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There’s no cure for asthma. However, it’s a highly treatable disease. In fact, some doctors say today’s asthma treatments are so effective, many people have near-complete control of their symptoms.
People with asthma have highly individual triggers and responses. Some doctors believe there are actually many asthmas, each with its own causes, risks, and treatments.
If you have asthma, your doctor will work with you to create an asthma action plan that focuses on your own symptoms and the things that seem to trigger them.
Asthma treatment serves two main purposes: long-term control and short-term symptom relief. Here are some of the asthma drugs your doctor could include in your asthma action plan:
Inhalers. These portable devices deliver a premeasured dose of asthma medicine into your lungs. You hold the J-shaped pumps to your mouth and press down on the canister. The pump sends out a mist or powder that you inhale.
Some inhalers contain corticosteroids that control swelling and irritation in your airways. These inhalers are for daily or seasonal use.
Other inhalers contain fast-acting drugs (such as bronchodilators, beta2-agonists, or anticholinergics) that can open your airways quickly if you’re having an asthma flare-up.
Some inhalers may contain a combination of medicines to control your precise reactions.
Nebulizers. These freestanding devices turn liquid medicine into a mist you can breathe. The drugs used in nebulizers reduce swelling and irritation in the airways.
Oral medicines. Your long-term action plan may also include oral medications. Oral asthma drugs include leukotriene modulators (which reduce inflammation) and theophylline (which has mostly been replaced with safer, more effective medications) which opens your airways. Both are taken in pill form. Oral corticosteroid pills are also sometimes prescribed.
Biologics. You may have an injection of a biologic medication once or twice a month. These medicines are also called immunomodulators because they reduce certain white blood cells in your blood or reduce your sensitivity to allergens in your environment. They’re only used for certain types of severe asthma.
Your doctor may prescribe one or more of these drugs to help control your asthma and relieve symptoms.
Long-term: inhaled corticosteroids
- Beclomethasone (Qvar RediHaler)
- Budesonide (Pulmicort Flexhaler)
- Ciclesonide (Alvesco)
- Fluticasone (Flovent HFA)
- Mometasone (Asmanex Twisthaler)
Long-term: leukotriene modifiers
- Montelukast (Singulair)
- Zafirlukast (Accolate)
- Zileuton (Zyflo)
If you’re taking Singulair, you should know that, according to the Food and Drug Administration (FDA), in rare cases, the drug has been linked to depression, aggression, agitation, and hallucinations.
Kalra D, et al. (2014). [Montelukast (Singulair)] Pediatric postmarketing pharmacovigilance and drug utilization review. https://wayback.archive-it.org/7993/20170113205720/http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM414065.pdfIt also increases the risk of severe mental health effects, such as suicidal thoughts and actions. FDA requires boxed warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair); advises restricting use for allergic rhinitis. (2020).Keep your doctor aware of any psychological symptoms you or your child are experiencing. https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug
Long-term: long-acting beta-agonists (LABAs)
You should always take LABAs along with corticosteroids because when taken on their own they can cause severe asthma flare-ups.
- Salmeterol (Serevent)
- Formoterol (Perforomist)
- Arformoterol (Brovana)
Some inhalers combine corticosteroids and LABA medicines:
- Fluticasone and salmeterol (Advair Diskus, Advair HFA)
- Budesonide and formoterol (Symbicort)
- Mometasone and formoterol (Dulera)
- Fluticasone and vilanterol (Breo Ellipta)
Theophylline is a bronchodilator that you take in pill form. Sometimes sold under the name Theo-24, this medication is rarely prescribed now.
Fast-acting: rescue inhalers
- Albuterol (ProAir HFA, Ventolin HFA, and others)
- Levalbuterol (Xopenex HFA)
If you experience severe asthma, your doctor could add oral corticosteroids like prednisone to your asthma action plan.
If your flare-ups seem to be triggered by allergens, your doctor might recommend immunotherapy (allergy shots) or antihistamines and decongestants.
- Xolair® (omalizumab)
- Nucala® (mepolizumab)
- Cinqair® (reslizumab)
- Fasenra® (benralizumab)
There are many natural asthma remedies to consider.
Always consult your doctor
Asthma is a serious condition, and asthma flare-ups can be life-threatening. Be sure to talk to your doctor before you add any home remedy to you or your child’s action plan. Never stop taking asthma medicine without first speaking to your doctor.
Black seed (Nigella sativa)
Nigella sativa is a spice in the cumin family used as medicine in several cultures, including the Ayurvedic tradition. Black seeds may be eaten, taken as a pill or powder, or used in the essential oil form.
A 2017 review of studies about Nigella sativa found that black seed may improve lung function and help with asthma symptoms.
Caffeine has also been studied as a natural remedy for asthma because it’s related to the drug theophylline, which is used to relax the muscles in your airways.
Although there are no recently-reported studies showing its usefulness, a 2010 review of the data showed that drinking coffee caused a mild improvement in airway function for up to four hours.
Choline is a nutrient your body needs in order to function well, but choline deficiency is rare. Some evidence indicates that a choline supplement may reduce inflammation in people with asthma, but ingesting too much choline may have side effects.
Choline may be taken as a pill or found in foods such as beef and chicken liver, eggs, cod and salmon, vegetables like broccoli and cauliflower, and soybean oil. Side effects are unlikely if your choline intake is from food alone.
Pycnogenol is an extract taken from the bark of a pine tree that grows in France. It’s generally taken as a capsule or tablet.
Although more research is needed, one study in 76 people found that pycnogenol reduced nighttime awakenings from allergic asthma, and the need for regular asthma medicines.
Another supplement people often include is vitamin D. Researchers in London found that taking vitamin D along with your asthma medications lowered the risk of going to the emergency room for an asthma attack by 50 percent.
Increasingly, doctors are looking to use certain biomarkers in your breath to try to customize your asthma treatment.
This area of research is most useful when doctors are prescribing the class of medicines known as biologics. Biologics are proteins that work in your immune system to prevent inflammation.
Asthma is a disease that causes your airways to narrow because of swelling, tightening, or increased mucus. While there’s no cure, there are many treatment options that can prevent asthma flare-ups or treat symptoms when they occur.
Some natural or home remedies may help, but always talk to your doctor before adding anything to your asthma action plan.