Asthma is a chronic condition that affects the airways in your lungs. These airways carry air in and out of your lungs. When you have asthma, it can become more difficult to breathe because these airways can become swollen, inflamed, and full of mucus. Symptoms for asthma can vary from person to person, but may include:
- Wheezing
- Coughing
- Shortness of breath
- Chest tightness
There is no cure for asthma, but proper treatment can help you control this condition and prevent permanent changes to your lungs. There are several different kinds of medications used to help control asthma symptoms and prevent acute asthma attacks.
1. Quick-relief medicines
There are many quick relief (or “rescue”) medications used to treat asthma attacks or flare-ups. They are used at the first sign of symptoms and quickly relax your airways; they can reduce or relieve symptoms in as little as five minutes and can last for 3-6 hours. Quick relief medications are also called short-acting beta 2 agonist bronchodilators (or SABAs) and include Proair and Ventolin (albuterol) and Xopenex (levalbuterol). They are available as inhalers and nebulizer treatments. See most common drugs to treat Asthma here.
2. Controller medicines
Controller medications help keep your asthma in check by controlling the underlying symptoms of asthma, such as reducing the swelling in your airways or minimizing mucus production. Controller medications must be used every day, even when you are feeling well, to prevent asthma symptoms from flaring up. These medicines will not help during an asthma attack or other breathing emergency.
There are several different kinds of medications your doctor may prescribe to help control your asthma.
Inhaled corticosteroids, which include Flovent (fluticasone), Pulmicort (budesonide), Asmanex (mometasone), and others, are very effective and safe for long term use. They are available as inhalers and nebulizer treatments. The most common side effect associated with these medicines is thrush, or a fungal infection in your mouth and throat. This can be prevented by rinsing your mouth thoroughly or brushing your teeth after each use.
Long-acting beta 2 agonist bronchodilators (or LABAs) include Serevent (salmeterol) and Striverdi (olodaterol). They are both available in inhaler formulation. The most common side effects associated with these medications is headache, dizziness, and increased blood pressure.
Combination inhalers, which contain both a corticosteroid and a LABA, are also often used as a controller medication for asthma. Combination medications include Advair and Airduo (fluticasone and salmeterol), Breo (fluticasone and vilanterol), Dulera (mometasone and formoterol), and others. These medications can also cause thrush, so it is important to rinse your mouth after each use.
Leukotriene modifiers, which include Singulair (montelukast) and Accolate (zafirlukast), can be found in granule form, chewable tablets, or regular tablets. The most common side effects include a rash or itching and abdominal pain. Rarely they can cause behavioral side effects such as sleep changes, anxiety, depression, sudden mood changes, or thoughts of suicide. These are usually used in addition to other controller medications but are sometimes used alone in patients with mild asthma.
3. Oral steroids
Oral steroids are sometimes used for a short period of time to treat severe asthma exacerbations. They work to decrease swelling in your lungs and are safe for short-term use. Some people with severe asthma may take them long-term but they should only be taken this way with careful monitoring by your doctor. These steroids are not the same kind that athletes use to gain muscle mass.
Examples of oral steroids include Decadron (dexamethasone), Prednisone Intensol or Orapred (prednisone), Cortef (hydrocortisone), and Medrol (methylprednisolone). There are tablet and liquid formulations. Common side effects include increased thirst and/or appetite, insomnia or restlessness, mood changes, increased blood pressure, and increased blood sugar. Long term use can increase risk for fractures, cataracts, and stomach ulcers.
4. Biologics
Biologic medications are used for patients who have certain types of moderate to severe asthma that doesn’t respond well to usual asthma treatments. They are injections or infusions given every few weeks and work by targeting certain cells or proteins in your body that cause airway swelling.
Examples of biologics include Cinqair (reslizumab), Dupixent (dupilumab), Fasenra (benralizumab), Nucala (mepolizumab), and Xolair (omalizumab). The most serious side effect from these medications is anaphylaxis, or a life-threatening allergic reaction. This is why these medications are given in a doctor’s office; they will have epinephrine available to treat any serious reactions you may have.
Paying for your medications
Inhalers and other asthma treatment options can be expensive. If you are having trouble paying for medications, Easy Drug Card may be able to provide medication discounts at one of the 65,000+ participating nationwide and local neighborhood pharmacies.
TL;DR
There are many different medications available to treat asthma. You should work closely with your medical doctor to determine your asthma severity and what medicines will work best for you. It is important to use your controller medications every day and see your primary care provider regularly to help keep your breathing under control.
References:
- “Asthma Medicines and Treatment.” Asthma and Allergy Foundation of America, June 2021, https://www.aafa.org/asthma-treatment/.
- Marion, DW. An overview of asthma management. In: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA, 2022.
