Common over-the-counter medications used for COPD management at home

The most common over-the-counter (OTC) medications that may be used for at-home management of chronic obstructive pulmonary disease (COPD) are short-acting beta-agonist (SABA) inhalers such as albuterol (available without prescription in some regions), and expectorants such as guaifenesin. However, the clinical benefit of guaifenesin in COPD is unproven, and it is not recommended as a primary therapy for symptom control or exacerbation prevention.

The American College of Chest Physicians and Canadian Thoracic Society guidelines emphasize that inhaled bronchodilators are the mainstay of therapy, and oral or OTC agents play a limited role in evidence-based management.[1-3]

Other OTC agents, such as oral theophylline, are not recommended due to limited efficacy and increased risk of adverse effects.[2][4] Mucolytics like N-acetylcysteine are used in some countries but are not widely available OTC in the United States and have limited supporting evidence for routine use.[1][3] Antitussives and antihistamines are not recommended for COPD management.[2]

The following algorithm from the New England Journal of Medicine visually summarizes the pharmacologic approach to COPD, highlighting that first-line therapies are prescription inhaled bronchodilators, with OTC medications playing a minimal role in guideline-based care.