencing side effects, it is best to seek medical attention. The doctor may be able to provide alternatives and help alleviate any worries.
Doctors have not yet found a cure for emphysema, but several medications can help manage symptoms and improve quality of life.
Medications can include bronchodilators, inhaled corticosteroids, PDE4 inhibitors, and antibiotics. Each type can come with side effects. Speak with a doctor if there are any concerns about taking the medications or the side effects that may occur.
Other ways to treat emphysema include stopping smoking, oxygen therapy, and lung surgery.