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Two combinations of an inhaled corticosteroid with an inhaled long-acting beta2-agonist are approved by the FDA for use in patients with COPD: fluticasone/salmeterol (Advair Diskus) and budesonide/formoterol (Symbicort). A Medical Letter reader has questioned the safety of using corticosteroid inhalers in patients with this disorder. No single-agent inhaled corticosteroid inhaler is approved for this indication.
STANDARD TREATMENT — Patients with mild, intermittent symptoms of COPD are generally treated with inhaled bronchodilators, usually a short-acting beta2-agonist such as albuterol (Proventil, and others), a short-acting anticholinergic such as ipratropium (Atrovent HFA, and others), or sometimes both (Combivent). When symptoms become more severe or persistent, many experts prescribe a long-acting beta2-agonist such as salmeterol... more