Medication cannot cure asthma, but it can help manage symptoms and reduce asthma attacks.
Treatment with asthma medication focuses on:
- Taking asthma medication that controls inflammation and prevents chronic symptoms such as coughing, and breathlessness at night, in the early morning, or after exertion ('preventers’).
- Providing asthma medication to treat asthma attacks when they occur ('relievers').
- Avoiding asthma triggers.
- Monitoring daily asthma symptoms in an asthma diary.
- Monitoring peak flows with daily asthma tests.
There are two general types of asthma medication that can give you long-term control or quick relief of symptoms.
- Relievers. These asthma medications are also known as bronchodilators. They relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways. This action rapidly opens the airways, letting more air come in and out of the lungs. As a result, breathing improves. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out more easily. If you need to use your reliever inhaler three or more times a week, you may need to take a preventer drug too.
- Preventers are the most important type of therapy for many people with asthma, although not everyone with asthma will need them. Preventers are anti-inflammatory medications that help to prevent asthma attacks on an on-going basis. Inhaled steroids, medically known as corticosteroids, are an important type of preventer medication for people with asthma. These asthma medications reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers.
These asthma medications can be administered in different ways. Successful treatment should allow you to live an active and normal life. If your asthma symptoms are not under good control, you should contact your doctor or asthma nurse for advice and discuss whether a different asthma medication may work better for you.
Long-term control asthma medications
If regular use of a preventer medication does not control your asthma symptoms, you may also need to use another add-on treatment - so-called because it is added on to your existing medication. Doctors and asthma specialists recognise that asthma has two main components: airway inflammation and acute bronchoconstriction (constriction of the airways). Research has shown that reducing and preventing further inflammation is the key to preventing asthma attacks, hospitalisations, and death from asthma.
Add-on treatments are used daily over an extended period of time to achieve and maintain control of persistent asthma that is not controlled by the regular use of a preventer drug.
These add-on medications include:
- Long acting reliever inhalers (bronchodilators) which act for longer than the usual reliever inhalers, usually for 12 hours, and are generally used twice a day. These long-acting reliever inhalers should only be used if you are also using a steroid preventer inhaler. Combination inhalers containing both a long-acting reliever and a steroid preventer are available.
- Leukotriene receptor antagonists (LRTA) are taken as tablets, usually once or twice a day, even when you do not have symptoms. Latest NHS guidance recommends these tablets alongside preventer inhalers, instead of combination inhalers (or 2 separate devices) delivering long acting beta-agonist (LABA) together with a low-dose inhaled corticosteroid (steroid).
- Theophylline (a bronchodilator) may be added to help prevent night-time symptoms.
- Omalizumab is an injectable asthma medication that is used to treat severe asthma symptoms that are difficult to control. It is only prescribed by specialists and is given by injection every two to four weeks.