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Drugs and Treatment for Asthma

By Ann Wu, M.D., M.P.H. ; Updated August 14, 2017

Asthma is a chronic illness without a cure, however, good asthma management can allow an individual with asthma to live a normal, active life with few symptoms. The goal of asthma treatment is to reduce asthma symptoms and minimize the risk of asthma attacks. Asthma management includes medications and non-medication therapies and strategies.

What Medications are Used to Treat Asthma?

There are two major types of medicines used to treat asthma: controller medications, which help achieve long-term control and are meant to be taken daily, and rescue medications, which are meant for quick-relief of asthma symptoms. Many people confuse their controller medication with their rescue medication, so it is important to ask your health care provider for clarification. I suggest writing “controller” on your controller medicine and “rescue” on your rescue medicine.

Asthma medicines can be taken in oral form (either by pill or liquid) or by using a device called an inhaler. In order to ensure that inhaled medicine goes directly into your lungs, your doctor will show you how to use the inhaler correctly. He or she will most likely give you a spacer or AeroChamber that attaches to your inhaler in order to ensure the medicine gets into your lungs rather than into your mouth or back of the throat.

It’s important to take your medications as prescribed. It is easy to forget to take controller medications for asthma when you are feeling well. If your doctor prescribed a controller medication, develop a way to remember to take the medication daily, such as by putting it next to your toothbrush or setting a reminder alarm.

What Are the Controller Medicines?

Inhaled corticosteroids are the most commonly used controller medications for asthma. Examples include fluticasone (Flovent), budesonide (Pulmicort), beclomethasone (Beclovent, Qvar, Vanceril) or mometasone (Asmanex). Clinical trials suggest that inhaled corticosteroids are the most effective medications to decrease the inflammation and swelling in the airways, which causes asthma attacks. Decreasing inflammation in the airways with inhaled corticosteroids prevents asthma symptoms.

Inhaled corticosteroids are generally safe when taken as prescribed, however, every medication has some side effects in certain people. In general, the benefits of taking inhaled corticosteroids for preventing asthma symptoms and attacks are greater than the risk of side effects. Side effects from inhaled corticosteroids include a mouth infection called thrush, which is a condition that can be treated. The chances of thrush occurring can also be decreased with the use of a spacer or AeroChamber. Rinsing your mouth with water after taking inhaled corticosteroids can also lower your risk for thrush. Inhaled corticosteroids aren’t addictive. If you have an asthma attack, your health care provider may have you take corticosteroid pills or liquid for short periods to get your asthma under control. If taken for long periods, these medications may raise the risk for cataracts and osteoporosis. For some individuals with severe asthma, a health care provider may prescribe oral corticosteroids to be taken daily.

Leukotriene antagonists, such as montelukast (Singulair), zafirlukast (Accolate, Vanticon) or zileuton (Zyflo), block a chain reaction that causes inflammation in the airways. These medications are taken by mouth. Sometimes health care providers choose leukotriene antagonists as an alternative to inhaled corticosteroids, and sometimes they add leukotriene antagonists to inhaled corticosteroids.

A combination of inhaled long-acting beta2-agonists and inhaled corticosteroid treatment, such as fluticasone-salmeterol (Advair), budesonide-formoterol (Symbicort) or mometasone-formoterol (Dulera) decreases inflammation and opens the airways. These medications are used in combination because inhaled long-acting beta2-agonists are not safe when used alone.

Ant-IgE medications like omalizumab (Xolair) are used for severe asthma and are given once a month by a shot.

Cromolyn is a controller medicine that is delivered by a nebulizer.

What Are the Most Commonly Used Rescue Medications?

Rescue medicines are used when you are experiencing asthma symptoms, such as when you’re having an asthma attack, therefore you should carry your rescue medication inhaler with you at all times. The most commonly used rescue medications for asthma are inhaled short-acting beta2-agonists, such as albuterol (Proventil, ProAir, Ventolin, Salbutamol, Accuneb). These medications act rapidly to relax tight muscles and open up the airway to allow you to breathe right away. Other rescue medicines include ipratropium-albuterol combination therapies (Combivent) or levalbuterol (Xopenex). If you find yourself using your rescue medication more than two times per week, you should contact your health care provider because you may need to increase the dosage of your controller medications, which are taken daily to reduce inflammation.

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