Trialing New Asthma Meds: How Long is Long Enough?
Depending on the medications you are taking for asthma, they may require varying amounts of time to begin feeling as if they are working. Some medications work rapidly and you will be able to feel a difference within minutes or hours, like bronchodilators, while others take days or—more often—weeks, like inhaled steroids. When you’re trialing new asthma medications, it’s important to keep the individual time frame of the asthma drug you are taking in mind so you can see if it is making a difference.
Successful medication trials take time
I recently heard about someone being switched off of a medication after just a couple of weeks, despite that they felt the medication was doing an okay job. That didn’t seem to make sense to me—when I have trialed both longer- and shorter-acting medications (from Singulair to Zenhale [Dulera] I’ve trialed them for a minimum of 4 weeks to determine they worked well for me. Depending on the medication, several weeks may be needed to determine if the drug or dosage is effective for you—at the end of the trial, you should visit your doctor again to discuss how things went, and determine if you will be continuing the drug, altering the dose, or trying something different. Most of the time, a successful medication trial takes time!
When you are prescribed a new medication, ask your doctor how long it will take before you start feeling the effects of the drug, and how long it will take to reach “peak” effectiveness. For example, if you are prescribed a inhaled steroid and long-acting beta-2 agonist bronchodilator (LABA), and have not been on the same class of medication for at least 3-4 weeks before, you will feel the effects of the bronchodilator immediately—within 3 to 30 minutes depending on the drug—but the peak effectiveness won’t be reached for a few weeks, when the inhaled corticosteroid component has had a chance to build up in your lungs and decrease the inflammation. In most cases, patience is required to see that the drug is working to its full potential—in the case of inhaled steroids, the best result is seen after 3 months of treatment 1… slow and steady is the name of the game when it comes to inhaled steroids.
Knowing when it’s not working
If you’ve had asthma for a while, you’ll know by a few weeks into your trial if the new medicine is better or worse than what you were on previously.
For example, I at one point tried Advair despite being on Symbicort successfully, due to preference for the standard MDI delivery device. I lasted less than three weeks, when I discovered quite by accident that the LABA in Advair and my lungs do NOT get along—it actually made my asthma worse, and I felt sicker than I had previously, but I mistakenly thought I’d just caught a September back-to-school cold. Of course, once I started feeling bad, I increased the Advair per my asthma action plan, which of course just gave me more of the drug that worsened my asthma! I spent a few weeks on Advair, thinking whatever “cold”-with-no-nasal-symptoms I’d caught was just really hard on my lungs… until one evening when I was hours away from starting prednisone, I was late for my evening dose of Advair and I could breathe. The next day, I was in the pharmacy getting a refill of Symbicort!
If you’ve been tracking your asthma before switching meds, this information might help you determine if you’re doing better, worse, or equal compared to before the switch. Your doctor may also do lung function tests to determine how you’re doing with the trial medication.
Trialing medication can be a long, slow and frustrating process, but in the end, it will lead to you finding the best possible medication(s) for you—while frustrating, it took me 5 years to figure out the current combo I’m on. It’s still not perfect, but I’m happy I kept pushing for better!