Medications for Asthma

Asthma Management: Quick-Relief and Controller Medications

Here are the basics about each of the medicines below. Only common problems with them are listed.

Prescription Medicine

Short-acting rescue medicine

  • Short acting beta-2-agonists
  • Anticholinergics such as ipratropium bromide
  • Corticosteroids
  • Magnesium sulfate

Long-term control medicines

  • Inhaled corticosteroids
  • Mast cell stabilizers
  • Long-acting Beta-2-antagonists
  • Leukotriene modifiers
  • Methylxanthines
  • Immunomodulators
  • Combination agents

Short-acting Rescue Medicines

These drugs can be used to treat sudden symptoms or for long-term control.

Beta-2-agonists (Inhalers)

Asthma Inhaler for a Child

Copyright © Nucleus Medical Media, Inc.

Common names are:

  • Albuterol
  • Levalbuterol
  • Pirbuterol

These drugs help to open the airways. This can provide quick relief. They can also be used before exercise.

Some problems are:

  • Fast heartbeat
  • Headache
  • Nervousness
  • Tremor
Ipratropium Bromide

Ipratropium opens the airways and may ease mucus. Tiotropium has also been used. They are inhaled to ease coughing, wheezing, and problems breathing. They are not often used in children.

Ipratropium is often used with other bronchodilators to treat sudden, severe attacks.

Common problems are:

  • Cough
  • Dry mouth
Corticosteroids (Oral)

Common names are:

  • Methylprednisolone
  • Prednisolone
  • Prednisone

These drugs help ease inflammation and prevent symptoms from getting worse. They can cause side effects when taken orally instead of being inhaled. Long term use is not advised.

Some problems are:

  • Indigestion, nausea, and possibly bleeding in the stomach
  • Lowered resistance to infections
  • Growth suppression (in children)
  • Obesity
  • Diabetes
  • High blood pressure
  • Osteoporosis (thinning of the bones)
  • Cataracts
  • Adrenal suppression
  • Muscle weakness
Magnesium sulfate (inhaled)

Magnesium sulfate may help treat adults with acute asthma.

Long-term Control Medications

These drugs are used to control symptoms and ease inflammation.

Corticosteroids (Inhaler)

Common names are:

  • Beclomethasone
  • Budesonide
  • Flunisolide
  • Fluticasone
  • Mometasone

These drugs reduce, control, and reverse inflammation. They may reduce the need to use oral corticosteroids and rescue medicine as often.

Some problems are:

  • Oral thrush
  • Cough
Mast-cell Stabilizer Inhalers

Common names are:

  • Cromolyn sodium
  • Nedocromil

These drugs may be used to prevent symptoms over the long term. They ease inflammation and can also be used before exercise.

Some people may have problems with cough when using these.

Long-acting Beta-2-agonists

Common names are:

  • Salmeterol
  • Formoterol

These drugs may be used to prevent symptoms over the long term. They are helpful at night and are often added to anti-inflammatory therapy, such as inhaled corticosteroids. They can also be used before exercise or exposure to an allergen. They should not be used during a sudden attack.

Some problems are:

  • Rapid heart beat
  • Tremor
  • Problems sleeping
  • Nervousness

Long-acting inhalers, like salmeterol, may raise the risk of asthma-related death, intubation (putting a tube in the windpipe to breathe), and hospitalization. This often happens when they are taken in error and used as rescue inhalers. These drugs are almost always given with an inhaled corticosteroid.

Methylxanthines

Common names include theophylline.

These drugs may be used to prevent symptoms over the long term. They are helpful at night. It works by opening the airways and relaxing the muscles around the bronchial tubes. It also makes it easier to clear mucus out of the airway.

Some problems are:

  • Headache
  • Fast heartbeat
  • Problems urinating
  • Nervousness
  • Problems sleeping
  • Upset stomach
Leukotriene Modifiers
  • Zafirlukast
  • Montelukast
  • Zileuton

Leukotriene modifiers ease inflammation by preventing the action of leukotrienes, which sustain inflammation. These types of medications are not used to ease sudden symptoms. They can be used to prevent symptoms from happening.

Some problems are:

  • Flu-like symptoms
  • Nervousness
  • Headache
  • Belly pain
  • Cough

Leukotriene blockers ease inflammation by stopping the production of leukotrienes. They are used for long-term control and prevention in mild asthma.

Some problems are:

  • High liver enzymes
  • Can cause problems when taken with other drugs
Immunomodulators

Omalizumab is a common name for this drug.

An injection of this drug binds to an antibody that leads to allergic symptoms. It provides long-term control and prevention of symptoms in mild asthma.

Some problems may be:

  • Pain and bruising at the injection site
  • Severe allergic reaction in some people

Combination Drugs

Some drugs are combined to make them easier to take and prevent people from using the wrong inhaler.

Common combinations are:

  • Fluticasone and salmeterol
  • Budesonide and formoterol

These drugs provide long-term control and prevention of symptoms by combining a long-acting beta-2-agonist and an inhaled steroid.

The side effects are the same as the ones listed for the individual drugs.

Special Considerations

When taking medicine:

  • Take your medicine as advised. Do not change the amount or schedule.
  • Be aware of the side effects. Tell your doctor if you have any.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicines can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one, including over the counter products and supplements.
  • Plan for refills.

References:

Acute asthma exacerbation in children. EBSCO DynaMed website. Available at: https://www.dyname... . Updated August 22, 2018. Accessed October 22, 2019.
Asthma exacerbation in adults and adolescents. EBSCO DynaMed website. Available at: https://www.dyname... . Updated January 29, 2019. Accessed October 22, 2019.
Asthma in adults and adolescents. EBSCO DynaMed Plus website. Available at: https://www.dyname... . Updated October 11, 2019. Accessed October 22, 2019.
Asthma treatment. Asthma and Allergy Foundation of America website. Available at:
...(Click grey area to select URL)
Updated September 2015. Accessed October 23, 2019.
Chronic asthma in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-asthma-in-children . Updated September 27, 2019. Accessed October 22, 2019.
Global Initiative for Asthma (GINA) global strategy for asthma management and prevention. GINA 2018.
Last reviewed September 2019 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 10/23/2019

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