If you’ve had an asthma attack, you know how important it is to prevent future attacks with long-term asthma management. Still, asthma is a complex condition, and there’s no one single treatment for people with moderate to severe symptoms.

Consider the following options for your long-term asthma management and discuss them with your doctor at your next appointment.

Long-acting beta agonists (LABAs)

LABAs work by stimulating the receptors to relax the muscles of your airway. They’re typically for people with severe asthma who need an additional maintenance inhaler when using ICSs.

They’re taken every 12 hours, and are only effective when combined with an ICS. Taken by themselves, LABAs can cause respiratory-related complications, and even death.

Inhaled corticosteroids (ICSs)

ICSs are for people with mild to moderate asthma who have persistent symptoms like coughing and wheezing and need to use their rescue inhaler multiple times per month. They work by decreasing swelling in the lungs, which prevents tightening of the airways.

They’re most effective when combined with LABAs and are typically taken twice a day, but the dose and frequency depend on the medication type. Risks include fungal infections and a sore throat or hoarseness after long-term use. Higher dosing regimens may affect height in some children.

ICS/LABA combination products

These combination products open your airways and reduce swelling for people with moderate to severe asthma symptoms. They’re meant for people who currently take an ICS alone or take an ICS and LABA, but as separate products.

They need to be taken daily, and long-term use can increase the same risks of long-term ICS use.

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Bronchodilators

Bronchodilators are for people with mild asthma symptoms, nighttime asthma, chronic bronchitis, or those who take daily medication as a rescue inhaler. These medications work by relaxing the airways for easier breathing.

Potential risks include heartburn and insomnia. Take bronchodilators as needed, or as recommended by your doctor.

Anti-leukotrienes/leukotriene modifiers

These medications are for people with mild to moderate, persistent asthma symptoms and allergies. They work by fighting leukotrienes in the body, which cause symptoms. Anti-leukotrienes are a once daily pill, and side effects may include anxiety and insomnia.

Anti-IgE injections (“allergy shots” or biologics)

If ICS/LABA combo therapy hasn’t worked for you and you have persistent asthma symptoms caused by allergies, these injections may work for you. They fight antibodies that cause allergy symptoms. Most are taken weekly for several months, and risks include bumps and swelling at the injection site and anaphylaxis.

The takeaway

Moderate to severe, persistent asthma is best treated with long-term medications to reduce the risk of complications like an asthma attack. But it’s still important to have your rescue inhaler on hand if needed. At the same time, quick-relief medications shouldn’t replace long-term treatments. You and your doctor will determine the right balance to achieve better breathing in the long run.