Asthma Medications

There are many different prescription drugs used to treat asthma. The 2 main types of asthma drugs are control medicines and rescue medicines. Control medicines are long-term drugs used to prevent and control asthma symptoms. Rescue medicines are quick-relief drugs that reduce symptoms during an asthma attack.¹

Most people with asthma use both types of drugs. Your doctor will recommend a drug treatment plan based on:^2-4

• Your age
• The type of asthma you have
• How severe your asthma is
• The side effects of the medicine
• Any other health issues you have and medicines you take

Doctors usually follow a stepwise approach with asthma medicines. This means they will change your drugs or dosage depending on how well symptoms are controlled. The effect is to maximize symptom relief while minimizing side effects. This approach also can be helpful if your asthma changes over time.^2,4

Asthma control medicines

Asthma control drugs are the most important treatment for asthma. They work in different ways to prevent and control symptoms. Some reduce inflammation in the airways. Others help open the airways. Some people need multiple types of asthma control drugs.^1,2

Asthma control drugs are taken every day for long-term symptom relief. Control drugs do not work quickly enough to help during an attack. There are several types of asthma control drugs.^1,5

Inhaled corticosteroids (ICS)

ICSs are usually the first and most effective drug used to control asthma. They reduce swelling and tightening in the airways. They also reduce inflammation and sensitivity. Pulmicort® (budesonide) and Flovent HFA® (fluticasone) are common ICSs.^1-3,5

Long-acting beta-agonists (LABAs) and ICSs

LABAs relax the airway muscles and open the airways. However, they have been linked to severe asthma attacks, so they are taken only in combination with an ICS drug. Formoterol and salmeterol are common LABAs used in combination with an ICS.^1,2,5

Long-acting muscarinic antagonists (LAMAs)

LAMAs are also called long-acting anticholinergics. They block proteins on nerve cells called muscarinic receptors. This reduces airway narrowing and mucus secretion. Spiriva® (tiotropium) is 1 common LAMA.^2,5

Leukotriene receptor agonists (LTRAs)

LTRAs are also called leukotriene modifiers. They block the action of immune system chemicals called leukotrienes. Leukotrienes cause asthma symptoms after exposure to allergens. Singulair® (montelukast) is 1 common LTRA.^1,2,5

Asthma rescue medicines

Asthma rescue drugs relax the airway quickly to provide relief during an asthma attack. They may be called quick-relief drugs. They are used only as-needed for acute symptoms of asthma or before exercise. This can keep an asthma attack from getting worse.^2,5

Your asthma action plan will help you know when to use quick-relief medications. Needing to use them too often is a sign that your symptoms are not well controlled. If this is the case, talk to your doctor about stepping up or changing your control medicines.²

Short-acting beta-agonists (SABAs)

SABAs are the most common asthma rescue medicine. Generic and brand name versions of albuterol are common examples.^2,5

Experts recommend that SABAs should not be used alone. Some doctors suggest taking a low-dose ICS whenever you take SABA for relief. Overusing SABAs can increase the risk of future asthma attacks. So, reducing the use of SABAs is a key goal of asthma control.^3,4

Short-acting muscarinic antagonists (SAMAs)

SAMAs are also called short-acting anticholinergics. Atrovent® HFA (ipratropium) is 1 common SAMA. Some combinations of SAMAs and SABAs also are available.²

Oral corticosteroids

Corticosteroids (aka steroids) work by reducing inflammation. To treat severe symptoms, they can be taken by mouth for a short time. But they can cause serious side effects when used long-term. Prednisone is 1 common oral corticosteroid.²

Single maintenance and reliever therapy (SMART)

SMART is a therapy option that lets you use the same inhaler for both rescue and control. This may work better for some people with moderate to severe asthma. SMART combines a low-dose ICS with a LABA that acts faster. Symbicort® (budesonide/formoterol fumarate) is an example of this combination.^3,4,6

The SMART approach makes treatment simpler. It also reduces the need to take SABAs. ICS-formoterol lowers the risk of future asthma attacks compared to SABAs alone. But not everyone can take ICS-formoterol for quick relief. Your doctor can tell you whether SMART is right for you.^3,4,6

Biologics

Biologics are drugs made from living cells. The cells are used to make proteins called antibodies. These antibodies are designed to target or block specific molecules involved in asthma. When taken with control medicines, biologics can affect biological processes that cause inflammation.²

Some biologics work better than others to treat different types of asthma. For example, Cinqair® (reslizumab) and Dupixent® (dupilumab) treat eosinophilic asthma. Xolair® (omalizumab) treats allergic asthma.^2,4

Medicines for allergy-induced asthma

Allergy control drugs help reduce the body’s sensitivity to a particular allergen. This can be helpful when there is a clear link between a specific allergy and asthma symptoms. Treatments for allergy-induced asthma include:^2,4

• Allergy shots (immunotherapy) – These are regular shots to reduce immune reactions to specific allergens.
• Immunotherapy tablets – This is the under-the-tongue (sublingual) version of immunotherapy.
• Over-the-counter and prescription allergy drugs – These drugs include oral and nasal spray antihistamines, cromolyn nasal sprays, and decongestants.

Before beginning treatment for asthma, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.