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Current Treatments

While there is no cure for asthma, there are many proven treatments for the disease. The key is taking these medications exactly as your doctor or respiratory therapist recommends.

The most common medications for asthma include:

Anti-inflammatories
These medications are prescribed by your doctor to control your asthma over the long run, not to provide immediate relief from asthma attacks when they are happening. When appropriately prescribed and taken according to doctor’s orders, they can allow the vast majority of people with asthma to live completely normal lives.

Anti-inflammatories come in several types, including:

Inhaled corticosteroids: These drugs, which are administered by metered dose inhaler (MDI), work to prevent asthma symptoms from occurring by reducing airway inflammation and mucus. They are considered the first-line treatment for moderate to severe asthma. Most are taken on a daily basis, with results usually seen within one to three weeks of starting on the medication. Most people benefit from using a device called a “spacer” when using traditional MDIs. Newer devices called dry powder inhalers can be successfully used without the spacer device. One drug in this class can be delivered via a nebulizer as well.

The generic (and brand names) of inhaled corticosteroids include:

  • beclomethasone (Vanceril, Beclovent)
  • budesonide (Pulmicort Turbuhaler, Pulmicort Respules)
  • flunisolide (AeroBid)
  • fluticasone (Flovent, Flovent Rotadisk)
  • triamcinolone (Azmacort)

There are generally few side effects seen with inhaled corticosteroids prescribed at lower doses. Higher doses have been associated with thrush, which is an infection in the mouth, and hoarseness, but these, too, are not common and can usually be prevented by taking time to rinse the mouth thoroughly after each use and by using a spacer device with your MDI.

Oral corticosteroids: Corticosteroids can also be taken in pill form, but unwanted side effects ranging from acne and weight gain to bone loss and eye changes generally restrict their use only for severe asthma attacks or extremely difficult to control asthma. Oral corticosteroids usually begin working about three hours after administration, with the greatest effectiveness coming 6–12 hours later. Most serious side effects from the drugs are related to long-term use. Short bursts of oral corticosteroids given in the case of a severe attack generally cause no harm.

The generic (and brand names) of oral corticosteroids include:

  • methylprednisolone (Medrol)
  • prednisone (Prednisone, Deltasone)
  • prednisolone (Prelone, Pediapred)

Mast cell stabilizers: These are also inhaled medications that work to control asthma symptoms over the long haul. They work particularly well for children who also have allergies and for those with exercise-induced asthma. Mast cell stabilizers generally must be taken multiple times each day, but they have few, if any side effects.

The generic (and brand names) of mast cell stabilizers include:

  • cromolyn sodium (Intal)
  • nedocromil sodium (Tilade)

Leukotriene modifiers: The newest drugs used for asthma, leukotriene modifiers, are given in pill form and work by blocking the actions of leukotrienes, chemicals that occur naturally in the body and can cause airway tightening, mucus, and fluid. They are taken one or more times a day and so far have been found to cause only mild side effects, such as headache and nausea. However, these drugs are known to interact with other common medications, such as Coumadin and theophylline, so inform your doctor if you are on these medications before receiving a prescription for a leukotriene modifier.

The generic (and brand names) of leukotriene modifiers include:

  • montelukast (Singulair)
  • zafirlukast (Accolate)
  • zileuton (Zyflo)

Bronchodialators
There are three basic types of bronchodialators, which, depending on the type, can be used for long-term asthma control or fast relief from acute symptoms.

Short-acting beta2-agonists: These drugs, best when administered in inhaled form, provide rapid relief when an asthma attack is imminent or occurring. You can expect relief within about 20 minutes, and the drugs continue to work for about 4 to 6 hours. Used 15 to 20 minutes prior to exercise, they can often prevent asthma symptoms in people with exercise-induced asthma. But while most asthma patients will want to have these drugs on hand in case symptoms get out of control, and they do work well to relieve symptoms, they are not considered appropriate for long-term asthma control. The best strategy is to use an inhaled corticosteroid or other long-term control medication to prevent asthma symptoms from occurring in the first place.

The generic (and brand names) of short-acting beta2-agonists include:

  • albuterol (Ventolin, Proventil)
  • bitolterol (Tornalate)
  • levalbuterol (Xoponex)
  • metaproterenol (Alupent)
  • pirbuterol (Maxair)
  • terbutaline (Brethaire, Brethine)

Long-acting beta2-agonists: Long-acting beta2-agonists come in either inhaled or pill form. The inhaled drugs can provide longer-term relief of asthma symptoms and are especially effective for evening symptoms and exercise-induced asthma. The pill form is also good for nighttime symptoms, but is rarely prescribed due to unwanted side effects resulting from the relatively high doses necessary to provide relief.

The generic (and brand names) of long-acting beta2-agonists include:

  • albuterol (Proventil Repetabs, Volmax)
  • formoterol (Foradil Aerolizer)
  • salmeterol (Serevent, Serevent Diskus)

Anticholinergics: This medication, available only in inhaled form, has limited use in asthma. By itself, it has no effect on asthma symptoms, but when used in conjunction with a short-acting beta2-agonist, it can help to relieve symptoms that come on suddenly or are severe. The drug generally takes about an hour to begin working. Side effects are mild.

The generic (and brand names) of anticholinergics include:

  • ipratropium bromide (Atrovent)

Theophylline: Available in pill or injectable form, this drug is usually used to provide long-term control and prevention of asthma attacks in people with severe or difficult-to-control asthma. The medication must be administered on a daily basis and doses should not be missed. Side effects range from nausea and vomiting to rapid or irregular heartbeat and muscle cramps, and blood tests are required to monitor the therapy. Theophylline also has many interactions with other medications, so be sure to tell your doctor about other drugs you are taking before receiving a prescription for this medication.

The generic (and brand names) of theophylline include:

  • theophylline (Uniphyl, Theo-Dur, Slo-Bid, Theo-24)

Combination Medications
In addition to these major classes of asthma medications, there are several drugs that can be found in combination form, allowing two different medications to be delivered via the same device. Some patients find this combination method more convenient, as it can reduce the number of times each day medication must be taken. Medications available in combination format include:

  • Advair (Flovent and Serevent)
  • Combivent (Proventil or Ventolin and Atrovent)

Over-the-counter Medications
You can purchase medications over-the-counter that help with asthma symptoms, but these drugs, which contain epinephrine, are not recommended for asthma treatment. While they can provide brief relief from symptoms, lasting about 20 or 30 minutes, they do nothing to control or prevent symptoms over the long run. They can also cause dangerous side effects in anyone with high blood pressure, diabetes, thyroid disease, or heart disease. The two most common types of over-the-counter asthma medications are Primatene Mist and Bronkaid.

Allergy Shots
Since asthma symptoms in many people are triggered by allergies, allergy shots aimed at helping a person build up resistance to specific allergens may help control asthma. Your doctor or respiratory therapist can help you decide if you are a candidate for this treatment.

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© 2017 American Association for Respiratory Care