Medically Reviewed and Compiled by Dr. Adam N. Khan, MD.

Quick Answer: Staying Safe with Your COPD Inhaler

Inhalers are the most important tools for managing COPD. While they are very safe because they send medicine directly to your lungs, they can still cause side effects. Common issues include a dry mouth, shaky hands, or a sore throat. Some people may also get a mild mouth infection called thrush if they use steroid inhalers. Serious warnings include a higher risk of pneumonia or heart palpitations for some users. The best way to stay safe is to use a spacer and always rinse your mouth after using a “preventer” (steroid) inhaler.

Understanding COPD Inhaler Side Effects and Warnings

If you have Chronic Obstructive Pulmonary Disease (COPD), your inhaler is likely your best friend. It helps you breathe better and keeps you out of the hospital. However, like any medicine, inhalers can have side effects. Knowing what to watch for helps you stay in control of your health.

In 2026, medical experts still agree that the benefits of using an inhaler far outweigh the risks. Because the medicine goes right into your airways, your body absorbs much less of it compared to taking a pill. This means fewer side effects for your whole body.

Common Side Effects by Inhaler Type

Not all inhalers are the same. Your side effects will depend on which type of medicine is inside your device.

1. Bronchodilators (The “Openers”)

These inhalers relax the muscles around your airways to make breathing easier. They come in short-acting (rescue) and long-acting versions.

Shaky Hands (Tremors): You might feel a bit jittery or notice your hands shaking. This is very common with “Beta-agonist” inhalers like Albuterol.
Fast Heartbeat: You may feel like your heart is racing or “pounding” in your chest for a short time after a puff.
Dry Mouth and Throat: This is common with “Antimuscarinic” inhalers. It can feel like you always need a sip of water.

2. Steroid Inhalers (The “Preventers”)

These help reduce swelling in your lungs. They are often used by people who have frequent “flare-ups” or also have asthma.

Oral Thrush: This is a yeast infection in the mouth. It looks like white spots on your tongue or throat. It can be sore, but it is easy to treat.
Hoarseness: Your voice might sound raspy or weak.
Bruising: Long-term use of high-dose steroids can make your skin thinner, leading to easier bruising.

Important Medical Warnings

While most side effects are mild, there are some serious warnings you should discuss with your doctor.

Pneumonia Risk: Some studies show that people using inhaled steroids have a slightly higher chance of getting lung infections like pneumonia. If you notice a fever or a change in your mucus color, call your doctor.
Bone Health: Using high doses of steroids for many years might weaken your bones (osteoporosis). Your doctor may suggest taking Vitamin D or Calcium to help.
Eye Problems: In rare cases, long-term use can increase the risk of glaucoma or cataracts. Regular eye exams are a good idea if you are on maintenance inhalers.
Heart Conditions: If you have an irregular heartbeat or high blood pressure, some bronchodilators need to be used with extra care.

3 Simple Ways to Prevent Side Effects

You can stop most side effects before they even start by following these three steps:

Use a Spacer: A spacer is a plastic tube that attaches to your inhaler. It catches the large drops of medicine that would normally hit the back of your throat (causing thrush and hoarseness) and helps the fine mist get deep into your lungs instead.
Rinse and Spit: If your inhaler contains a steroid, always rinse your mouth with water and spit it out after every use. Never swallow the rinse water!
Check Your Technique: Even if you have used an inhaler for years, it is easy to pick up bad habits. Ask your pharmacist or nurse to watch you use it once a year to make sure the medicine is actually getting to your lungs.

When to Call Your Doctor

Most side effects go away as your body gets used to the medicine. However, you should seek medical help immediately if you experience:

A sudden “closing” of your throat or hives (allergic reaction).
Severe chest pain or a heart rate that won’t slow down.
Vision changes or sudden eye pain.
A cough that gets much worse after using the inhaler.