COPD (chronic obstructive pulmonary disease)

Managing COPD flare-ups

A flare-up – sometimes called an exacerbation – is when your symptoms become particularly severe.

The signs of a flare-up are:

  • your breathlessness gets worse
  • you cough more
  • you produce more sputum
  • a change in the colour and consistency of your sputum

A flare-up might be triggered by an infection or there may be no apparent reason.

You should have an action plan that you’ve agreed with your health care professional so you know what to do if you have a flare-up. Your plan may include a rescue pack of drugs (antibiotics and steroid tablets) that you keep at home.

Make sure you know when:

  • you should start to take steroid tablets
  • you should start to take antibiotics. This will usually be if you notice that as well as being more breathless, you’re producing more sputum than usual or it has changed colour
  • to make changes to how you take your bronchodilator medicine – such as increasing the dose or changing how you take it – to help with your symptoms

Remember to tell your doctor or nurse if things don’t improve within two days of starting the drugs you keep at home.

Most people can be treated at home if they have a flare-up, but you may need to go to hospital depending on how severe your symptoms are. If you use the ambulance service, make sure to say you have COPD, so you get the right oxygen treatment.

If you have more than two flare-ups in one year that require your rescue drugs, get a review with your GP or nurse.

It may be a good idea to get some specimens of your sputum analysed to see if you have an unusual or resistant infection. These can include pseudomonas and atypical mycobacterial infections.

Your doctor may order a scan of your chest to see if there is an area of damaged lung that makes you more susceptible to infections.

If you are susceptible to these infections, make sure you act very quickly when you have a flare-up and be aware your usual rescue drugs may not be effective. Sometimes people who have frequent chest infections benefit from taking regular antibiotics. This is usually started by specialist teams.

Flare-up checklist

Symptoms may include:

  • Getting more out of breath
  • More sputum, change in colour (is it green, brown, or yellow?)
  • Increased chesty cough
COPD flare up symptoms graphic

What can I do?

  • Continue or increase my inhaler or nebuliser treatment
  • Start my rescue pack drugs
  • Keep calm and do my breathing exercises
COPD flare up what can I do graphic

I must remember...

  • Contact my nurse or doctor, or the community respiratory team
  • If symptoms are severe, call 999
COPD flare up I must remember graphic

Hospital at home schemes

In some areas of the country, people with COPD can be treated at home when they have a flare-up.

These local hospital at home schemes provide medication and visits by a specialist team. This means you can recover at home where you might feel more comfortable and can be more active when you feel ready.

If you would prefer to be treated at home, speak to your doctor or nurse.

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Last medically reviewed: September 2016. Due for review: September 2019

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.