COPD: how to organise your inhalers and tablets day to day
How to tell your maintenance inhaler from your reliever, fit inhalers and tablets into your routine and look after your technique if you have COPD.
In short
- In COPD, your maintenance inhaler is used every day, even when you feel well; your reliever inhaler only when you are short of breath.
- If you need your reliever inhaler often, tell your doctor: it may be a sign that your treatment needs reviewing.
- Good inhaler technique matters as much as the medicine itself; ask for it to be checked at every visit.
- Stopping smoking, getting vaccinated and staying active are as much a part of treatment as your medicines.
Organising your COPD (chronic obstructive pulmonary disease) medication well starts with telling apart two types of inhaler: the maintenance inhaler, used every day at the same time even when you have no symptoms, and the reliever inhaler, used only when you are short of breath. From there, it is about fitting inhalers and tablets into your routine and looking after your technique.
If you also take medicines for other conditions, such as blood pressure or cholesterol, having a clear system helps you avoid missed doses and mix ups.
| What will you find in this article? |
Which medicines are used in COPD?
The core of treatment is long acting inhaled bronchodilators, which keep the airways open for many hours. According to the Basque Government's INFAC bulletin (2025), they are the mainstay of treatment for stable COPD, and everyone with COPD also needs a short acting bronchodilator to relieve occasional breathlessness.
| Type | What it is for | When it is used |
|---|---|---|
| Long acting bronchodilators (LABA and LAMA), alone or combined | Keeping the airways open and reducing symptoms | Every day, at the prescribed time |
| Inhaled steroids, combined with the above | Reducing flare ups in some people | Every day, only if your doctor prescribes them |
| Short acting bronchodilator (reliever) | Relieving breathlessness there and then | Only when you need it |
| Tablets such as theophylline or mucolytics | Opening the airways or making phlegm thinner | As your doctor prescribes |
| Oral steroids or antibiotics | Treating a flare up or an infection | Short courses, when the doctor prescribes them |
The NHS notes that theophylline may require regular blood tests to check its levels. Your specific treatment depends on your symptoms and flare ups, and your doctor decides it.
How do you tell the maintenance inhaler from the reliever?
The maintenance inhaler is used every day even when you breathe well; the reliever only when you feel short of breath. MedlinePlus stresses that control medicines should be taken even when you feel well and makes clear that they are not for treating flare ups.
- Keep each inhaler in a different place: the maintenance one next to your morning or evening routine, and the reliever always with you.
- If they look alike, label them "every day" and "only if breathless".
- Note how often you use the reliever. According to INFAC, if you use it frequently your doctor should consider adjusting your regular treatment, and shaking or palpitations may indicate you are overusing it.
- Check the dose counter and request your prescription before it runs out.
How do you fit inhalers and tablets into your day?
Link each dose to a fixed habit, such as breakfast or brushing your teeth, and keep a visible list of what to use and when. The fewer different devices and times you have, the easier it is to stay on track.
- Rinse your mouth: if you use an inhaled steroid, MedlinePlus advises rinsing with water, gargling and spitting after each use. Doing it just before brushing your teeth is a good way not to forget.
- Few devices: INFAC notes that using a single device may be more convenient than several. If you have different types of inhaler and get confused, mention it to your doctor.
- Technique matters: according to INFAC, the choice of device is as important as the choice of medicine, and poor technique or low adherence are linked to worse outcomes. Ask your pharmacist or nurse to check how you use it.
- Tablets separately: organise the rest of your oral medication by dose time, in a pill organiser or prepared by the pharmacy.
To go over the most common inhaler mistakes, read common inhaler mistakes in COPD.
What else is part of treatment?
Medicines are only one part. INFAC points out that non drug treatment should always go alongside drug treatment and that stopping smoking is the main measure to prevent and treat COPD.
- Stopping smoking: the NHS describes it as the most effective way to stop COPD getting worse. Your health centre can help.
- Vaccines: INFAC recommends completing the immunisation schedule, which currently includes pneumococcus, COVID and flu. Check which vaccines are recommended in your region.
- Physical activity: staying active helps you keep your ability to do things without getting breathless.
- Pulmonary rehabilitation: exercise and education programmes, mainly considered if you have more symptoms or flare ups.
A practical example: Antonio's daily routine
Let us take the example of Antonio, 66, recently retired and a former smoker. He has COPD and uses a maintenance inhaler with two bronchodilators and a reliever inhaler. He also takes a tablet for blood pressure and another for cholesterol. At first he mixed up the inhalers and sometimes forgot his morning one.
With his nurse and pharmacist he organises his day like this (it is an illustrative example; each schedule is set by the doctor):
| When | What Antonio does |
|---|---|
| On getting up, before brushing his teeth | Maintenance inhaler, kept next to his toothbrush. |
| Breakfast | Blood pressure tablet, prepared by dose time. |
| During the day | Reliever inhaler in his pocket; he notes on his phone each time he uses it. |
| Dinner | Cholesterol tablet, prepared by dose time. |
| Once a month | He checks the inhaler counter and requests a prescription if it is running low. |
At his next review, he brings his reliever log and asks for his technique to be checked. Antonio feels more confident because he always knows what is due.
How can IMA Health help you?
If you take several tablets as well as your inhalers, having them prepared by day and time of each dose leaves you more attention for what needs technique, such as your inhalers, which are used separately. At IMA Health we coordinate with a specialised pharmacy that prepares your oral medication in a personalised dosage system, we deliver it to your home and we provide personalised follow-up.
You can learn more about this system in what an SPD is.
Sources
- Basque Government Department of Health: INFAC, Drug treatment of COPD (vol. 33, no. 4, 2025, in Spanish)
- MedlinePlus: COPD control medicines (in Spanish)
- NHS: Chronic obstructive pulmonary disease (COPD), treatment
This article is for information only and does not replace advice from your doctor or pharmacist.