Reduced lung function as a result of COPD can cause one or more of the following signs and symptoms:

  • Shortness of breath
  • Coughing
  • Mucus (sputum) production
  • Wheezing and chest tightness

Over time, most people living with COPD develop many of the signs and symptoms listed above.

COPD Flare-ups

People with COPD may also experience “flare-ups” or “exacerbations.” A COPD flare-up is a worsening over several days of your COPD symptoms like shortness of breath, coughing, mucus (sputum) production, wheezing, and chest tightness. Typically, oral steroids (like prednisone), antibiotics, and/or hospitalization may be needed to help your breathing. COPD flare-ups are often triggered by a bacterial infection or a virus. They can also be caused by pollutants or unknown factors. It’s important that you understand and recognize the signs and symptoms of a flare-up and call your doctor if you’re experiencing one.

Examples of COPD flare-up symptoms you may experience:

  • A change in the amount of mucus—either bringing up more or less than usual
  • A change in the color of your mucus from clear to deep yellow, green, brown, or red
  • Increasing shortness of breath
  • More coughing or a change in your cough

Daily COPD management is important to help prevent future flare-ups before they start. No matter how many flare-ups you’ve experienced, it’s important to talk to your doctor about how you can manage them.

BREO is not a rescue medicine and should not be used to treat sudden symptoms of COPD.

Learn about the difference between chronic bronchitis and emphysema.


  • People with asthma who take long-acting beta2-adrenergic agonist (LABA) medicines, such as vilanterol (one of the medicines in BREO), have an increased risk of death from asthma problems.


  • People with asthma who take long-acting beta2-adrenergic agonist (LABA) medicines, such as vilanterol (one of the medicines in BREO), have an increased risk of death from asthma problems.
  • Call your healthcare provider if breathing problems worsen over time while using BREO.
  • Get emergency medical care if your breathing problems worsen quickly, or if you use your rescue inhaler but it does not relieve your breathing problems.
  • Do not use BREO to relieve sudden breathing problems. Always have a rescue inhaler with you to treat sudden symptoms.
  • Do not use BREO if you have a severe allergy to milk proteins or are allergic to any of the ingredients in BREO. Ask your healthcare provider if you are not sure.
  • Do not use BREO more often than prescribed.
  • Do not take BREO with other medicines that contain a LABA for any reason. Tell your healthcare provider about all the medicines you take and about all of your health conditions.
  • BREO can cause serious side effects, including:
    • fungal infection in your mouth or throat (thrush). Rinse your mouth with water without swallowing after using BREO to help reduce your chance of getting thrush.
    • pneumonia. People with COPD have a higher chance of getting pneumonia. BREO may increase the chance of getting pneumonia. Call your healthcare provider if you notice any of the following symptoms: increase in mucus (sputum) production; change in mucus color; fever; chills; increased cough; increased breathing problems.
    • weakened immune system and increased chance of getting infections (immunosuppression). You should avoid exposure to chickenpox and measles, and, if exposed, consult your healthcare provider without delay. Worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infections, or herpes infection of the eye may occur.
    • reduced adrenal function (adrenal insufficiency). This can happen when you stop taking an oral corticosteroid (such as prednisone) and start taking a medicine containing an inhaled corticosteroid (such as BREO). During this transition period, when your body is under stress such as from fever, trauma (such as a car accident), infection, surgery, or worse COPD symptoms, adrenal insufficiency can get worse and may cause death. Symptoms include: feeling tired; lack of energy; weakness; nausea and vomiting; low blood pressure.
    • sudden breathing problems immediately after inhaling your medicine. If you have sudden breathing problems immediately after inhaling your medicine, stop taking BREO and call your healthcare provider right away.
    • serious allergic reactions. Call your healthcare provider or get emergency medical care if you get any of the following symptoms of a serious allergic reaction: rash; hives; swelling of your face, mouth, and tongue; breathing problems.
    • effects on heart: increased blood pressure; a fast or irregular heartbeat, awareness of heartbeat; chest pain.
    • effects on nervous system: tremor; nervousness.
    • bone thinning or weakness (osteoporosis).
    • eye problems including glaucoma and cataracts. You should have regular eye exams while using BREO.
    • changes in laboratory blood values (sugar, potassium).
  • Common side effects of BREO 100/25 for COPD include:
    • runny nose and sore throat
    • upper respiratory tract infection
    • headache
    • thrush in your mouth or throat. Rinse your mouth with water without swallowing after use to help prevent this
    • back pain
    • pneumonia
    • bronchitis
    • inflammation of the sinuses
    • cough
    • mouth and/or throat pain
    • joint pain
    • high blood pressure
    • flu
    • fever

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit, or call 1-800-FDA-1088.