As many as 11 million Americans live with chronic obstructive pulmonary disease (COPD). In its earlier stages, this life-long condition is often mistaken for other medical problems. In these cases, diagnosis and treatment may be delayed. But eventually, the symptoms of COPD worsen to the point where breathing is difficult. This drives many people to see their doctors immediately. People living with COPD are encouraged to quit smoking if they are smokers. Smoking cessation can often make symptoms more manageable. But if that’s not enough, doctors will likely prescribe daily maintenance medication to promote symptom relief and control the condition as much as possible. Maintenance medications are a mainstay of COPD treatment, and you have many options when determining just which medication is right for you. It can be confusing to know when you should start these types of COPD medications, however. That’s why it’s important to speak with your doctor about the severity of your symptoms and which, if any, other treatments you’ve tried in the past. How severe is your COPD? By its very nature, chronic obstructive pulmonary disease is a progressive condition. That means it gets worse over time. However, many people don’t recognize the signs and symptoms of COPD until the disease is in a later stage. You may think you’re just short of breath, or that the breathing changes you’re experiencing are simply a result of aging. Doctors use a specific test, called spirometry, to help determine which stage of COPD you may have. During this test, you blow all the air out of your lungs into a mouthpiece. The mouthpiece is connected to a spirometer, a special machine that obtains two measurements: how much air you can forceably exhale in one second and the amount of air you exhale in six seconds or more. The results of your spirometry test can help your doctor tell how severe your COPD is. The severity of your symptoms is also a good indication of how advanced the disease is. People living with moderate to severe COPD often live with symptoms that include: Chest tightness Chronic cough producing excess mucus Fatigue Frequent respiratory infections Shortness of breath, especially during exertion Unintended weight loss Wheezing When should you start COPD maintenance medications? In general, doctors recommend starting daily COPD maintenance medications when the condition noticeably interferes with your breathing ability. Even if you only experience occasional shortness of breath and wheezing, your doctor may decide maintenance medications are your best bet for controlling COPD as much as possible. Additionally, maintenance medications may be recommended if your symptoms worsen and you’ve already tried other therapies, such as pulmonary rehabilitation. Pulmonary rehabilitation programs help you increase your fitness level and learn to control the symptoms of COPD, like shortness of breath, so you can enjoy normal daily activities. There are many types of maintenance medications prescribed for COPD. It may take time to figure out which medications work best for you. Many people living with COPD take a combination of maintenance medications, including: Bronchodilators: These medications help the muscles surrounding your airways relax. Long-acting bronchodilators, usually found in COPD inhalers, are taken every day to help make breathing easier. Inhaled steroids: Certain medications, called corticosteroids, help reduce and prevent inflammation inside your airways. Theophylline: Doctors have prescribed theophylline for years in the treatment of COPD and other conditions that make breathing difficult. This drug relaxes airways, helping them to open and preventing symptoms such as shortness of breath, wheezing, and chest tightness. Phosphodiesterase-4 inhibitors: This new class of maintenance drugs helps to relax airways and prevent inflammation. In most cases, these medications are reserved for people living with severe COPD. Controlling COPD may seem difficult, but with your doctor’s help, it’s possible to find an effective way to manage your condition. Keep in mind, determining when to begin COPD maintenance medications isn’t a one-size-fits-all solution. Your individual treatment course will depend on the severity of your symptoms and medical history. Fortunately, a variety of COPD medications are available to provide you with the symptom relief you need.