<s>[INST] I have copd. I was on symbicort 2puffsmorning and 2 puffs evening. Along with Tudorza 1 puff morning 1 puff evening. Due to cost I ask doctor to see if I could get cheaper. I m trying spiriva once daily. With qvar 80 once a day. I started out spiriva in am it only lasts 4 hours at most. So have switched to evening. I have started cheating with at least one puff if symbicort especially if I leave the house. I tried advair and second day my voice leaves me. There is a new product breo inhaler would it be worth trying. I don t smoke anymore. I have oxygen at home. Do you think there might be a pill we could take [/INST] Hello dear, thanks for your question on HCM. I can understand your situation and problem. COPD (chronic obstructive Pulmonary disease)  is chronic, progressive obstructive disease of the airway. It is incurable. Inhaled treatment is the first line therapy for COPD. And if patient is not improving or controlled with Inhaled treatment then we can add oral bronchodilators too. Oral bronchodilators are theophylline group. Acebrophyllin and doxophyllin are commercially available. Since both are prescribed drugs, you need doctor's prescription for them. You should also enroll yourself in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercises are done. These will  improve your lung function and decrease the symptoms. So consult pulmonologist and discuss all these. </s>