What drugs should someone take (and avoid) when they have a history of COPD?

The following are medications you may want to take (or avoid) if you have a history of chronic obstructive pulmonary disease (COPD):

• Butrans: If you have COPD, you should not take Butrans; work with your doctor to find a different painkiller to treat your pain.
  Butrans (buprenorphine), an opioid seven-day patch for the treatment of moderate to severe chronic pain, is a narcotic that depresses breathing. That makes it particularly dangerous for people with lung diseases such as COPD. If you have COPD, taking Butrans can lead to conditions such as apnea, in which you have episodes in which you stop breathing. If there are no suitable alternate painkillers and your doctor does prescribe Butrans, he or she may start you on a lower-than-normal dose and monitor your breathing carefully.
• Buprenex: If you have a history of COPD, your doctor will be cautious about giving you Buprenex (buprenorphine). This drug, which is a powerful narcotic that's given by injection to relieve pain, can interfere with normal breathing. This could be dangerous for someone who has a respiratory illness. If your doctor decides to give you Buprenex, he or she will likely lower the typical dosage to help prevent breathing problems.
• Percodan: If you have COPD ask your doctor if you can take Percodan, a strong pain reliever that is a combination of oxycodone and aspirin. Experts say people generally shouldn't use Percodan if they have respiratory trouble, such as COPD or asthma, because opioid medications like oxycodone can make breathing shallow or slow. This can be dangerous, and the danger can be magnified for people who already have breathing problems.
• Actiq: You may be able to use the cancer-pain medication Actiq (fentanyl) if you have a history of COPD, but your doctor may need to monitor you carefully. Actiq can cause breathing problems, which is a particular concern for someone with COPD, an umbrella term for chronic lung problems such as chronic bronchitis or emphysema. If you have COPD and need treatment for breakthrough cancer pain (that is, pain episodes that occur even though you're regularly taking another pain medication), your doctor will evaluate whether it makes sense for you to use Actiq. If you do, he or she will monitor your lung function carefully while you use it.
• Avinza: You shouldn't take the painkiller Avinza (morphine) if you have acute or severe asthma; COPD, including emphysema or chronic bronchitis; sleep apnea; difficulty breathing; or other lung problems. If you have one of these conditions, Avinza could make you stop breathing.
• Embeda: If you have COPD, you should work with your doctor to find an alternative to Embeda (morphine and naltrexone), a time-release form of morphine for treatment of moderate to severe chronic pain. In fact, you should seek a different class of painkiller entirely. The morphine in Embeda is an opioid, and all opioids depress the central nervous system, which can affect breathing. This can be dangerous, even fatal, if you have a lung disease such as COPD.
• Fentora: A history of COPD doesn't necessarily bar you from using Fentora (fentanyl), a morphine-like drug for breakthrough cancer pain. However, your doctor will probably monitor your dose and your reaction to the medicine carefully, because your history of COPD does increase your risk for one of Fentora's most serious side effects—a potentially life-threatening slowdown in your breathing.
• Lazanda: A history of COPD doesn't necessarily mean you should not use the pain medication Lazanda (fentanyl). However, your doctor will probably monitor your dose and your reaction to the medicine carefully, because having had COPD increases your risk of a serious side effect of Lazanda—a potentially life-threatening slowing of your breathing.
• Magnacet: Don't take the prescription pain medication Magnacet (oxycodone and acetaminophen) if you have COPD, such as emphysema and chronic bronchitis. Because Magnacet lowers your breathing rate, it can severely interfere with your ability to breathe if you have COPD.
• Nucynta: Your doctor may not want you to take the pain medication Nucynta (tapentadol) if you have COPD, which includes emphysema and chronic bronchitis. Nucynta can interfere with your ability to breathe—and even cause you to stop breathing altogether—if you have compromised lung function. Be sure your doctor knows about your condition before you start taking Nucynta.
• Opana: It's likely your doctor will not prescribe the pain medication Opana (oxymorphone) for you if you have COPD. Because Opana slows your breathing rate, it may worsen your ability to breathe if you have COPD, an umbrella term for serious breathing problems including emphysema and chronic bronchitis. If your doctor wants to prescribe Opana for you, make sure that he or she knows about your COPD.
• Tylox: If you have a history of COPD, which includes emphysema and chronic bronchitis, your doctor likely will be cautious about prescribing Tylox (acetaminophen and oxycodone) for you. This drug, which is used to treat moderate to moderately severe pain on an as-needed basis, contains oxycodone, an opioid (narcotic) pain reliever. Like many other opioids, oxycodone can slow respiration, which could be dangerous for someone who already has breathing problems.