Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Treatments and drugs
By Mayo Clinic staffFor many people with exercise-induced asthma, using an inhaled bronchodilator (brong-koh-DIE-lay-tur) opens the airways before working out and is enough to control symptoms. Other people need to take one or more other medications prior to exercise or on a daily basis to prevent asthma symptoms.
You may need daily long-term control medications if you have frequent asthma symptoms when you're not exercising, or if using a medication before exercise doesn't keep your symptoms under control. Your asthma may not be under control if you need to use an albuterol or other inhaled bronchodilator more than twice a week for asthma flare-ups in addition to using the inhaler before you exercise.
Medications used to treat exercise-induced asthma include:
- Short-acting beta agonists. These inhaled bronchodilator medications are also called rescue or quick-relief medications because they can rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA), pirbuterol (Maxair Autohaler) and ipratropium (Atrovent HFA). For most people, one to two puffs of albuterol or another inhaled short-acting beta agonist 10 to 15 minutes before exercise is enough to prevent symptoms for up to four hours.
- Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), triamcinolone (Azmacort), flunisolide (Aerobid), beclomethasone (Qvar) and others. They are the most commonly prescribed type of long-term asthma medication. You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these medications have a relatively low risk of serious side effects.
- Long-acting beta agonists. These inhaled medications include salmeterol (Serevent Diskus) and formoterol (Foradil). Taken 30 minutes before exercise, long-acting beta agonists can prevent symptoms of exercise-induced asthma for up to 12 hours. These medications are always used in combination with an inhaled corticosteroid. In some people, long-acting beta agonists may increase the risk of a severe asthma attack.
- Leukotriene modifiers. These oral medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR). These medications can prevent symptoms for up to 24 hours. With regular use of zileuton, you may need regular blood tests to make sure the medication isn't causing liver problems. In rare cases, these medications may increase your risk of certain psychological reactions, such as agitation, aggression, hallucinations, suicidal thinking and depression. See your doctor if you have any unusual reactions.
- Combination inhalers. These medications include an inhaled corticosteroids plus a long-acting bronchodilator. Advair HFA and Advair Diskus combine the corticosteroid fluticasone and the bronchodilator salmeterol. Symbicort contains the corticosteroid budesonide plus the bronchodilator formoterol.
- Oral corticosteroids. Because oral corticosteroids can cause long-term side effects, they're generally reserved for severe asthma symptoms. Examples include prednisone, methylprednisolone and hydrocortisone.
Allergy shots (immunotherapy)
If your asthma is triggered or worsened by allergies, allergy-desensitization shots may be an option. These injections are generally given once a week for a few months, then once a month for a period of three to five years. Over time, they gradually reduce your immune system reaction to specific allergens.
- O'Byrne P. Exercise-induced bronchoconstriction. http://www.uptodate.com/home/index.html. Accessed Sept. 30, 2009.
- Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma. National Institutes of Health. Bethesda, Md. http://www.nhlbi.nih.gov/guidelines/asthma/07_sec3_comp4.pdf. Accessed Sept. 30, 2009.
- American Academy of Allergy, Asthma & Immunology work group report: Exercise-induced asthma. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/members/academy_statements/position_statements/exercise_induced.pdf. Accessed Sept. 30, 2009.
- McFadden ER. Approach to the patient with exercise-induced airway narrowing. In: Adkinson NF. Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa.: 2008. http://www.mdconsult.com/das/book/body/163002133-3/0/1806/82.html?tocnode=56311172&fromURL=82.html#4-u1.0-B978-0-323-05659-5..00078-4_2735. Accessed Sept. 30, 2009.
