Asthma Treatments and Medications

Asthma is a common, lifelong condition that causes inflammation and narrowing in the airways. People with asthma often experience wheezing, shortness of breath, coughing, and chest tightness. These asthma attacks or flare-ups can occur due to different triggers, including smoke, cold air, and even exercise. While it’s not a curable disease, it can be managed with the right medications that help reduce inflammation and open up the airways. It’s important to see a healthcare provider for symptoms that are severe or occur frequently, especially if breathing problems become harder to manage. 

How is asthma diagnosed?

Experiencing symptoms such as wheezing and difficulty breathing is usually enough to warrant a visit to a healthcare provider. They may make a diagnosis themselves or refer an individual to a pulmonologist or allergist. A diagnosis could entail the following:

• A review of symptoms and potential triggers: A healthcare provider may ask about symptoms, family history, and potential triggers for breathing problems. 

• A physical exam: This usually includes listening to breathing patterns and checking for possible signs of allergies.

• Pulmonary function tests: A spirometer is a device that measures airflow and can be used to check the effects of any narrowing or inflammation in the lungs. 

• Other tests: A peak flow meter can track breathing at home, while allergy tests can identify triggers. A fractional exhaled nitric oxide (FeNO) test can also measure airway inflammation to aid a diagnosis.

The severity and frequency of symptoms are key in determining what stage and type of asthma a person has. With this information, a healthcare provider can better understand potential treatment options.

Asthma treatment options

Asthma has no specific cure. Instead, treatment options are meant to control symptoms and prevent the condition from worsening. Avoiding potential triggers and using medication are the main options. Maintenance asthma medications are used every day to help manage airway inflammation for long-term control. In contrast, rescue medications are used during a flare-up to help open up the lungs. A healthcare provider may adjust treatment based on symptom control, with biologic injections and certain procedures reserved for severe cases.

Asthma action plan 

Patients with asthma will have an asthma action plan, or management plan. The plan lists the patient’s medications and instructions. It also describes what to do when certain symptoms occur, and when to contact the healthcare provider or seek emergency medical attention. If you or your child does not have an action plan, you can download and print one, then bring it to your healthcare provider to discuss and complete together. 

Types of asthma medication

Most asthma medications are inhaled and can work in different ways depending on the drug class. Some people may need to use more than one medication. 

Inhaled corticosteroids

Inhaled corticosteroids (ICS) are the first-line controller medication that helps reduce airway inflammation over time. Examples include Pulmicort (budesonide) and QVAR RediHaler (beclomethasone). Short treatment courses of oral steroids like prednisone may be prescribed for severe asthma flare-ups. 

Beta agonists

Beta agonists are medications that relax the muscles in the airways. Short-acting beta agonists (SABAs) can relieve symptoms during an asthma attack, with common examples including Ventolin HFA (albuterol) and Xopenex (levalbuterol). Long-acting beta agonists (LABAs) are used daily and provide longer-lasting control of symptoms, with examples including Serevent (salmeterol) and formoterol. Beta agonists are mainly used alongside an ICS, never alone. 

Combination inhalers

Combination inhalers have more than one medication to help better control symptoms that don’t improve with just one. The most commonly prescribed combination for asthma is an inhaled steroid with a long-acting bronchodilator. Symbicort (budesonide and formoterol) is an ICS-formoterol combination that can both control and relieve symptoms. Other similar combinations include Advair Diskus (fluticasone and salmeterol), Breo Ellipta (fluticasone furoate and vilanterol), and Dulera (mometasone and formoterol).

Long-acting muscarinic antagonists (LAMAs)

LAMAs, such as Spiriva Respimat (tiotropium), are bronchodilators that can be added to a combination inhaler for severe asthma. These medications can help further open the airways and improve breathing. They’re taken daily, not as a rescue inhaler. 

Leukotriene modifiers

Leukotriene modifiers are medications taken by mouth that help block leukotrienes, which are chemicals that can contribute to asthma-related inflammation. Singulair (montelukast) is the most common medication in this drug class, although Accolate (zafirlukast) is another option. 

Biologics

Biologics, or monoclonal antibodies, are injectable medications to control symptoms of severe asthma. They work by blocking or modifying the immune response that can cause airway inflammation. They’re mainly used if other inhalers aren’t enough to manage the disease. Examples include Xolair (omalizumab) and Dupixent (dupilumab). 

Over-the-counter asthma medicine

There are very few over-the-counter options for asthma. Primatene Mist is an over-the-counter epinephrine inhaler, but it is not usually recommended as a substitute for prescription inhalers to manage asthma. Keep in mind that some products could trigger asthma symptoms, including NSAIDs like ibuprofen and aspirin. Consult a healthcare provider if you’re not sure about whether you can take an over-the-counter medicine with asthma. 

RELATED: How much do inhalers cost?

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