Why--and When--Should I Premedicate?
Premedicating is a topic I thought I’d written a lot about. It actually turns out it is a topic I’ve written a lot around.
I’ve written about premedicating for exercise and for exposure to cold air and carpentry and poor air quality and for dentist appointments. I’ve written about how having to premedicate sucks the spontaneity right out of exercise, adding another layer of planning and challenge. I’ve written about using timers as a “sort of hack” for using time before exercise intentionally. Heck, I’ve written about ideas for HOW to use that time at least somewhat usefully.
Apparently, I’ve written all kinds of things AROUND premedicating, and making it suck less, but perhaps never really ABOUT premedicating and why it’s helpful. So let’s get into it!
What is premedicating?
Most simply, premedicating is taking your rescue inhaler before you are exposed to anticipated triggers. It is most often done with a rescue inhaler like salbutamol (albuterol), also known as Ventolin. Xopenex (levalbuterol/levosalbutamol) and Bricanyl (terbutaline) also work similarly for premedicating.1
Always talk with your doctor to determine if it is important for you to premedicate for certain activities or situations, as they have insight to your specific needs.
If you use Symbicort SMART or a different type of rescue inhaler than those above, talk with your doctor for specific instructions. Because Symbicort contains a long-acting bronchodilator (which works quickly), the below information may not be as applicable to your individual dosing situation. Your doctor may also provide instructions for how you might premedicate with Advair.
How does premedicating help?
When you have asthma, certain triggers—such as dust or cold air—or activities (exercise) can cause asthma symptoms. Premedicating by taking your rescue inhaler beforehand can prevent or reduce the chances of asthma symptoms developing. As rescue inhalers are bronchodilators this prophylactically (preventatively) opens up your airways and keeps them that way for a number of hours (usually 3-6, depending which medication you’re using).
When should I do it?
I think my doctor originally told me to premedicate 20-30 minutes before exercise (it’s been awhile!), but 15 is usually the go-to recommendation (and the amount of time I usually use now).2
At minimum, you should give at least 10 minutes for your inhaler to start working before exercising.2 This would also apply to other unavoidable trigger exposure, as it really just correlates to how long short-acting bronchodilator medicine takes to begin working in your lungs.
Other tidbits on premedicating
Even if you premedicate, you should always keep your inhaler close in case you have asthma symptoms. If you frequently develop asthma symptoms during exercise despite premedicating, speak with your doctor to ensure you are using your medication correctly or your breathing problems have not been misdiagnosed.
It is important to always warm-up properly for exercise if you have asthma, as it helps ease your lungs into the activity and can prevent symptoms from developing. I’ve written more about warm-ups and cool-downs here.
If you don’t already premedicate and are thinking it could be helpful, always speak to your doctor for specific advice. By taking steps to prevent asthma symptoms from occurring while participating in activities you enjoy—which can include premedicating, wearing a mask, or other steps depending on your triggers—it can make it easier to exist more happily with your asthma, and make it feel less intrusive!
Have you ever gotten "moon face" as a side effect of prednisone?