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Is there a pill to treat asthma?

Oral medications can help control your symptoms alone or in combination with an inhaler

During an asthma attack, it can feel like you can’t get enough air into your lungs. Your breathing may become labored, causing wheezing that makes a whistling sound. You may experience chest tightness, coughing, and difficulty breathing so intense that you’re unable to speak. Some describe it as trying to breathe through your mouth with a straw. 

Asthma can be scary, but it’s far from uncommon. This chronic condition affects 1 in 12 people in the United States, according to the Asthma and Allergy Foundation of America. The good news? Though there is no cure, there are multiple ways to treat asthma, from inhalers and infusions to pills. This guide investigates how asthma pills work, their effectiveness, and how to find the right medication for you.

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Is there a pill for asthma?

Asthma pills are oral medications used to manage asthma, says Don. J. Beasley, MD, an otolaryngologist at Boise ENT in Idaho. These options are considered when traditional asthma medications such as rescue inhalers (like Ventolin and Xopenex HFA) and inhaled corticosteroids (like Flovent and Pulmicort) are insufficient or when patients have difficulty using inhalers.

According to the American Lung Association, there are two general types of asthma medications—both of which come in pill form:

  • Quick-relief medications, or rescue medications, work as bronchodilators to quickly relax the airway muscles to improve breathing during an asthma attack. 
  • Long-term control medications, or controller medications, are anti-inflammatory drugs that reduce airway swelling and inflammation to prevent asthma symptoms.

Most asthma patients are treated with combination therapy that includes quick-relief medicine and long-term control medicine.

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Types of asthma pills

Oral corticosteroids 

Oral corticosteroids are potent medications that reduce the immune system’s inflammatory reaction to prevent and treat asthma symptoms and attacks. By reducing swelling and inflammation, they help open up the airways to improve airflow. 

Corticosteroids for asthma in pill form include: 

Prednisone is the most common and effective asthma pill, says Twinkle R. Chandak, MD, a pulmonary specialist at Loma Linda University Health in California. It’s typically used to treat severe asthma attacks and prevent hospitalization and life-threatening consequences when other therapies have failed.

“[Corticosteroids] are typically used for short-term control of severe asthma symptoms and to prevent exacerbations,” Dr. Beasley says.

Short-acting beta agonists

Short-acting beta agonists (SABAs) are a type of fast-acting asthma medication that relieves symptoms of an asthma attack. They relax the smooth muscles surrounding the airways, which helps to open up and widen the air passages to alleviate asthma symptoms. 

In addition to inhaled medications, there is one SABA  in pill form called terbutaline, a bronchodilator that opens up closed airways tightened by asthma. It controls symptoms for up to six hours. Terbutaline is not recommended for routine treatment of asthma due to slower onset of action and more side effects.

Previously, there was another option called metaproterenol, but it is no longer available in the U.S. 

Long-acting beta agonists 

Long-acting beta agonists (LABAs) are a mainstay of therapy in asthma maintenance,” says Robert Glatter, MD, a board-certified emergency medicine physician and assistant professor of emergency medicine at Lenox Hill Hospital in New York. LABAs come in inhaled forms. Long-acting beta agonists help relax the muscles around the airways, making breathing easier. They work similarly to short-acting beta agonists but have a longer duration of action (12 to 24 hours). They are never used as a standalone treatment. Rather, they are prescribed with an inhaled corticosteroid (ICS), usually with one inhaler containing both a LABA and ICS. This combination helps lower the risk and frequency of asthma attacks by reducing inflammation in the smaller airways in the lungs, known as bronchioles. 

Standalone long-acting beta agonists (LABAs), which act as bronchodilators, could be used along with a standalone ICS as two different products. They include:

Antileukotrienes 

Antileukotrienes, also called leukotriene modifiers or leukotriene receptor antagonists (LTRAs), block leukotrienes, which are chemicals in the immune system that contribute to asthma and allergy symptoms. This drug class helps reduce inflammation, bronchoconstriction, airway edema, and mucus production. Long-term use of LTRAs helps to prevent asthma symptoms. These medications include:

It’s important to note that Singulair (montelukast) has a black box warning from the U.S. Food and Drug Administration because of the risk of mental health side effects, including suicidal ideation.

“The risk of suicidal ideation for those taking montelukast was more prevalent in patients with a prior history of suicidal thoughts and depression,” Dr. Glatter says. Because of this, healthcare providers must screen people for a history of mood disorders and suicidal ideation before prescribing Singulair. 

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Methylxanthines

Methylxanthines are an older class of medication that work by relaxing bronchial muscles in the lungs and chest to make it easier to breathe. Dr. Glatter says these medications are not often prescribed as often because their anti-inflammatory and bronchodilation properties are not as strong as newer classes of asthma medications, which also have fewer side effects. When prescribed, methylxanthines are typically an add-on therapy for individuals with moderate-to-severe asthma. 

Methylxanthines for asthma include:

Antibiotics

Sometimes, bacterial respiratory infections can exacerbate asthma symptoms. In that case, antibiotics may be prescribed to treat the underlying infection, says Dr. Chandak. They are not a primary asthma treatment. For example, these antibiotics can treat common infections:

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Role of asthma pills in long-term control

Although asthma inhalers like combination inhalers, metered-dose inhalers, and dry powder inhalers are the first line of treatment for asthma control, asthma pills also play a small role. 

“Asthma pills can be effective, especially for those who struggle with inhaler use or have specific types of asthma (like allergic asthma or exercise-induced asthma),” Dr. Beasley explains. However, he adds that their effectiveness varies based on the type of medication, the individual’s specific asthma triggers and symptoms, and how consistently they are taken.

When taken consistently as prescribed, long-term benefits of asthma maintenance medications include:

  • Better control of asthma symptoms
  • Reduced frequency of asthma attacks
  • Improved overall lung function 

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The bottom line: Asthma pills are crucial for treatment

Asthma pills can play a crucial role in an asthma treatment plan. These medications are designed to manage and control asthma symptoms, reduce inflammation in the airways, and prevent or relieve asthma attacks. Available options include corticosteroids, short-acting beta agonists, antileukotrienes, xanthines, and antibiotics.

“Consulting with a healthcare professional who can tailor treatments based on individual health needs and circumstances is crucial,” Dr. Beasley says. It’s a good idea to ask your provider to help you create a written asthma action plan. Likewise,  it’s essential to have regular follow-ups to monitor a medication’s effectiveness and adjust the treatment plan as needed.

Key takeaways

  • Asthma pills are oral medications used to manage asthma when traditional asthma treatments like rescue inhalers and inhaled corticosteroids fail.

  • Prescription medications include corticosteroids, short-acting beta agonists, antileukotrienes, methylxanthines, and antibiotics.

  • These pills control asthma symptoms, reduce inflammation in the airways, and prevent or relieve asthma attacks.

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