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LABAs (Long-Acting Beta-Agonists) for Asthma

If you have asthma, it is likely that you use an inhaler every day as part of your treatment plan. Many asthma inhalers contain a drug that is in a class of medicine called LABAs, or long-acting beta-agonists.

What are LABAs?

LABAs are also known as bronchodilators. Bronchodilators come in the form of short-acting or long-acting.1

Short-acting beta-agonists (SABAs) are used as-needed as a “rescue inhaler” or to prevent exercise-induced asthma. LABAs, on the other hand, are taken every day. A LABA is not to be used as a rescue inhaler.1

Taken every day, LABAs relax muscles in the airways. This makes it easier for people with asthma or chronic obstructive pulmonary disease (COPD) to breathe.1

For safety, LABAs should always be taken in combination with an inhaled corticosteroid (ICS). LABAs come in the form of an inhaler (metered-dose or dry powder inhaler).1

The most common LABAs are available as combination products with an ICS. Having both ingredients together in 1 product makes it more convenient for people to use. It also helps people stick to their treatment plan. Below, the LABA is listed first in each parenthesis:1

  • Symbicort® (formoterol + budesonide)
  • Dulera® (formoterol + mometasone)
  • Advair® (salmeterol + fluticasone)
  • Breo® (vilanterol + fluticasone)

Some LABAs are also available alone, such as Serevent® (salmeterol). Even though they are available alone, they should be taken in combination with an ICS. This is because LABAs alone have a much higher risk of asthma-related death.2

How do LABAs work?

LABAs work by relaxing muscles in the airways. This allows the airways to stay open, making it easier to breathe.1

LABAs should only be used in combination with an inhaled corticosteroid (ICS).1

When are LABAs used for asthma?

New updates to asthma guidelines were published in 2020. These updates are known as the “2020 Asthma Guideline Update From the National Asthma Education and Prevention Program.” These guidelines help doctors decide which drugs are right for asthma.3

The guidelines recommend major changes to the way doctors use LABAs treat asthma. They also make asthma treatment much simpler for most people with the condition. Now, in general:3

  • Most people with asthma can be prescribed just 1 inhaler – an ICS-LABA combination product. This should be used as both a maintenance and rescue inhaler.
  • Most people, even those with mild asthma, should start with an ICS-LABA combination. Before, doctors recommended people start with an ICS alone.
  • For people with mild intermittent asthma, an ICS-LABA should include low-dose ICS and be used as needed for symptoms. When asthma symptoms are under control, people can go without any inhalers. The ICS-LABA replaces albuterol as a rescue inhaler.

What are the possible side effects?

The most common side effects of LABAs include:4

  • Fast heart rate (tachycardia)
  • Heart palpitations
  • Chest pain
  • Headache
  • Tremors
  • Nervousness

Other less common side effects may include:4

More severe side effects include:4

  • Hives, rash, or swelling of the mouth, face, or tongue (hypersensitivity reaction)
  • Unexpected difficulty breathing (paradoxical bronchospasm)

If you experience any side effects that may be life-threatening, contact 911 right away.

These are not all the possible side effects of LABAs. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with LABAs.

Considerations for LABAs and asthma

Ask your doctor or pharmacist if you need help using your LABA. For example, if you have a LABA inhaler, they can show you how to prime, use, and clean your inhaler.

Use your LABA medicine as prescribed. Do not change the dose or frequency of your LABA unless your doctor tells you to do so.

A LABA should always be used in combination with an ICS. LABAs are not a substitute for an ICS but should always be given with one, preferably as a product that contains both a LABA and an ICS. A LABA does not treat an acute asthma attack.4

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

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