The first step in managing your asthma symptoms is to become familiar with and then avoid your personal asthma triggers. But avoidance only goes so far; most likely, you'll take an asthma drug to help control your symptoms. The right medication will depend on a range of factors, including your age, specific symptoms, triggers, and personal response to the asthma drugs. Asthma medications are most often delivered via asthma inhalers.
Quick-relief medications are used only to provide rapid relief from asthma flare-ups or more serious attacks.
Short-acting Beta Agonists
These are bronchodilators that provide near-instant relief during an asthma attack. They are the drug of choice for treating exercise-induced attacks. These inhaled medications can provide relief for several hours. Examples include:
These are another class of fast-acting, inhaled bronchodilators that prevent muscles in the airways from constricting and can provide quick relief from an asthma attack. An example is ipratropium bromide (Atrovent).
Oral and Intravenous Corticosteroids
A systemic administration of corticosteroids can be used to treat severe asthma symptoms. Long-term use can lead to potentially serious side effects, such as peptic ulcer, osteoporosis, glucose intolerance, and weight gain. Therefore, these can only be used for short-term treatments. They act by relieving airway inflammation. Examples include prednisone, methylprednisolone, and hydrocortisone.
Long-Term Control Medications
Long-term asthma control medications are taken on a daily basis and target the two causes of asthma; they either reduce inflammation (anti-inflammatory drugs) or keep the airway open so that you can breathe freely (bronchodilators). Your doctor may prescribe an anti-inflammatory drug, a bronchodilator, or a combination. These drugs include:
These anti-inflammatory drugs are the strongest and most commonly prescribed long-term asthma drug. Included in this category are:
- beclomethasone (Qvar)
- budesonide (Pulmicort Flexhaler)
- flunisolide (Aerobid)
- fluticasone (Flovent Diskus, Flovent HFA)
- mometasone (Asmanex)
Long-acting Beta Agonists
Long-acting beta antagonists (LABAs) are designed to open the airways and reduce inflammation. In the inhaled form, these bronchodilators are usually taken twice a day via inhaler and combined with an inhaled corticosteroid. They are quick acting and last four to six hours. LABAs have been linked to severe asthma attacks. This class of drugs includes:
- albuterol (Proventil, Ventolin) – also available in pill or syrup form that may be taken to control nocturnal asthma symptoms
- formoterol (Foradil Aerolizer)
- salmeterol (Serevent Diskus)
It's very common to be prescribed a combination of a corticosteroid and a LABA. Combinations available in the U.S. include:
- budesonide and formoterol (Symbicort)
- fluticasone and salmeterol (Advair Diskus)
This relatively new class of drugs works by counteracting leukotrienes, substances released by white blood cells in the lung that cause the air passages to constrict and promote mucus secretion. Leukotriene modifiers are administered via inhaler and include:
- montelukast (Singulair)
- zafirlukast (Accolate)
- zileuton (Zyflo, Zyflo CR)
Rarely prescribed, these bronchodilators, administered in pill form, are also thought to have some anti-inflammatory effects.
- theophylline (Uniphyl, Theo-24, Theo-Dur)