COPD Drugs to Avoid Illustration

13+ Drugs and Medications to Avoid if You Have COPD (2024)

by | Updated: Apr 28, 2024

Chronic obstructive pulmonary disease (COPD) is a progressive lung disorder characterized by difficulty breathing, chronic bronchitis, and emphysema.

As the prevalence of this debilitating disease continues to rise, it is vital for patients and healthcare professionals alike to be aware of the most effective treatments available.

However, it is equally important to identify medications and substances that may exacerbate symptoms, hinder treatment, or potentially lead to dangerous complications.

In this article, we will delve into a comprehensive list of drugs and medications to avoid for individuals living with COPD, ultimately leading to improved health outcomes and quality of life.

Drugs and Medications to Avoid With COPD

  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

1. Opioids

Narcotic opioids are a class of potent pain-relieving medications that include codeine, morphine, hydrocodone, and oxycodone, among others.

While they can provide significant relief for acute or chronic pain, they pose a considerable risk to individuals with COPD.

Opioids depress the central nervous system and can cause respiratory depression, leading to a decrease in the drive to breathe. This can be particularly dangerous for COPD patients who already have compromised respiratory function.

Additionally, opioids can increase the risk of sleep apnea, which may further worsen the symptoms of COPD.

Examples:

  • Codeine
  • Morphine
  • Hydrocodone
  • Oxycodone

2. Antihistamines

Antihistamines are medications commonly used to treat allergies and cold symptoms by blocking histamine, a chemical involved in the body’s immune response.

First-generation antihistamines, such as diphenhydramine (Benadryl) and chlorpheniramine, are known to cause drowsiness and may exacerbate COPD symptoms by thickening mucus in the airways, making it more difficult to clear.

This can lead to increased difficulty in breathing and a higher risk of respiratory infections. It is generally advised that individuals with COPD use second-generation antihistamines, like loratadine (Claritin) or cetirizine (Zyrtec), which typically have fewer respiratory side effects.

Examples:

  • Diphenhydramine (Benadryl)
  • Chlorpheniramine

3. Decongestants

Decongestants, such as pseudoephedrine (Sudafed) and phenylephrine, are medications used to relieve nasal congestion by narrowing blood vessels in the nasal passages.

However, they can have adverse effects on COPD patients, as they may also constrict blood vessels in the lungs, making it harder to breathe.

Additionally, decongestants can raise blood pressure and increase heart rate, putting extra strain on the heart and further compromising respiratory function.

COPD patients should consult their healthcare provider before using decongestants and consider alternative options for congestion relief.

Examples:

  • Pseudoephedrine (Sudafed)
  • Phenylephrine

4. Diuretics

Diuretics, also known as “water pills,” are medications that help to reduce fluid retention in the body by increasing urine output. They are often prescribed for conditions like heart failure, hypertension, and kidney disease.

While diuretics may be useful in some cases, they can also lead to dehydration and electrolyte imbalances, which may negatively impact COPD patients. Dehydration can thicken mucus in the airways, making it harder to expel and leading to increased difficulty in breathing.

Moreover, electrolyte imbalances can cause muscle weakness and cramping, further exacerbating COPD symptoms.

Note: It is crucial for individuals with COPD to discuss the potential risks and benefits of diuretics with their healthcare provider before starting any treatment regimen.

Examples:

  • Furosemide (Lasix)
  • Hydrochlorothiazide
  • Spironolactone

5. Sedatives

Sedatives are a class of medications used to reduce anxiety, induce relaxation, and promote sleep. Common examples include benzodiazepines (e.g., diazepam, lorazepam) and certain sleep aids (e.g., zolpidem, eszopiclone).

For individuals with COPD, sedatives may be particularly risky as they can depress the central nervous system, leading to decreased respiratory drive and shallow breathing.

This can exacerbate existing respiratory difficulties and potentially result in dangerous respiratory complications.

If you have COPD and require anxiety or sleep medications, consult your healthcare provider for alternatives that may have a lower risk of respiratory depression.

Examples:

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

6. Beta-Blockers

Beta-blockers are medications primarily used to treat high blood pressure, heart arrhythmias, and angina by blocking the effects of adrenaline on the heart and blood vessels.

While they can be helpful for certain cardiovascular conditions, non-selective beta-blockers, such as propranolol, can be harmful to COPD patients as they are associated with a deterioration of lung function

In some cases, cardioselective beta-blockers (e.g., bisoprolol, nebivolol) may be prescribed with caution, as they have a lower risk of bronchoconstriction.

Examples:

  • Propranolol

7. Antitussives

Antitussives are medications designed to suppress coughing, and they are commonly found in over-the-counter cold and flu remedies. Examples include dextromethorphan and codeine.

Although cough suppression might seem beneficial for COPD patients, it can be counterproductive, as coughing helps clear mucus from the airways.

By suppressing the cough reflex, antitussives can lead to mucus buildup in the lungs, increasing the risk of respiratory infections and making it more difficult to breathe.

If you have COPD, it is essential to speak with your healthcare provider about managing your cough in a way that supports lung health.

Examples:

  • Dextromethorphan
  • Benzonatate
  • Codeine

8. Anticonvulsants

Anticonvulsants, or antiepileptic drugs, are medications used primarily to treat seizure disorders, such as epilepsy, but they may also be prescribed for other conditions, like nerve pain or bipolar disorder.

Some of these medications can negatively affect respiratory function in COPD patients by depressing the central nervous system and causing respiratory depression, similar to sedatives and opioids.

This can lead to worsened pulmonary function and more frequent COPD symptoms. If you have COPD and require anticonvulsant medications, consult your healthcare provider to discuss the potential risks and explore safer alternatives.

Examples:

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

9. Cold Medications

Cold medications are commonly used to treat the symptoms of colds, flu, and other respiratory infections. They often contain a combination of ingredients, such as decongestants, antihistamines, and antitussives, which can pose risks for COPD patients.

As mentioned previously, these ingredients can cause increased difficulty in breathing, thickening of mucus, and suppression of the cough reflex, which can exacerbate COPD symptoms and hinder effective mucus clearance from the lungs.

If you have COPD, it is important to carefully read medication labels and consult with your healthcare provider before using any over-the-counter cough and cold remedies.

Examples:

  • Nyquil
  • Theraflu
  • Robitussin

10. Alcohol

While alcohol is not a medication, its consumption can have negative effects on individuals with COPD, potentially exacerbating symptoms and compromising overall health.

As a central nervous system depressant, alcohol can lead to respiratory depression, causing slowed breathing and a decreased respiratory drive. This can be particularly dangerous for those with compromised lung function due to COPD.

Excessive alcohol consumption can also disrupt sleep patterns, leading to poor sleep quality, which in turn can worsen COPD symptoms.

Furthermore, alcohol can impair the immune system, making individuals more susceptible to respiratory infections, such as colds, flu, or pneumonia, which can significantly aggravate COPD.

Note: It is recommended that individuals with COPD limit alcohol consumption or avoid it altogether to maintain optimal lung health and effectively manage their condition.

Examples:

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

11. Nicotine

Nicotine, the primary addictive substance in tobacco products, is extremely harmful to individuals with COPD. Smoking cigarettes or using other tobacco products, such as cigars or smokeless tobacco, can cause significant damage to the lungs and worsen COPD symptoms.

Smoking causes inflammation and irritation in the airways, making it harder to breathe, and can also contribute to the progression of COPD.

Furthermore, nicotine replacement therapies like patches, gum, or e-cigarettes, while potentially helpful in smoking cessation, may still pose risks for COPD patients.

It is essential for individuals with COPD to quit smoking and discuss appropriate smoking cessation strategies with their healthcare provider.

Examples:

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

12. Sugar

While sugar is not a medication, it is an ingredient in many foods and beverages that can impact individuals with COPD.

High sugar consumption can lead to weight gain and obesity, which can worsen breathing difficulties and put additional strain on the respiratory system.

Additionally, a diet high in sugar can contribute to the development of chronic conditions like type 2 diabetes and cardiovascular disease, both of which can further complicate COPD management.

Furthermore, some studies have suggested that high sugar intake can cause inflammation in the body, which may exacerbate COPD symptoms.

Individuals with COPD are advised to maintain a healthy, balanced diet that is low in added sugars to help manage their condition effectively and support overall health.

Examples:

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

13. Oxygen

Believe it or not, oxygen is a drug. While supplemental oxygen therapy can be an essential treatment for individuals with advanced COPD who have low blood oxygen levels, it is important to follow your healthcare provider’s guidelines carefully.

Using too much oxygen or not adhering to the prescribed flow rate can lead to oxygen toxicity or suppression of the respiratory drive, resulting in shallow breathing or hypoventilation.

It is essential for individuals with COPD on oxygen therapy to closely monitor their oxygen levels and work with their healthcare provider to ensure the correct oxygen flow rate is being used to maintain optimal blood oxygen levels.

Examples:

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

Final Thoughts

Understanding which drugs and substances to avoid is essential for individuals with COPD to effectively manage their condition.

By being aware of the potential risks associated with certain medications, patients and healthcare providers can work together to tailor treatment plans that optimize patient well-being and minimize complications.

Remember: Every individual’s experience with COPD is unique, and what works for one person may not be suitable for another.

As such, it is essential to maintain open communication with your healthcare team to ensure that your treatment plan is tailored to your specific needs.

By staying informed and vigilant, you can take control of your COPD journey, better manage your symptoms, and ultimately enhance your quality of life.

John Landry, BS, RRT

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

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