A number of long-acting bronchodilators are now available as fixed-dose combination inhalers for treatment of patients with COPD. What is their place in therapy and what common prescribing mistakes should be avoided?
Inhaled long-acting bronchodilators have long been used in the management of chronic obstructive pulmonary disease (COPD), either as monotherapy (e.g. tiotropium) or in combination with inhaled corticosteroids (e.g. eformoterol plus budesonide, salmeterol plus fluticasone and vilanterol plus fluticasone). The number of long-acting bronchodilators available has expanded considerably in recent years, with a variety of new long-acting muscarinic antagonists (LAMAs) and long-acting beta-2 agonists (LABAs) approved by the PBS for use in patients with COPD. Although additional medications give additional choices to prescribers, they also bring added complexity and a need to understand which inhalers can and cannot be used in combination.
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