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Asthma Treatment Options

Many treatment options are available to help manage your asthma symptoms. Here you’ll find information on different types of asthma medications your healthcare provider may prescribe, other therapies your provider may recommend, and devices that may be used to deliver medications or monitor how you’re doing.

 

There are many types of asthma medications. Some medications reduce airway inflammation, while others relax the muscles around the airways to help relieve constriction. Both airway inflammation and airway constriction can cause asthma symptoms.

Some medicines are taken daily on a long-term basis for as long as your healthcare provider deems necessary, while other medications are taken as needed for the quick relief of sudden asthma symptoms, or during periods of worsening asthma. Talk with your provider about your treatment plan. Make sure you know how to take your medicines correctly.

How does your healthcare provider decide which medications are right for you?
Your healthcare provider will consider the severity of your asthma when prescribing medications. If you are on a long-term control medication, your healthcare provider will adjust your treatment as necessary based on your level of asthma control. One way to help find out if your asthma symptoms are well controlled is to take the Asthma Control Test™ (for ages 12 years and older) or the Childhood Asthma Control Test* (for ages 4 to 11 years). Discuss the test results with your healthcare provider.

Asthma medications have certain risks and side effects. Your healthcare provider will discuss these with you when determining which treatment option, if any, is right for you.

Select a category to learn more about the different medicines and how they work.

Quick-relief asthma medicines are bronchodilators. They work by relaxing the muscles around the airways of the lungs. This helps air to flow more freely through the lungs. Quick-relief medicines are typically used to relieve symptoms when they occur. Using your quick-relief inhaler more than usual may be a sign that you are having trouble controlling your inflammation. Talk with your doctor about ways to control your inflammation if you are using your quick-relief inhaler more than usual.

It is important to track the amount of times you use your rescue medicine. It may be helpful to monitor your symptoms daily so that you know when to use your quick-relief medicine. Quick-relief medicines should be carried with you at all times. Talk with your healthcare provider about when to use your quick-relief medicine.


SHORT-ACTING BETA2-AGONISTS (SABA)
Short-acting beta2-agonists (SABA), also referred to as quick-relief medicines, act within minutes to relieve sudden asthma symptoms. This type of medication is typically delivered by a device called an inhaler. When you inhale a dose, the medicine quickly relaxes the muscles surrounding your airways. If it does not relieve your symptoms quickly, notify your healthcare provider immediately. Ask your provider to demonstrate how to use your inhaler correctly to ensure you are on the right track.

For people with intermittent asthma, a SABA is sometimes the only medicine required. But if you are using your quick-relief medicine more than 2 days a week to treat asthma symptoms, talk to your doctor. This could be a sign that your asthma symptoms are worsening.

It's important to keep your quick-relief inhaler with you at all times and to make sure you refill it before it expires or before you run out of medicine. Some inhalers have dose counters that can help you monitor how many puffs of medicine are left in your device. If and when you need your medicine, you don't want to be caught with an empty or expired inhaler.

Being able to use your asthma inhaler correctly is important. This can help you get the medicine you need. Show your provider how you use the device to make sure you are using it correctly.

Long-term asthma control medicines are taken daily, whether you have symptoms or not. Most are anti-inflammatories and work by reducing inflammation in the airways of the lungs. These medicines help to prevent symptoms, so they are different from quick-relief medicines, which are used to help relieve sudden asthma symptoms when they occur.

Below are several different types of long-term asthma control medicines.

ANTI-INFLAMMATORIES
Inhaled Corticosteroids

Inhaled corticosteroids treat the inflammation associated with asthma and are very similar to a chemical that the body naturally produces to combat inflammation. Because they are inhaled, they go directly to the airways of the lungs to help reduce inflammation. They should be taken every day as prescribed, even when you are not experiencing symptoms.

It’s important to know that inhaled corticosteroids are NOT anabolic steroids, the steroids used by some athletes to build muscle.

Leukotriene Receptor Antagonists
Leukotriene receptor antagonists belong to a class of long-term control medicines that work by blocking the action of leukotrienes, which are chemicals that can increase inflammation in the airways of your lungs.

Leukotriene receptor antagonists are available in the form of pills or tablets, not as inhalers. They can be prescribed alone to treat mild persistent asthma or in combination with inhaled corticosteroids to treat moderate or severe persistent asthma.

IMMUNOMODULATORS
IgE Inhibitors

Immunoglobulin E, or IgE, is an antibody in the immune system. When people with asthma are exposed to allergens, their bodies launch an immune response, producing IgE antibodies that can cause inflammation and a worsening of asthma symptoms. Medicines called IgE inhibitors block this action, helping to prevent asthma symptoms before they occur.

IgE inhibitors are typically given by injection once or twice a month to people whose moderate to severe persistent allergic asthma is not controlled with inhaled corticosteroids.

BRONCHODILATORS
Theophylline

Theophylline is a bronchodilator, a type of medicine that relaxes the muscles around the airways of the lungs. It is taken by mouth rather than inhaled.

Theophylline is sometimes used alone to treat mild persistent asthma, but most of the time it is used in combination with inhaled corticosteroids to treat moderate or severe persistent asthma and should be taken every day as directed by your healthcare provider. If your provider prescribes theophylline, he or she may watch your blood levels closely to make sure the dose is right for you.

Asthma may be treated with more than one medication at a time. Some of these medications are delivered together in one inhaler device. These combination inhalers are prescribed to be taken daily to help prevent symptoms. They are different from quick-relief medicines, which are used to help relieve sudden symptoms when they occur.


INHALED CORTICOSTEROIDS COMBINED WITH LONG-ACTING BETA2-AGONISTS (LABA)
Inhaled corticosteroids are sometimes combined with long-acting beta2-agonists (LABA) to treat the inflammation and bronchoconstriction that can cause asthma symptoms. While inhaled corticosteroids are anti-inflammatories, LABAs are bronchodilators, meaning they help keep the airways of the lungs open by relaxing the smooth muscle surrounding the airways.

Your healthcare provider may prescribe a combination medicine if he or she decides your asthma symptoms are not well controlled with a long-term asthma control medicine. When your asthma symptoms are well controlled on a combination inhaler, your healthcare provider will decide if a different asthma medicine is right for you.

People with asthma who take LABA-containing medicines have an increased risk of death from asthma problems. Children and adolescents with asthma who take LABA-containing medicines may have an increased risk of hospitalization for asthma problems. Your healthcare provider will decide if and when a LABA-containing medicine is right for you.

LONG-ACTING BETA2-AGONISTS (LABA) 
Long-acting beta2-agonists (LABA) are bronchodilators, meaning they help keep the airways of the lungs open by relaxing the smooth muscle surrounding the airways. LABAs are not used alone to treat asthma symptoms. They must always be prescribed in combination with a long-term asthma control medicine such as an inhaled corticosteroid.

These medicines are prescribed to be taken daily to help prevent symptoms, so they are different from quick-relief medicines, which are used to help relieve sudden symptoms.

People with asthma who take LABA medicines have an increased risk of death from asthma problems. Children and adolescents with asthma who take LABA medicines may have an increased risk of hospitalization for asthma problems. Your healthcare provider will decide if and when a LABA medicine is right for you.

SYSTEMIC CORTICOSTEROIDS
Typically, oral or injectable systemic corticosteroids (e.g., prednisone) are used in short "bursts" to reduce inflammation and help speed recovery following an asthma attack or illness.

Oral corticosteroids are not the type of steroids used by some athletes to build muscles. Oral corticosteroids are available in pill or liquid form.

Many asthma medications must be taken with a device that helps deliver the medication directly into the lungs. There are several types of devices, and your healthcare provider will prescribe the medication and device he or she thinks are best for you. Spend some time learning how to use your device so you receive the proper dose of medication. Improper use of the device can prevent you from receiving the appropriate amount of medication. Carefully follow the instructions for your specific product.

If you have any questions about how to use an asthma device, talk to your healthcare provider immediately.

Select one of the following to learn more:

Dry-powder inhalers deliver medication in the form of a fine powder directly into your lungs.

Metered-dose inhalers use a propellant called HFA to deliver medication into your lungs. Most MDIs require that you activate the device by coordinating hand movements with breathing in. Some patients, such as children and elderly people, may benefit from the use of an accessory device called a spacer or valved holding chamber.

Spacers and valved holding chambers, or VHCs, help you inhale your medication into the lower airways—where it's supposed to go—instead of into your throat. Most types of spacers fit onto the end of most metered-dose inhalers, or MDIs.

If you're using an MDI, your healthcare provider may recommend using a spacer or VHC to help with the delivery of your medication. Spacers are especially helpful for children or people who have trouble breathing in while pressing the inhaler.

Nebulizers deliver a fine mist of medication. You inhale this mist into your lungs by breathing through a mouthpiece or through a mask that fits over your nose and mouth.

Nebulizers are used by people who have trouble using an inhaler, including young children and people who are very ill. Delivery of quick-relief medicines, through nebulizers, is also sometimes used to help treat asthma attacks.

Knowing how well you are breathing is an important part of your asthma management. Take a look at the monitoring devices below and discover how they can help you and your healthcare provider better manage your asthma.

For help using a monitoring device, talk to your healthcare provider.

Select one of the following to learn more:

A peak flow meter is a device you can blow into to see how fast air moves out of your lungs. You can use it at home. If you keep track of your results and bring them to your healthcare provider, peak flow readings can help to determine:

  • What triggers may be making your asthma symptoms worse
  • Whether your Asthma Action Plan needs to be adjusted
  • Whether you need emergency treatment

Several types of peak flow meters are available, including meters that are suitable for the smaller airways of children. Your healthcare provider can help you decide which is best for you. For best results with a peak flow meter, be sure to follow the instructions that come with your specific model.

Spirometry is a breathing test that your healthcare provider may administer. All you have to do is breathe as hard as you can into the device. The spirometry test measures the rate and volume of air flowing out of your lungs. These measurements will help your healthcare provider to assess how well your lungs are working.

Spirometry is a common breathing test that may be used by healthcare providers to diagnose asthma and to monitor lung function in patients who already know they have asthma.

You may want to explore other ways to help manage asthma symptoms. The methods below may be helpful. Talk to your healthcare provider.

Many people with asthma have allergies that may trigger their asthma symptoms. Knowing what you're allergic to and avoiding those possible triggers may help you manage your asthma. Follow-up with your healthcare provider to learn more information about allergy testing.

If your healthcare provider determines that you have one or more allergies that may be affecting your asthma, he or she may recommend allergy shots. These are injections of small amounts of the substances to which you are allergic. Your healthcare provider will administer these shots regularly, gradually increasing the strength of the dose. As the dose increases, your body may become less sensitive to the allergens.

If you have asthma and get influenza (also called the flu), you may be more prone to complications, such as worsening asthma symptoms or pneumonia. To help reduce this risk, your healthcare provider may recommend getting a flu shot. It is generally recommended that most people six months and older get a flu shot, but it is especially important for people with chronic conditions such as asthma to reduce serious illness. The flu vaccine is also available as a nasal spray, but according to the Centers for Disease Control and Prevention (CDC), the spray should NOT be used in people with asthma. Flu shots are given annually each fall because the flu virus changes from year to year. Keep in mind, the flu is a respiratory illness, not to be confused with stomach and intestinal viruses that may be called "stomach flu."

People with asthma sometimes consider alternative treatments. Before you decide to try them, be sure to speak with your healthcare provider.

Asthma Control Test is a trademark of QualityMetric Incorporated.
The Childhood Asthma Control Test was developed by GSK.

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