Hey, Bob! Army VN vet here...or as my USMC buddy says, "that's an anacronym for Aren't Real Marines Yet". As far as "the best", I think you just gotta recon what's out there 'til you find something that works better than whatever else you've been using. Stiolto (tiotropium and olodaterol) has consistently worked for me. I belong to another online support group, also, called "StuffThatWorks", you've got to dig around to find the COPD group there, but lots of good info, and I learned that I wasn't the only one with voice issues from inhaling steroids. Keep yer powder dry, Marine, and thanks for reaching out to me. // CapnJack

Hi semperfibob16 - I tried different inhalers over the past 6 years. They all contained a steroid, and yes, within the first 2 weeks, I was hoarse. I did a lot of research on it, because initially it looked like this was a coincidence. It's not. Research is finally showing that well over 50% of us who use ICS inhalers become hoarse. I did everything 'right' - rinsed my mouth thoroughly, including using an herbal antifungal - no help. Not a Marine Corp Vet :-), but I was a singer and still love to sing, even with my 75 year old vocal chords (and its good for us too), so I finally asked my pulmo if we could try and inhaler without the steroid. Since I was aready on Trelegy at the time, I switched to Anoro, which is basically Trelegy without the steroid. After 6 month 'trial', the numbers on all of my pulmo tests remained basically the same. And the hoarseness was gone! This may not work for everyone - we are all different. Some of us do much better with the steroid component added. But it's worth a try. What's the worst that can happen? - You go back onto your inhaled steroids... All the best to you! And thank you for your service.