Medications are usually needed for asthma, even if it's mild asthma. Although progress is being made in finding new asthma medications, we currently have available excellent asthma drugs that do a great job of getting asthma under control.
There are two types of asthma medications:
- Controllers
- Relievers
Asthma controllers
These are usually taken every day, even if you feel well. They help prevent asthma symptoms and asthma attacks. However, they do NOT help quickly during an asthma attack.
Types of controller medications
1. Inhaled steroids (corticosteroids):
- Controller medications are daily inhalers that control the inflammation in the airways of your lungs.
- This type of medication is generally the most effective for controlling asthma long term.
- Examples: Flovent, Pulmicort, Qvar, Alvesco
Some possible side effects of inhaled steroids (corticosteroids):
- Hoarseness and sore throat
- Thrush or yeast infection - looks like a whitish layer on your tongue. You can prevent thrush by:
1.Rinsing your mouth, gargling and spitting out the water after you take an inhalation
2.Using a spacing chamber with your metered dose inhaler (if that is the device you are using).
Your doctor will adjust your dose so you get the best asthma control using the least amount of medication. For a full list of side effects, see your doctor or pharmacist. In most cases, inhaled corticosteroids have few side effects with the dose needed to control asthma.
2. Long-acting bronchodilators:
- These inhalers open up your lungs by relaxing the tiny bands of muscle that surround the airways.
- Since they can take longer to work than the reliever medications, they are not to be used to quickly relieve symptoms, such as during an asthma attack.
- They are similar to the blue inhalers, but they last longer - about 12 hours.
- Examples: Serevent, Oxeze.
Some possible side effects of long-acting bronchodilators:
- Increased heart rate
- Anxiety
- Tremors (shaking) in the hand
3. Leukotriene-receptor antagonists:
- Leukotriene-receptor antagonists are daily pills that help control inflammation in the airways.
- For people with mild asthma, doctors may prescribe leukotriene receptor antagonists alone, however they are generally not as effective as low dose inhaled corticosteroids.
- Doctors may also prescribe leukotriene receptor antagonists to people who are already taking inhaled corticosteroids to help further reduce symptoms or to help reduce the dose of corticosteroid.
- Examples: Singulair, Accolate.
Some possible side effects of leukotriene receptor antagonists:
- Headache
- Dizziness
- Heartburn
- Upset stomach
For a full list of side effects, see your doctor or pharmacist. In general, side effects with leukotriene receptor antagonists are very rare.
4. Combination medications
These have two medications in one inhaler: an inhaled steroid and a long-acting bronchodilator.
They are used when inhaled steroids alone do not fully control your symptoms.
Examples: Advair (Flovent + Serevent), Symbicort (Pulmicort + Oxeze)
5. Anti-IgE
- This new medication, called Xolair (medicine name: omalizumab) is for asthma patients who also have severe allergies and the corresponding high levels of 'IgE' in their blood (IgE is an antibody produced by the body which causes allergic reactions).
- Xolair is a set of injections that clock the effects of the IgE antibodies.
- It may be useful for people who are taking high doses of inhaled corticosteroids, but still have regular symptoms.
Relievers (fast-acting bronchodilators)
These are usually only taken when needed for quick relief or for an asthma attack. They help open up your lungs by relaxing the muscles that surround the airways.
Reliever medications:
- Sometimes also called "rescue" medications or "quick relief" medications, since they start working quickly (usually within a few minutes)
- This is the inhaler you use when you have an asthma attack.
- It is also used for less severe symptoms, or before you exercise.
- These medications are not useful for long-term control of asthma since they do not control the inflammation in your lungs.
- If you need this medication more than three times a week, see your doctor.
- Examples: Ventolin, Salbutamol, Bricanyl, Airomir.
Some possible side effects of reliever medications:
- Trembling
- Nervousness
- Flushing
- Increased heart rate
Spacer (holding chamber):
This is a plastic device that is used with pressurized inhalers (the kind that spray the medication out) to better deliver medication to your lungs.
It makes it easier to coordinate inhaling the medication from the inhaler.
You get more medication in your lungs and less in your mouth and throat.
Corticosteroid pills
Sometimes, the swelling in people's airways is severe - this may be because they have a chest infection or for some other reason. In cases of severe airway swelling the doctor may prescribe corticosteroid pills. Corticosteroid pills basically do the same thing as inhaled corticosteroids, but they are more powerful. Doctors often prescribe these pills for a short time to get the swelling under control.
Examples of corticosteroid pills: Prednisone, Prednisolone (PediaPred®), and Dexamethasone (Decadron®)
What corticosteroid pills do: Corticosteroid pills reduce the swelling, redness, and mucus in the airways.
Side effects of corticosteroid pills: For a full list of side effects, see your doctor or pharmacist.
In the short term (prescriptions that last 3-7 days) side effects of corticosteroid pills may include:
- Increased appetite
- Mood changes
- Water retention
- Hyperactivity in children
In the long-term (prescriptions that last many weeks or months) side effects of corticosteroid pills may include:
- Increased appetite
- Weight gain
- Stomach irritation
- Bone thinning
- Dependency: your body can go into withdrawal if you stop taking prednisone all of a sudden. Your doctor may ask you to taper off your dose slowly.
Where to learn more
Your doctor, pharmacist, or Certified Asthma Educator can:
- Explain how each of your asthma medications work
- Discuss any concerns about potential side effects
- Show you how to use your medication inhalation device (your metered-dose inhaler, spacing chamber, Diskus, Turbuhaler, etc.)
We're here to help you:
Ontario residents can reach our Certified Asthma Educators through our toll-free Asthma Action Helpline.
1-888-344-LUNG (5864)
8:30am to 4:30pm - Monday to Friday