13+ Drugs and Medications to Avoid if You Have COPD (2025)

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition that causes difficulty breathing and includes conditions such as chronic bronchitis and emphysema. As the number of people affected by this debilitating disease continues to grow, it’s crucial for both patients and healthcare providers to stay informed about the most effective treatments available.

Equally important, however, is understanding which medications and substances can worsen COPD symptoms, interfere with treatment, or pose serious health risks.

This article provides a comprehensive list of drugs and medications that individuals with COPD should avoid to help improve their overall health and quality of life.

Drugs and Medications to Avoid With COPD

When managing COPD, it’s essential to be aware of certain drugs and medications that can worsen symptoms, reduce the effectiveness of treatments, or increase the risk of complications.

Some medications, even those commonly used for other conditions, may pose risks to individuals with COPD.

Here’s a list of drugs and substances to avoid or use with caution:

1. Opioids
2. Antihistamines
3. Decongestants
4. Diuretics
5. Sedatives
6. Beta-Blockers
7. Antitussives
8. Anticonvulsants
9. Cold medications
10. Alcohol
11. Nicotine
12. Sugar
13. Oxygen

Watch this video or keep reading to learn more about the drugs and medications to consider avoiding if you have COPD.

1. Opioids

Opioids, including medications such as codeine, morphine, hydrocodone, and oxycodone, are powerful pain relievers often used to manage acute or chronic pain. However, for individuals with COPD, these medications can pose significant risks.

Opioids work by depressing the central nervous system, which can lead to respiratory depression—a reduction in the body’s natural drive to breathe. For COPD patients who already struggle with impaired lung function, this can be particularly dangerous.

Opioids can reduce oxygen levels, worsening breathing difficulties and increasing the risk of life-threatening complications. Additionally, these drugs can trigger or worsen sleep apnea, further compounding respiratory issues in COPD patients.

Examples:

• Codeine
• Morphine
• Hydrocodone
• Oxycodone

2. Antihistamines

Antihistamines are commonly used to treat allergies and cold symptoms by blocking histamine, a chemical involved in allergic reactions. However, certain types of antihistamines can be problematic for people with COPD.

First-generation antihistamines, such as diphenhydramine (Benadryl) and chlorpheniramine, are known for causing drowsiness and can thicken mucus in the airways. This makes it harder to clear, which can increase breathing difficulties and heighten the risk of respiratory infections.

For individuals with COPD, this can lead to more severe symptoms and potential complications. It’s generally recommended that COPD patients opt for second-generation antihistamines, like loratadine (Claritin) or cetirizine (Zyrtec), which have fewer side effects related to respiratory function.

Examples:

• Diphenhydramine (Benadryl)
• Chlorpheniramine

3. Decongestants

Decongestants like pseudoephedrine (Sudafed) and phenylephrine are commonly used to relieve nasal congestion by narrowing blood vessels in the nasal passages. However, for individuals with COPD, these medications can have unintended consequences.

In addition to narrowing blood vessels in the nasal area, decongestants may constrict blood vessels in the lungs, making breathing even more difficult for COPD patients. Furthermore, decongestants can increase blood pressure and heart rate, placing additional strain on the heart and exacerbating respiratory function.

Due to these risks, it’s important for COPD patients to consult their healthcare provider before using decongestants and explore safer alternatives for congestion relief.

Examples:

• Pseudoephedrine (Sudafed)
• Phenylephrine

4. Diuretics

Diuretics, often referred to as “water pills,” help reduce fluid retention by increasing urine output and are typically prescribed for conditions like heart failure, high blood pressure, and kidney disease. While they can be beneficial in certain situations, diuretics can pose risks for individuals with COPD.

One of the main concerns is dehydration, which can thicken mucus in the airways, making it harder to clear and worsening breathing difficulties.

Additionally, diuretics can lead to electrolyte imbalances, which may cause muscle weakness, cramps, and fatigue—further exacerbating COPD symptoms. COPD patients should discuss the risks and benefits of diuretics with their healthcare provider to ensure they are used safely and effectively.

Examples:

• Furosemide (Lasix)
• Hydrochlorothiazide
• Spironolactone

5. Sedatives

Sedatives, including benzodiazepines like diazepam (Valium) and lorazepam (Ativan), as well as sleep aids such as zolpidem (Ambien) and eszopiclone (Lunesta), are often used to manage anxiety, promote relaxation, or aid sleep. However, for individuals with COPD, these medications can be particularly hazardous.

Sedatives depress the central nervous system, which can lead to shallow breathing and reduced respiratory drive—an especially dangerous scenario for someone with already compromised lung function. This can worsen breathing difficulties and increase the risk of serious respiratory complications.

COPD patients who require medication for anxiety or sleep issues should work closely with their healthcare provider to find safer alternatives that carry a lower risk of respiratory depression.

Examples:

• Diazepam (Valium)
• Lorazepam (Ativan)
• Zolpidem (Ambien)
• Eszopiclone (Lunesta)

6. Beta-Blockers

Beta-blockers are commonly prescribed to manage high blood pressure, heart arrhythmias, and angina by blocking the effects of adrenaline on the heart and blood vessels.

While these medications are essential for certain cardiovascular conditions, they can pose a risk for individuals with COPD, especially non-selective beta-blockers like propranolol. Non-selective beta-blockers affect both the heart and lungs, leading to bronchoconstriction, which can further impair breathing in COPD patients.

In contrast, cardioselective beta-blockers, such as bisoprolol and nebivolol, primarily target the heart and may be prescribed with caution as they carry a lower risk of affecting lung function. It’s important for COPD patients to consult with their healthcare provider before using any beta-blocker to ensure it is safe for their respiratory condition.

Examples:

• Propranolol
• Bisoprolol
• Nebivolol

7. Antitussives

Antitussives are cough suppressants found in many over-the-counter cold and flu remedies, with common examples including dextromethorphan and codeine. While suppressing a cough might seem helpful for people with COPD, it can actually be detrimental.

Coughing plays a crucial role in clearing mucus from the airways, and by suppressing this reflex, antitussives can lead to mucus buildup in the lungs. This can increase the risk of respiratory infections and make breathing more difficult.

For COPD patients, it’s essential to manage a cough in a way that promotes lung health rather than suppressing it. Always consult with a healthcare provider for the best approach to managing a COPD-related cough.

Examples:

• Dextromethorphan
• Benzonatate
• Codeine

8. Anticonvulsants

Anticonvulsants, used primarily to treat epilepsy and seizure disorders, are also prescribed for conditions such as nerve pain and bipolar disorder. However, for individuals with COPD, some anticonvulsants can present risks by depressing the central nervous system, leading to respiratory depression.

This effect is similar to that of sedatives and opioids, causing weakened breathing and a reduction in lung function, which can worsen COPD symptoms.

If anticonvulsants are necessary, COPD patients should consult their healthcare provider to assess the potential risks and consider alternative treatments that do not compromise respiratory health.

Examples:

• Phenytoin (Dilantin)
• Carbamazepine (Tegretol)
• Gabapentin (Neurontin)

9. Cold Medications

Cold medications are widely used to alleviate symptoms of colds, flu, and other respiratory infections, but they can be risky for individuals with COPD. These over-the-counter remedies often contain a mix of decongestants, antihistamines, and antitussives, all of which may exacerbate COPD symptoms.

As mentioned earlier, these ingredients can cause issues such as thickening of mucus, suppression of the cough reflex, and increased difficulty breathing—making it harder for COPD patients to clear mucus from their lungs and manage their condition effectively.

For individuals with COPD, it’s crucial to carefully read medication labels and consult a healthcare provider before using any cold or flu medications to avoid complications.

Examples:

• Nyquil
• Theraflu
• Robitussin

10. Alcohol

While alcohol isn’t a medication, its effects on individuals with COPD can be significant and harmful. Alcohol acts as a depressant on the central nervous system, which can slow breathing and reduce respiratory drive. This poses a serious risk for those already struggling with compromised lung function due to COPD.

Excessive alcohol consumption can also negatively affect sleep quality, leading to restless nights and fatigue, which in turn can worsen COPD symptoms. Additionally, alcohol weakens the immune system, increasing the risk of respiratory infections such as colds, flu, or pneumonia—conditions that can drastically aggravate COPD.

For these reasons, individuals with COPD are advised to limit or avoid alcohol to maintain better lung health and manage their condition more effectively.

Examples:

• Beer
• Wine
• Spirits (e.g., vodka, whiskey, gin)

11. Nicotine

Nicotine, the addictive substance found in tobacco products, is particularly harmful to individuals with COPD. Smoking cigarettes, cigars, or using smokeless tobacco significantly damages the lungs and exacerbates COPD symptoms.

Smoking triggers inflammation and irritation in the airways, making breathing more difficult, and can accelerate the progression of COPD, leading to further lung damage.

Even nicotine replacement therapies, such as patches, gum, or e-cigarettes, which are often used to help quit smoking, may carry risks for COPD patients. It’s critical for individuals with COPD to stop smoking entirely and consult their healthcare provider to develop a safe and effective smoking cessation plan.

Examples:

• Cigarettes
• Cigars
• Smokeless tobacco (e.g., chewing tobacco, snuff)
• E-cigarettes

12. Sugar

Though not a medication, sugar can have a negative impact on individuals with COPD. A diet high in sugar can lead to weight gain and obesity, both of which can exacerbate breathing difficulties by putting additional strain on the respiratory system.

Furthermore, excessive sugar intake can contribute to other chronic conditions, such as type 2 diabetes and cardiovascular disease, complicating COPD management.

Some research also suggests that high sugar consumption can increase inflammation in the body, which may worsen COPD symptoms. To better manage COPD, individuals are advised to maintain a balanced diet low in added sugars to support overall health and improve lung function.

Examples:

• Soft drinks
• Candy
• Pastries
• Processed foods high in added sugars

13. Oxygen

While it may seem surprising, oxygen is considered a drug, and for individuals with advanced COPD, supplemental oxygen therapy is often necessary to maintain adequate blood oxygen levels.

However, it is crucial to follow healthcare provider guidelines carefully, as improper use of oxygen—such as using too much or setting the flow rate too high—can lead to oxygen toxicity or suppress the respiratory drive. This can result in shallow breathing or hypoventilation, which can be dangerous for COPD patients.

For those on oxygen therapy, it’s essential to regularly monitor oxygen levels and work closely with healthcare providers to ensure the correct flow rate is used, maintaining optimal oxygen saturation levels.

Examples:

• Oxygen therapy (when used incorrectly or at inappropriate levels)

Final Thoughts

Understanding which drugs and substances to avoid is crucial for individuals with COPD to manage their condition effectively. By recognizing the potential risks associated with certain medications, patients and healthcare providers can collaborate to create personalized treatment plans that maximize well-being while minimizing complications.

Since every person’s experience with COPD is different, treatments that work for one individual may not be appropriate for another. This makes it essential to maintain open and ongoing communication with your healthcare team, ensuring that your treatment plan is tailored to your unique needs and circumstances.

Staying informed and proactive allows you to take control of your COPD management, reduce the impact of symptoms, and ultimately improve your overall quality of life.