CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Chronic obstructive pulmonary disease - Management
What inhaled treatments should I offer a person with COPD whose FEV1 is less than 50% predicted?
- If the person is breathless and has exercise limitation:
- If the person prescribed a SABA or SAMA remains breathless or has exacerbations, offer either of the following:
- A SABA (as required) may be continued at all stages.
- If the person remains breathless or has exacerbations despite treatment with a LABA plus an ICS or a LAMA alone:
- Treat with triple therapy: a LABA plus an ICS (in a combination inhaler) and a LAMA.
- For an algorithm on the use of inhaled treatments, see the NICE quick reference guide.
- Consider using a mucolytic or theophylline (methylxanthine).
© NHS Institute for Innovation and Improvement