Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.

Evidence: GOLD 2026 · sources last checked 2026-08-20

Reference tool — not medical advice. Thresholds, targets, and first-line agents differ by guideline body and change over time — switch the lens to compare. Clinician judgement, dosing/monitoring, contraindications, and live coverage always required. Runs entirely in your browser — no data is collected.

COPD inhaler selector

Choose the guideline lens (GOLD / CTS / NICE), the symptom burden, exacerbation history and blood eosinophils — get the group, the ICS decision and the recommended inhaler regimen. The lenses disagree on ICS: GOLD gates it on eosinophils; CTS does not.

Guideline lens

Symptom burdenchoose one

mMRC or CAT

Exacerbations in the past yearchoose one

Blood eosinophils (cells/µL)choose one

2–3 stable readings; GOLD gates ICS on this, CTS does not

Current therapychoose one

Comorbidity

GOLD group

A (low symptom, low risk)

ICS decision

ICS not indicated — LABA+LAMA

GOLD gates ICS on eosinophils (≥300, or 100–299 with frequent/severe exacerbations or asthma)

Recommended regimen

Single long-acting bronchodilator (LAMA or LABA)

Notes

  • • Never treat COPD with a short-acting bronchodilator (SABA) alone as maintenance — use a long-acting bronchodilator.
  • • GOLD 2026 lowered the Group E bar to ≥1 moderate OR severe exacerbation (from ≥2 / hospitalization) — a change some argue risks overtreatment from a single moderate exacerbation. Blood eosinophils gate the ICS decision.
  • • Match the inhaler DEVICE to the patient (DPIs need adequate inspiratory flow; a soft-mist inhaler or spacer helps frail/elderly patients) and confirm technique at every visit.

Suggested drug classesPer GOLD 2026.

Enter symptom burden and exacerbation history to begin.

Switch the lens to see how the ICS decision changes: GOLD (eosinophil-gated) vs CTS (eosinophil-agnostic, by exacerbation risk) vs NICE (asthmatic-features branching).

Guidelines

References

  1. [1]GOLD. Global Strategy for Prevention, Diagnosis and Management of COPD — 2026 Report (ABE groups; eosinophil-guided ICS; Group-E threshold lowered to ≥1 moderate/severe exacerbation). link
  2. [2]Bourbeau J, et al. Canadian Thoracic Society Guideline — Pharmacotherapy in Patients with Stable COPD (2023 update; eosinophil-agnostic ICS by exacerbation risk; mortality-benefit claim). link
  3. [3]NICE NG115 — Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2018/2019; asthmatic-features branching; protocolized azithromycin). link