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Asthma Medications

Asthma medications fall into two categories.1 Fast-acting medications relieve sudden symptoms. Control medications help to control asthma long term.

Each of the long-term control medications works in a different way. Some reduce inflammation. Others help to open up the airways. Some reduce allergy symptoms. A combination of medications might be used to get your asthma symptoms under control, including:

  • Inhaled corticosteroids
  • Long-acting beta agonists
  • Leukotriene modifiers
  • Biologic medications
  • Oral corticosteroids

Short-acting beta agonists are used to treat asthma attacks. Asthma symptoms start or worsen when your airways begin to get narrow. Short-acting beta agonists relax the muscles surrounding your airways within minutes.

Inhaled corticosteroids

Most adults and children with persistent asthma take inhaled corticosteroids.2 These medications reduce inflammation, making the airways less sensitive.

There are many different inhaled corticosteroids available.3 Most have similar side effects. Common side effects are flu-like symptoms and thrush, a fungal infection in the mouth. It takes about two weeks of treatment before you will notice improvements. All the inhaled corticosteroids are about equally effective.1 None of them treat an asthma attack.

There are differences in inhaler type, schedules, and dosing.1 Inhaled corticosteroids can come in a dry powder inhaler or a metered dose inhaler. Some medications come in both forms. The instructions for using each inhaler are slightly different.

Another difference is how often you have to take your medication. Most of these medications are taken twice a day, in the morning and evening, but not all follow this pattern. Additionally, some medications come in several strengths.1 This can make it easier for your healthcare provider to find the right match for you. Your provider will give you instructions on the appropriate dosage for your specific case and medication.

Long-acting beta agonists

Some people with moderate to severe asthma need more than inhaled corticosteroids for control treatment.2 In this case, a long-acting beta agonist (abbreviated: LABA) might be used in addition. LABAs relax the muscles that surround the airways. This helps the airways to open up and improves breathing. Different LABAs may take effect at faster rates than others, but most help open the airways between five and twenty minutes after they’re used.1 The effects of a LABA can last up to 12 hours after administration.

Although some LABAs may be sold and packaged separately (like salmeterol), it is not safe to use these on their own. If you are prescribed a LABA on its own, you should also be prescribed (and use) a second inhaler. Most LABAs are used in combination with an inhaled corticosteroid, and many of these treatments are sold as one combination inhaler.4

All LABA medicines have a warning that they can cause an increased risk of asthma-related death. Taking too much of a LABA can cause increased heart rate, high blood pressure, chest pain, headache, tremor, or nervousness.

Combination inhalers

Combination inhalers typically combine a LABA and an inhaled corticosteroid. They are more convenient than using two separate inhalers.1 The drawback is that it is harder to adjust the inhaled corticosteroid dose without increasing the amount of LABA. If you need a higher dose of corticosteroids, you may have to use a second inhaler.

Rescue inhalers

Rescue inhalers contain a short-acting beta agonist (abbreviated SABA), which opens your airways within minutes (Table 3).2 These medications are taken as needed. Using your rescue inhaler more than two times per week is a sign that your asthma is not well controlled.2 Talk with your healthcare provider about making changes to your long-term control medications.

All patients with asthma should have a rescue inhaler.2 Be sure to refill your prescription when you before you run out of your rescue medication. Keep your inhaler with you so that you can treat an attack early.2

The currently available SABAs have similar effectiveness and side effects.1 All the SABAs can cause side effects such as tremor, nervousness, chest pain, palpitations, increased heart rate, dizziness, muscle pain, sore throat, or a runny nose. Currently, all SABA products come in metered dose inhalers.

Add-on and alternative medications

As we learn more about asthma and potential new treatment options, a greater number of medications have started making their way to the market. Patients with moderate to severe asthma may need a combination of several medications or may need to use a new treatment option instead of their old regimen. Some of these medications can also be used in place of inhaled corticosteroids, while others may be added on. Your healthcare provider will determine whether or not one of these medications are appropriate in your situation. Many medications in this category target some aspect of the inflammatory or allergic response, to help improve breathing and reduce asthma symptoms. Some of these treatment options include:

  • Leukotriene modifiers
  • Biologic medications
  • Oral corticosteroids
Written by: Sarah O'Brien | Last Reviewed: April 2019.
  1. Fanta CH. Asthma. N Engl J Med. 2009;360:1002-1014.
  2. National Heart, Lung, and Blood Institute. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma - Full Report 2007. Accessed 11/12/14 at: http://www.nhlbi.nih.gov/files/docs/guidelines/asthgdln.pdf
  3. American Academy of Allergy, Asthma, and Immunology. Allergy and Asthma Drug Guide. Accessed 2/13/15 at: http://www.aaaai.org/conditions-and-treatments/drug-guide.aspx
  4. US Food and Drug Administration. FDA Drug Safety Communication: Drug labels now contain updated recommendations on the appropriate use of long-acting inhaled asthma medications called Long-Acting Beta-Agonists (LABAs). Accessed 2/13/15 at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm213836.htm