Medications

5) Combination inhalers

Steroid inhalers are useful in more severe COPD or if you experience frequent flare ups/exacerbations. They can help to prevent flare ups of your COPD and need to be taken regularly, as they do not have their effect straight away.

If a steroid and a long acting bronchodilator are needed regularly, it is easier to give them in a combination inhaler.

Combination inhalers are also available which contain two long acting relievers, if you need both of these medicines it is easier to give them in one inhaler.

A new combination is available containing two different bronchodilators, to open up the airways.

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Medicine name Device How its taken Side effects
Beclometasone/Formoterol (Fostair®) Metered dose inhaler
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly once a day.
 The more common side effects include shakiness, headaches and palpitations. If you experience symptoms that suggest an allergic reaction seek medical advice as soon as possible.
With steroids you can get an increased number of infections including oral thrush. Some practical tips on avoiding oral thrush are:

  • Wash your mouth out and/or brush your teeth after using your inhaler
  • Make sure you are using your inhaler correctly
  • You may need to use a spacer device

High doses of steroids can cause long term effects – It is important you attend regular COPD reviews to assess your treatment and reduce the risk of long term side-effects.

Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

Most side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Budesonide/Formoterol (Symbicort®, Duoresp®) Turbohaler, Spiromax
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly twice a day.
Fluticasone/Salmeterol (Seretide®) Accuhaler
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly twice a day.
Fluticasone/Vilanterol (Relvar Ellipta®) Ellipta
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly once a day.
Umeclidinium/Vilanterol (Anoro Ellipta®) Ellipta
  • Combination of a long acting anti-muscarinic and a long acting reliever.
  • Taken regularly once a day.

Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.