Other Medications to Control Asthma
Asthma medication falls into two general categories: drugs for quick relief and those for long-term control.
Quick-Relief Medication for Asthma
Quick-relief medication, which includes short-acting beta-agonists and anticholinergics, is inhaled (with the devices described above) to relieve flare-ups of asthma symptoms.
Short-acting beta-agonists include medications like albuterol and levalbuterol (Xopenex); they are the first choice for quick relief during attacks.
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These drugs relax the smooth muscles around the airways and reduce swelling in the lining of the airways.
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Anticholinergics like ipratropium (Atrovent) also rapidly relax the smooth muscles around the airways, similar to short-acting beta-agonists.
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In some cases, usually for severe asthma, corticosteroids (which reduce inflammation) are needed. These drugs are taken either orally at home or intravenously at a hospital.
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Long-Term Control Medication for Asthma
Long-term control medication helps prevent asthma symptoms by reducing the inflammation that makes your airways more sensitive to asthma triggers. These drugs are usually prescribed to be taken daily.
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Numerous drugs for long-term control are available:
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Inhaled Corticosteroids The standard treatment, and widely considered the most effective type of medicine to prevent attacks, inhaled corticosteroids work by reducing the body’s inflammatory responses.
Inhaled Long-Acting Beta-Agonists These drugs prevent the narrowing of the airways by relaxing the smooth muscles there; they should always be taken in combination with inhaled corticosteroids.
Biologics These drugs are made from cells extracted from living organisms — such as bacteria or mice. They’re then engineered to target molecules in the body that trigger inflammation or other immune system components that produce asthma symptoms. They are injected drugs, taken every two to four weeks, to prevent your body from reacting to allergenic triggers. They include omalizumab (Xolair), mepolizumab (Nucala), resulizumab (Cinqair), benralizumab (Fasenra), and dupilumab (Dupixent). They are most commonly prescribed for cases of severe asthma.
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Leukotriene Modifiers Taken by mouth, these drugs block either the production or the effect of leukotrienes, chemicals that can lead to asthma attacks and promote inflammation in the lungs.
Methylxanthines Taken by mouth, these drugs help relax and open the airways.
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Oral Corticosteroids Taken in pill or liquid form, these drugs are used when other medicines don’t adequately prevent asthma attacks.
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They are also used to treat certain cases of severe asthma.
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Combination Single Maintenance and Reliever Therapy
The National Asthma Education and Prevention Program (NAEPP) published updated treatment guidelines for people with moderate to severe asthma that’s not well controlled with current medication.
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The new guidelines suggest that a single inhaler with a specific medication combination — a corticosteroid plus the long-acting beta-agonist formoterol — may be more effective than increasing the dose of your current controller medication and using a separate rescue medication.
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This combination may help prevent unexpected trips to the emergency room or your doctor’s office. It may also help avoid larger corticosteroid dosages, which with long-term use, may raise the risk of side effects like osteoporosis and eye issues like cataracts and glaucoma.
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