Common side effects of the following medicines used to treat COPD include:

• Inhaled corticosteroid (ICS): dysphonia, oral candidiasis, increased risk of pneumonia, increased risk of fracture, muscle wasting
• Long-acting muscarinic antagonist (LAMA): glaucoma, urinary retention, dry mouth, potential contribution to anticholinergic burden
• Long-acting beta₂ agonists (LABA): tremor, hypokalaemia, palpitations (especially if overused)
• Oral corticosteroids: adrenal suppression, raised blood glucose levels, mood changes, increased risk of pneumonia, osteoporosis, gastrointestinal ulceration, cataracts.

This is not an exhaustive list and the summary of product characteristics of individual medicines should be referred to for further information.

The oropharyngeal deposition of inhaled medicines can be minimised by ensuring use of a spacer with pressurised metered dose inhaler (pMDIs). Correct inhaler technique is also important and pharmacy professionals should take every opportunity to check this with patients and help them to optimise it where necessary.