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Asthma medications: Know your options
Various asthma medications, for short- and long-term treatment of asthma, can help you manage your asthma symptoms. Treatment options include bronchodilators, corticosteroids, immunotherapy and anti-IgE antibodies.
By Mayo Clinic staffAlong with avoiding your triggers and staying healthy, asthma medications play an important role in managing asthma. Long-term control medications keep your asthma under control on a day-to-day basis. Quick-relief (rescue) medications treat symptoms once they start. If your asthma is triggered by airborne allergies, you may need allergy medications along with asthma medications to help keep your asthma under control.
You'll need to work closely with your doctor to determine which asthma medication or combination of asthma medications works best for you. Your age, your symptoms and possible side effects all play a role in choosing the dose and type of asthma medications you need. Asthma medications are different in dose and type for children, women who are pregnant, and for people who have certain health problems or who take certain other medications. Asthma symptoms often change over time. This means you'll need to monitor your asthma carefully and work with your doctor to adjust your asthma medications as needed.
Types of asthma medication
| Category | Purpose | Medication types |
|---|---|---|
| Long-term asthma control medication | Taken regularly to control chronic symptoms and prevent asthma attacks — the most important type of treatment for most people with asthma |
|
| Quick-relief medication (rescue medication) | Taken as needed for rapid, short-term relief of symptoms — used to prevent or treat an asthma attack |
|
| Medication for allergy-induced asthma | Taken regularly or as needed to reduce your body's sensitivity to a particular allergen |
|
Long-term-control medications
Long-term use of medications is critical to controlling persistent asthma. You'll probably need to take them every day on a long-term basis. There are several types of long-term control medications, which include:
Inhaled corticosteroids
These anti-inflammatory drugs are the most effective long-term control medications for asthma. They reduce inflammation in your airways, prevent blood vessels from leaking fluid into your airway tissues and block allergic responses. Examples include:
- Fluticasone (Flovent)
- Budesonide (Pulmicort)
- Triamcinolone (Azmacort)
- Flunisolide (Aerobid)
- Beclomethasone (Qvar)
- Mometasone (Asmanex)
If you're using a metered dose inhaler, use a spacer and rinse your mouth with water after each use. This reduces the amount of drug that can be swallowed and absorbed into your body. It also reduces side effects, such as mouth and throat irritation and oral yeast infections.
Long-acting beta-2 agonists (LABAs)
These asthma medications are part of a group of medications called bronchodilators, which open up constricted airways and reduce inflammation. Their effects last at least 12 hours and are used to control moderate to severe asthma and to prevent nighttime symptoms. LABAs are used on a regular schedule along with inhaled corticosteroids for moderate or severe persistent asthma. LABAs are often used to treat persistent asthma in combination with inhaled corticosteroids. They shouldn't be the only medication you take for asthma. Examples include:
- Salmeterol (Serevent Diskus)
- Formoterol (Foradil Aerolizer)
Leukotriene modifiers
These inhaled asthma medications reduce the production or block the action of leukotrienes — immune system chemicals that cause asthma symptoms. Leukotriene modifiers are sometimes used with other medications such as inhaled corticosteroids to help prevent asthma attacks in older children and adults with mild persistent asthma. Examples include:
- Montelukast (Singulair)
- Zafirlukast (Accolate)
Cromolyn and nedocromil
These inhaled asthma medications are sometimes prescribed to help prevent attacks in people with mild persistent asthma. They may also be used to help prevent asthma triggered by exercise or allergens by decreasing allergic cell reactions. These are generally taken three to four times a day and include:
- Cromolyn
- Nedocromil (Tilade)
Theophylline
You take this bronchodilator in pill form every day to treat mild persistent asthma. Theophylline (Theo-24, Theochron, Uniphyl, others) is a bronchodilator — it relaxes the airways and decreases the lungs' response to irritants. It may be helpful for relieving your nighttime symptoms of asthma. If you're taking theophylline, you'll need regular blood tests to make sure you're getting the correct dose.
Combination medications: Corticosteroid and bronchodilator
A few inhaled asthma medications contain both a corticosteroid and a bronchodilator. They include:
- Fluticasone and salmeterol (Advair Diskus)
- Budesonide and formoterol (Symbicort)
Quick-relief medications
Short-acting bronchodilators — often called "rescue" or "quick-relief" medications — help reduce asthma symptoms or stop the symptoms of an asthma attack in progress. You take these medications when you begin to have symptoms, such as coughing, wheezing, chest tightness or shortness of breath. You may also use short-acting bronchodilators to prevent an asthma attack when your peak flow meter shows that your readings are lower than normal.
Short-acting beta-2 agonists (SABAs)
These bronchodilators open the lungs by relaxing airway muscles. They begin working within minutes and last four to six hours. If your symptoms are minor and infrequent, you may be able to manage your symptoms with these medications alone. However, most people with persistent asthma also need to use a long-term control medication as well. SABAs are the most common medication used to treat asthma flare-ups and exercise-induced asthma, but you shouldn't use them on a regular, daily basis. Your asthma may not be under control if you need to use a short-acting beta agonist more than two days a week to relieve your symptoms. These medications are usually delivered with an inhaler, but some are available in tablet form. They include:
- Albuterol (AccuNeb, Proventil, Ventolin, others)
- Levalbuterol (Xopenex)
- Pirbuterol (Maxair)
The Food and Drug Administration (FDA) has required that metered dose albuterol inhalers that use chlorofluorocarbon (CFC) propellant be replaced with hydrofluoroalkane (HFA) inhalers by the end of 2008. HFA inhalers work as well as CFC inhalers and are as safe, but they don't harm the ozone layer. If you're used to using a CFC inhaler, talk to your doctor about making the switch to HFA inhalers. There are a few differences you should know about:
- Your HFA inhaler may have a different taste and feel than your older CFC inhaler.
- HFA inhalers have a less forceful spray than the older CFC inhalers. Make sure you know how to use your inhaler correctly — otherwise, you may not get the full dose of medication with each spray.
- HFA inhalers are more costly than the older generic CFC albuterol inhalers.
Ipratropium (Atrovent)
This short-acting bronchodilator is usually prescribed for emphysema or chronic bronchitis. Your doctor might prescribe this medication for the immediate relief of your asthma symptoms. It may be used along with — or as an alternative to — short-acting beta-2 agonists.
Oral corticosteroids for serious asthma attacks
These medications may be taken to treat acute asthma attacks or severe asthma. They can cause bothersome short-term side effects, and more-serious side effects if they're taken for a long period of time. Examples include:
- Prednisone
- Methylprednisolone
- Hydrocortisone
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