Steroids for COPD include oral steroids, inhaled steroids, and combination inhalers. Each type comes with its own benefits and side effects.

Chronic obstructive pulmonary disease (COPD) is a term used to describe a few serious lung conditions. These include:

While no cure currently exists for COPD, several types of medication can often reduce symptom severity.

Steroids are among the medications commonly prescribed to treat COPD. They help reduce the inflammation in your lungs caused by flare-ups.

Steroids come in oral and inhaled forms. There are also combination drugs that include a steroid and another medication. Each type of steroid works a little differently in controlling or preventing symptom flare-ups.

You may use steroids in pill or liquid form for a moderate or serious flare-up, also known as an acute exacerbation.

These fast-acting oral medications are usually prescribed for short-term use, often 5 to 7 days. Your dose will depend on:

  • symptom severity
  • medication strength
  • other factors

Among the more commonly prescribed oral steroids for COPD are:

Prednisone and prednisolone are considered off-label drugs for treating COPD.

Off-label drug use

Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that it has not been approved for.

However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients’ medical conditions.

So your doctor can prescribe a drug however they think is best for your care. Learn more about off-label drug use.

Benefits

Oral steroids are usually prescribed for short-term use. This may make you less likely to experience complications associated with long-term use of the medication.

Side effects

Side effects from short-term use of steroids are usually minor if they occur at all. They include:

Prolonged use of these medications may raise your risk of:

Since the medications may contribute to osteoporosis, your doctor may advise you to increase your vitamin D and calcium intake or start taking medications to fight bone loss.

Oral steroids should be taken with food.

You can use an inhaler to deliver steroids directly into your lungs. Unlike oral steroids, inhaled steroids are not usually prescribed for flare-ups.

You may also use a nebulizer. This is a machine that turns the medication into a fine aerosol mist. It then pumps the mist through a flexible tube and into a mask that you wear across your nose and mouth.

Examples of inhaled steroids for COPD include:

  • beclomethasone dipropionate (Qvar Redihaler)
  • budesonide (Pulmicort Flexhaler)
  • ciclesonide (Alvesco)
  • flunisolide (Aerospan)
  • fluticasone propionate (Flovent)
  • mometasone (Asmanex)

These inhaled steroids are not FDA approved to treat COPD but may be used as part of some treatment plans. Combination products are more commonly used.

Benefits

Research suggests that inhaled steroids may help:

  • decrease the rate of flares
  • improve lung function
  • improve quality of life

If asthma is a part of your COPD, an inhaler may be particularly helpful.

Side effects

Side effects of inhaled steroids can include:

  • decreased glycemic control (blood sugar management)
  • decrease in bone density
  • changes in skin
  • cataracts
  • pulmonary infections
  • oral thrush

To reduce the risk of oral infections, rinse your mouth and gargle with water after you use the inhaler.

Research also suggests long-term, high-dose use of inhaled steroids is associated with an increased risk of pneumonia.

Steroids can also be combined with bronchodilators. These are medications that help relax the muscles surrounding your airways. Various medications used in a combination inhaler can target the large or small airways.

Some common combination inhalers include:

Benefits

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 treatment guidelines, combination inhalers may be more effective than single therapies in improving COPD symptoms and quality of life.

Combination inhalers may also reduce the frequency of flare-ups.

Side effects

Possible side effects of combination inhalers include:

As with a standard steroid inhaler, use of a combination inhaler should be followed with a mouth rinse to help prevent infections in your mouth.

When to seek help

Call your doctor’s office if you experience these or any other side effects after starting a combination inhaler (or any medication).

If you’re having trouble breathing or having chest pain, call 911 or seek emergency medical attention immediately.

Steroids in any form pose a risk if they’re used over a long period of time.

Steroids may also interact with other medications. Mixing prednisone with pain relievers, such as aspirin or ibuprofen (Advil, Motrin), may raise your risk of ulcers and stomach bleeding.

Taking nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids together for a long time can also cause electrolyte imbalances, which put you at risk of heart and kidney problems.

Telling your doctor about all the medications and supplements you take better prepares them to inform you about possible interactions. This includes any medications you may take occasionally, such as for a headache.

In addition to steroids and bronchodilators, other medications may be helpful in reducing flare-ups and controlling symptoms.

Research suggests that there’s some evidence indicating phosphodiesterase-4 inhibitors may help reduce inflammation in the lungs and reduce exacerbations. However, these medications are usually prescribed in addition to other therapies.

Your medical team may also prescribe antibiotics if you have a bacterial infection that’s making your COPD symptoms worse. Antibiotics may also help control acute exacerbations, but they are not meant for long-term symptom management.

There are many different steroids for COPD, including oral steroids, inhalers, and combination inhalers. They may help reduce flare-ups and improve your quality of life.

Your doctor will be able to determine the best medication for you and explain any side effects or risks.