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Preventer medicines

Preventer inhalers contain corticosteroids (with the exception of theophylline). These corticosteroids are effective in COPD and are different to anabolic steroids. In more severe COPD, these medicines help to reduce the number of flare ups people may experience by reducing inflammation which causes swelling and sputum production in the breathing tubes or airways.

They are especially important to use if you also have asthma as they specifically treat the type of inflammation or swelling that commonly occurs in asthma. Preventers must be taken twice a day every day to be effective. It may take up to a few weeks for you to start noticing their effect. So, it is important for you to keep taking them to have an impact on your symptoms.


Beclomethasone (QVAR®) It is recommended that this is used with a spacer.

Budesonide (Pulmicort®)

Fluticasone (Flixotide®) Are often given as a puffer to use with a spacer.

Ciclesonide (Alvesco®)



  • Inhaled twice a day.
  • Must be used regularly to be effective.


  • Reduces swelling and the amount of sputum in the breathing tubes or airways.
  • May take up to a few weeks for you to notice its effect.

Side effects

A sore mouth and throat caused by a thrush infection or hoarseness of the voice are the most common side effects. To avoid these effects, use a spacer when using a metered dose aerosol (puffer), and rinse your mouth and gargle after each dose).


Sometimes inhaled corticosteroids (preventers) are combined with a long-acting bronchodilator (maintenance inhalers) in one inhaler. This is often called ICS/LABA combination therapy. These are usually prescribed for those with moderate to severe COPD who have had two or more flare ups over the previous year.

Combining medicines like this can help to reduce the number of flare ups which in turn improves lung function and overall health. In addition, combined medicines are easier to use since they are available in one inhaler for two different medicines. They are prescribed twice daily.

Combination inhalers include:

  • Budesonide and eformoterol (Symbicort®). Delivered via Turbuhaler or given as a rapihaler to use with a spacer.
  • Fluticasone and salmeterol (Seretide®). Delivered via Accuhaler but often given as a puffer to use with a spacer.
  • Fluticasone furoate and vilantero (Breo Ellipta®)


  • Designed to improve patient adherence with two medicines in one inhaler.
  • Improves quality of life, improves lung function, and prevents flare ups.

Effects and side effects

Refer to individual medicines.




  • Use twice (daily)
  • For use in severe COPD with frequent flare ups.
  • Is less often used because of the potential for more significant side effects.
  • Regular blood tests are required.
  • Take with food.
  • Available in controlled release tablet and syrup.


  • Theophylline relaxes the bronchial smooth muscle and reduces inflammation in the breathing tubes or airways.
  • There are both short-acting (works for 6 hours) and long-acting (works for 12-24 hours) forms of theophylline.

Side effects

  • Theophylline is associated with more frequent side effects and therefore is used less often than other bronchodilators. If you have been prescribed theophylline, your doctor may wish to monitor you more closely.
  • Tremor, nervousness, light-headedness, nausea and vomiting.