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Finding the Right Treatment for You When You Have Severe Asthma

Medically reviewed by Suzanne Falck, MD on October 16, 2017Written by Kristeen Cherney on October 16, 2017
treating severe asthma

Overview

To prevent an asthma attack and long-term airway damage, you have to manage your severe asthma symptoms effectively. But finding the right treatment can be as complicated as the condition itself.

Just as the symptoms and triggers of severe asthma vary from person to person, so do the best treatment methods. A medication that works well for some might not have the same effect for others.

Luckily, there are many treatment options. Learn more about the different types of severe asthma treatments, and work with your doctor to find which one may work best for you.

Long-term control medications

Asthma is caused by inflammation and constriction of the airways. In severe cases, these issues are more significant. Long-term control medications are essential in treating severe asthma. These drugs are designed to help stop inflammation so that your airways won’t constrict.

There are also different types of long-term control medications. Severe asthmatics are almost always on inhaled corticosteroids and a long-acting bronchodilator. Others may also be on leukotriene modifiers, such as montelukast sodium (Singulair). These are available in chewable or traditional tablets that are taken once a day.

Perhaps the most common long-term approach to severe asthma is inhaled corticosteroids. This medication more effective than pills because it’s delivered right to the source: your airways. Inhaled corticosteroids are taken in the same way as a rescue inhaler. However, this medication is taken daily.

Take these consistently. Missing doses may allow inflammation to return and cause problems with your asthma.

A nebulizer with a medication called cromolyn may be used with other types of long-term control asthma medications. The medicine is inhaled via steam that is propelled through a chamber connected to an electronic machine.

Some side effects are possible with long-term control medications. This includes anxiety, osteoporosis, and vitamin D deficiency. Yet the risks associated with severe asthma are far more significant.

Quick-relief medications

A traditional inhaler, such as albuterol, is one of the most well-known treatments for asthma. These types of quick-relief medications aren’t for everyday use. It’s not a coincidence they’re called “rescue” medications.

Quick-relief treatments are designed to treat early symptoms of an asthma attack. An attack can happen despite taking long-term control medications.

Options include:

  • bronchodilators such as short-acting beta agonists (like albuterol)
  • intravenous corticosteroids
  • oral corticosteroids

If you need rescue medications more than a few times a month, talk to your doctor about long-term control medications.

Biologics

Biologics are an emerging set of treatments. These drugs may help prevent asthma attacks for people who don’t respond to inhaled corticosteroids, long-acting bronchodilators, allergy medications, and other standard asthma treatments.

One example is an injectable drug called omalizumab (Xolair), which is administered once or twice a month. It tailors your immune system so that you respond to allergens and other severe asthma triggers differently over time.

The downside is that there’s a possibility of a severe allergic reaction. If you develop hives, breathing difficulties, or facial swelling, call 911.

Biologics aren’t recommended for young children.

Other treatments

Other medications might be prescribed to address your severe asthma triggers. In allergic asthma, either over-the-counter or prescription allergy medications can help. By blocking symptoms of an allergic reaction, such as inflammation and wheezing, your asthma symptoms may improve. Immunotherapy (allergy shots) can also treat the allergies that lead to symptoms.

Additional triggers, such as severe anxiety, may be treated with antidepressants. Tell your doctor about any health conditions you have. Also, make sure they’re aware of all the medications and supplements you already take.

The bottom line

There’s no cure for asthma. Staying on track with your treatment plan is essential in managing your severe asthma. If you don’t see any improvements despite treatment, it may be time to talk to your doctor. They can help you rework your treatment plan. This often includes trying out new medications or even taking more tests.

To find the right medication, you might need to try out a few different types to see which one works best.

If you suspect you’re having a severe asthma attack, call 911 or head to a nearby emergency room.

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