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Asthma Treatment and Management

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By Editorial Team

5 min read

Reviewed by: HU Medical Review Board | Last reviewed: August 2024 | Last updated: August 2024

The keys to controlling asthma are long-term management and understanding what to do when your asthma flares. This includes avoiding triggers, monitoring lung function, and taking asthma drugs.1

The right treatments for you depend on your symptoms, triggers, asthma severity, lung function, and other personal factors. Your doctor may follow a stepwise approach to treatment. This means they will increase or decrease your medicines based on how controlled your asthma is.2,3

To treat an asthma attack, you may need to use quick-relief medicines such as a combination inhaled corticosteroid (ICS) plus a long-acting beta agonist (LABA) or a short-acting beta agonist (SABA). A good sign that your asthma is under control is when you rarely need to use a quick-relief inhaler. Follow your asthma action plan to determine when to take which medicines.2

Long-term asthma control medicines

Long-term control drugs are key to managing asthma and are usually taken daily. Long-term control drugs work by reducing inflammation in the airways. When airways are less inflamed, they are less sensitive. This reduces the risk of having an asthma attack.1,2

The following drug types and examples are used for long-term asthma control. Combination inhalers that contain inhaled corticosteroids plus  LBABAs are the most common long-term asthma control drugs. Leukotriene modifiers and other long-term drugs may be used if combination inhalers do not work.2

Inhaled corticosteroids

Examples of inhaled corticosteroids include:1,4-6

Leukotriene modifiers

Examples of leukotriene modifiers include:1

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Long-acting beta agonists (LABAs)

Examples of LABAs include:1

When used alone, LABAs can increase asthma-related deaths. LABAs should only be used when also using an inhaled steroid. Talk to your doctor about long-term safety when taking a LABA.7

Other long-term medicines

Examples of other medications include:1

  • Mast cell inhibitors: cromolyn sodium inhalation solution (cromolyn sodium)
  • Methylxanthines: theophylline (multiple brand names)
  • Anticholinergics: Spiriva Respimat® (tiotropium bromide)

Combination medicines

Examples of combined inhaled corticosteroids (ICS) and LABAs include:1,8-10

  • Advair®Diskus and Advair HFA® (fluticasone propionate/salmeterol)
  • Symbicort® (budesonide/formoterol)
  • Dulera® (mometasone furoate/formoterol)
  • AirDuo RespiClick® (fluticasone propionate/salmeterol)
  • Breo Ellipta® (fluticasone furoate/vilanterol)
  • Breyna™ (budesonide/formoterol fumarate)
  • Wixela® Inhub (fluticasone propionate/salmeterol)

Examples of combined ICS, LAMAs, and LABAs include:1,11

Examples of combined inhaled corticosteroids and SABAs include:12

  • AirSupra® (albuterol/budesonide)

Quick-relief asthma medicines

Quick-relief drugs are used for short-term symptom relief during an asthma attack. They are usually used as needed or before exercise if your doctor recommends it. They work by opening up swollen airways (bronchodilation).1,2

Types and examples of quick-relief drugs include SABAs such as:1

  • ProAir Respiclick® (albuterol sulfate)
  • Ventolin HFA® (albuterol sulfate)
  • Proventil HFA® (albuterol sulfate)
  • Albuterol sulfate HFA
  • Xopenex® Neb (levalbuterol HCL), Xopenex® HFA (levalbuterol tartrate)
  • Levalbuterol tartrate HFA (levalbuterol tartrate)
  • Levalbuterol inhalation solution (levalbuterol HCL)

Short-acting muscarinic agonists (SAMAs) are another option to SABAs. SAMAs are also called short-acting anticholinergics. These relax airway muscles to make it easier to breathe. But they work slower than other options.3,7

An example of a SAMA is Atrovent® HFA (ipratropium). An example of a SAMA-SABA combination is Combivent Respimat® (ipratropium and albuterol). Your doctor may prescribe using these drugs if your asthma is not well controlled on another type of inhaler.7

Use these drugs exactly as your doctor describes. If you find yourself using them more often than prescribed, tell your doctor. This is a sign that your asthma is not well controlled.2

Systemic steroids

If you are in an acute asthma flare that is not improving or is getting worse, your doctor may prescribe steroid pills. Steroids taken by mouth are absorbed throughout your body. This provides a greater anti-inflammatory effect to treat your asthma. Typically, you would take these for several days and continue to use your rescue medicine.3

Examples of systemic steroids include corticosteroids such as:3

Allergy medicines

Allergy medicines may help if your asthma is triggered by allergies. Types of allergy medicines include:1

  • Allergy shots (immunotherapy)
  • Intranasal steroids (nasal sprays)
  • Antihistamines

In asthma immunotherapy, you take increasing doses of an allergen over time. This helps reduce your sensitivity to that allergen. It works best when you know exactly which allergen is triggering your asthma symptoms.1

Biologics

Biologics target specific molecules in the body that lead to asthma. Biologics are helpful for people with allergy-induced asthma or eosinophilic asthma. Biologics are usually used by people with severe asthma that is not controlled by other drugs.1

Types of biologics used to treat asthma include:13

Bronchial thermoplasty

Bronchial thermoplasty is not widely recommended at this time. But it may be helpful for some adults with uncontrolled, severe asthma. It is only considered if asthma symptoms do not improve with inhaled corticosteroids or other long-term medicines.1

During a bronchial thermoplasty procedure, a doctor uses a catheter to heat the inside of a person's airways. This reduces smooth muscle in the airways, which limits how much they can tighten. This makes breathing easier and reduces asthma attacks.1

This procedure is not right for everyone. Talk to your doctor about whether bronchial thermoplasty may be right for you.

Lifestyle changes and home remedies

Along with medicines, lifestyle changes can help reduce the risk of asthma attacks. For example, you can reduce your exposure to asthma triggers by:1,14

  • Using an air conditioner instead of opening windows
  • Minimizing dust by using dust-proof bedding and removing carpeting
  • Using a humidifier or dehumidifier for ideal air moisture
  • Cleaning damp areas to prevent mold from growing
  • Reducing pet dander
  • Cleaning your home weekly
  • Using a face mask outside in cold, dry, or polluted air

Maintaining good overall health can also help you control your asthma symptoms. Some ways to stay healthy include:1

Monitoring your asthma at home is also important. You can monitor asthma based on symptoms or with a peak flow meter. Talk to your doctor about how you should monitor your asthma symptoms. This can help you notice the start of an asthma attack.1

Alternative medicine

There is not yet much evidence that complementary or alternative techniques can treat asthma. Some studies have shown promising results for relaxation techniques, breathing exercises, and yoga. But more research is needed to understand how to use them safely.1

A few herbal remedies may also improve asthma symptoms. For example, black seed, caffeine, and turmeric may be helpful. Some dietary supplements may also improve asthma symptoms. However, there is not yet convincing evidence that any herbal or dietary supplements will work.1

Talk to your doctor before trying any alternative practices or herbal remedies. They can suggest how to safely add these to your treatment plan.

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.