Questions about Inhalers

This article was reviewed by Senior Director of Community Engagement and COPD360social Community Manager, Bill Clark, as well as certified staff Respiratory Therapists on January 31, 2020.

Dear COPD Coach,
I have a question on taking medications. I use a powdered inhaler twice a day and use a rescue inhaler throughout the day. My hardest time breathing is in the morning, but I am afraid that I am not able to breathe deeply enough to make the powdered inhaler effective when I first wake up. I also have to bring up a lot of mucus in the morning, and I am afraid that all the medications are doing is coating the mucus. Do you have any suggestions?


Dear Perplexed,

The one thing that is true about COPD is that it is not the same for all patients. Many COPD patients experience problems breathing in the morning, while others tend to have worsening symptoms later in the day. If you have a bronchitis component to your COPD, you might well be experiencing mucus plugs in the morning that restrict your breathing.

If this is the case, you should discuss this with your doctor. I also experience mucus plugs after awakening, and it seems at this time is when I need the medications most. Mucus plugs are when the mucus you produce gathers in one area blocking your airway. You are also correct in assuming that the mucus you are experiencing might well be restricting the medicines. When you are out of breath to begin with, it is hard to generate enough strength to inhale the powdered inhaled deep enough to be effective.

What I generally do is try to time taking my dry inhalers to the time they would be most effective. Instead of taking my medications first thing when I get out of bed, I take them a little later in the morning when I have cleared some of the mucus. I am still taking them as directed (once every 12 hours). The first order of business might well be to clear as much of the mucus as possible before taking your meds. Talk with your doctor about what methods and devices for mucus removal might be most effective. Drinking lots of water first thing in the morning often helps to thin the mucus making it easier to expel. There are also medications available that will help move the mucus more easily.

Once you have the mucus under control, you will have an easier time inhaling the powdered medication. You doctor might also suggest using your mist inhalers first to help open your airways to allow for more effective use of your other medication. Another trick to get rid of the mucus is to drink something very cold followed by something very hot. The theory is related to expansion and contraction, and in my case, it seems to work!

Best regards,
The COPD Coach

Coaches Corner is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to The COPD Coach.


You need to login to comment.
  • I would like to know about medications to help mucus mobilization.
    Could you provide some suggestions?
    • Hydration and Guaifinesen. I take 400 mg twice daily. If conditions deteriorate I will take 400 mg every four hours. Harold B
  • I use a nebulizer four times a day. I also use a powdered inhaler once a day and an inhaled corticosteroid twice daily. My pulmonologist suggested using the nebulizer first, expel any loosened mucous, then use my inhalers. He informed me that this is the best way to get the medications as deeply into my lungs as possible to ensure the most benefit.
    • I agree with the coaches. Until I had my first exacerbation I had no clue that drinking water diluted the mucus. When I went into the hospital I had 0 lung capacity and stayed in the hospital for 3 weeks. I thought I was going to die. It was so scary. To top it off it caused me to have a panic and anxiety attack. I was coughing like crazy trying to get this goop up and when I did it was just like glue. I didn't like water and drank mainly soda once or twice a day. When my body needed water it would tell me. Anyway, Now I drink lots of water but I still can't bring myself to drink tap water. So I buy spring water and I love it. I don't go any where without my water. I found out eating and or drinking sugary products thickens your mucus. No more soda for me only water!
  • I do nebulizer treatments at 8AM, 2PM and 8PM every day: Spiriva &Symbicort both BEFORE my morning nebulizer and then Symbicort in the evening before my 8PM nebulizer. Also I was given 2 simple Breather exercise tools by the Therapists who helped me rehab following a near fatal fall in my pulse ox numbers. I am able to keep my lungs cleared out with a minimum of work and even though I am on oxygen 24/7 I am only on 2 and have a good quality of life-STAY Hydrated all the time too.