Asthma medication

Asthma is a chronic breathing and airway condition. Like other chronic conditions, it needs ongoing treatment to stay in control. Uncontrolled or untreated asthma puts you at greater risk of having more asthma attacks. Working with your doctor, you can make a plan that sets out the correct prescribed medication and when to seek help.

Your asthma action plan#

An asthma action plan is like an instruction manual for your asthma, written with your doctor. It tells you how to use your asthma medications based on your symptoms. Do not change how you use asthma medication (for yourself or a child in your care) without checking the plan or speaking to your doctor.

Everyone with asthma should have an action plan, no matter their age or how mild their asthma feels. With the right medication, asthma can be well controlled in almost all people.

The main types of asthma medication#

• Preventers slowly make the airways less sensitive to triggers by reducing swelling and mucus inside the airways. Preventer medication is taken daily. It aims to prevent symptoms and asthma attacks, maintain good lung function and improve quality of life.
• Relievers are used when you have symptoms and need relief immediately. A reliever is used during an asthma attack, and can also be used before exercise when prescribed by a doctor.
• Combination preventers contain two or three different medications that reduce inflammation as well as relax the airway muscles.
• Dual-purpose relievers treat breakthrough symptoms by relaxing the airway muscles and providing anti-inflammatory action at the same time.

Some people with asthma need additional medication to stay well, including “add-on” medications and injectable medications for asthma that is difficult to control.

Reliever medication#

If you have asthma, you need to carry a reliever at all times. Relievers contain a bronchodilator, which simply means they open the airways by relaxing tight airway muscles. They are only used when you have symptoms, or before exercise if your doctor recommends it. Avoid overusing your reliever: if you notice you need it more than 2 days a week, make an appointment to discuss your asthma control with your doctor.

Preventer medication#

Preventer medication is the key to keeping well with asthma. It reduces swelling and mucus in the airways and lowers your risk of severe symptoms or flare-ups. It is usually taken once or twice daily, and it is important to take it every day as prescribed, even when you feel well.

The most effective preventers are inhaled, and are known as inhaled corticosteroids (ICS). A preventer is also available in tablet form, sometimes used for children and some adults. Most adults and children can achieve good control of symptoms with a low-dose preventer — for example, during the local pollen season if pollen is a trigger, or at times when viruses are a trigger.

Best practice is to use only the smallest dose of medication needed to keep symptoms under control, but you should never reduce the dose without speaking to your doctor first. Have any changes to your preventer recorded on your written asthma action plan.

Combination preventers#

If an inhaled corticosteroid alone has not controlled your asthma, your doctor may prescribe a combination preventer. Occasionally one may be prescribed when asthma is first diagnosed.

A combination preventer is taken in one device and usually includes an inhaled corticosteroid (ICS) to reduce inflammation and sensitivity, plus a medication to relax the airways — a long-acting bronchodilator known as a long-acting beta-agonist (LABA).

Some combination preventers now have three ingredients, called triple therapy: an inhaled corticosteroid (ICS) plus two airway-relaxing medications, a long-acting beta-agonist (LABA) and a long-acting muscarinic antagonist (LAMA). The two relaxing medications work in different ways to open the airways. Triple therapy is often used for asthma that is more difficult to control, or when asthma occurs alongside another breathing condition such as chronic obstructive pulmonary disease.

Dual-purpose relievers#

A dual-purpose reliever is a combination medication used as a reliever, to treat symptoms as they happen. It is prescribed for people with mild asthma, where symptoms are infrequent and not severe. “Dual purpose” means it has two aims: rapid relief of symptoms from the bronchodilator that relaxes the airways, and reduced swelling and mucus from the inhaled corticosteroid that reduces inflammation. Using this combination as needed has been found to reduce the risk of life-threatening flare-ups.

Side effects of asthma medication#

All medication has the potential to cause side effects. If you experience side effects, discuss them with your doctor and pharmacist before stopping any medication.

The most common side effects of inhaled preventers (inhaled corticosteroids) are a hoarse voice, a sore mouth and throat, and fungal infections of the throat. You can reduce these by rinsing and gargling with water and spitting it out after using the preventer. If your preventer is a metered-dose inhaler, using it with a spacer reduces the risk further.

The most common side effects of relievers include tremor, rapid heartbeat and headache. These usually go away quickly, and using a spacer can again help reduce them. A spacer is cheap and easy to use, and it can help you keep taking your medication while limiting side effects.

The only preventer available as a tablet, montelukast, can cause serious mood and behavioral side effects in a very small number of children who take it. If your child is prescribed this medicine, tell your doctor immediately if you notice a change in their behavior or mood.

If you are worried about any side effects, do not stop your medication, or that of a child in your care, without speaking to your doctor first. Stopping medication could lead to an asthma attack or emergency that is worse than any potential side effect, and side effects may be preventable once discussed with your health professional.

Asthma attacks and emergencies#

During an asthma attack, follow your written asthma action plan. In an asthma emergency, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and ask for an ambulance. Tell the operator that someone is having an asthma attack.

While waiting for the ambulance, give 4 separate puffs of blue reliever medication with a spacer, taking 4 breaths for each puff, every 4 minutes. If you do not have a blue reliever and have a different reliever puffer, learn how to use it as part of asthma first aid in an emergency.

Key Points#

• Preventer medication is the key to keeping well with asthma.
• Reliever treatment is used when you have symptoms and need relief immediately.
• Your action plan tells you how to use your asthma medications based on your symptoms.
• Relievers can also be used before exercise when prescribed by a doctor.
• Relievers are only used when you have symptoms or when your doctor recommends using one before exercise.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).