Treatment Options for Allergy-Triggered Asthma

If you're one of the millions of Americans with allergic asthma, treatments can help you live a full and active life.

Rescue Inhalers (Short-Acting Bronchodilators)

These medicines work quickly and are usually the first ones your doctor will give you to use for an asthma attack. Everyone who has asthma should have a short-acting bronchodilator.

They're often called rescue inhalers because they come in a small inhaler that you carry with you and puff when you have symptoms. The effects last 4-6 hours.

They work by opening up, or dilating, the airways in your lungs. Rescue medications include albuterol (Proair, Proventil, Ventolin), levalbuterol (Xopenex), and pirbuterol (Maxair).

Inhaled Corticosteroids

If your doctor thinks you're using your rescue inhaler too often, that's a sign your asthma isn't under control. You may need to take medications such as inhaled steroids every day.

You inhale these drugs through a portable device. They curb inflammation in your lungs' airways.

They're called "controller" medications because they help control your asthma over longer periods. These medications can help keep your lungs working better after future asthma attacks. You probably won't need your rescue inhaler as much either.

Long-Acting Bronchodilators

Long-acting bronchodilators are another type of controller medication. They work like rescue inhalers, but the effects last longer, usually about 12 hours. You use them regularly, twice a day.

You should only use them along with inhaled steroids and never as the only medication to control your asthma.

Anti-Leukotriene Drugs

Montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) are pills that help long-term asthma control.

These drugs shut down the effects of molecules called leukotrienes, which trigger airway inflammation.

Oral Corticosteroids

Prednisone is a common steroid used by people whose rescue inhaler doesn't help enough when they have a severe asthma attack. It's usually taken as a pill. It works by lessening the inflammation that causes the serious symptoms.

You should use steroids only when you need them because they can cause serious side effects if you take high doses for a long time.

Antibody Treatment

Omalizumab (Xolair) is usually for people with severe asthma that doesn't go away and isn't controlled with other treatments. It prevents cells in your body from starting the inflammation process and makes you less sensitive to your triggers.

Continued

It's given as an injection every 2 or 4 weeks at your doctor's office because you might have a severe allergic reaction to it. It doesn't often cause other side effects, but it is expensive.

Mepolizumab (Nucala) is a new biologic injectable that targets the blood cells that trigger asthma attacks. By limiting interleukin 5 (IL-5), Nucala helps lower the number of severe asthma attacks and can also help a patient take less of their other asthma medications.

Immunotherapy

Some people with mild to moderate allergic asthma choose to get allergy shots from a doctor. This is called immunotherapy.

Allergy shots contain small amounts of what you're allergic to. When you get the shots over time, your body gets used to having those substances around, and it reacts less to them. Not only can allergy shots improve your asthma symptoms, sometimes they can prevent a flare.

Also, the FDA has approved three under-the-tongue tablets that can be taken at home. The prescription tablets, called Grastek, Oralair, and Ragwitek, treat hay fever and work the same way as shots. The goal is to boost a patient’s tolerance to allergy triggers. These meds, though, need to be used with caution. All 3 have a black box warning about the potential for life-threatening allergic reactions, so they should not be given to patients with severe, unstable, or uncontrolled asthma.

Alternative Therapies

While low levels have been linked with severe asthma, no studies show that vitamin D supplements can improve asthma. And no studies have shown that acupuncture or adjustments by a chiropractor help with allergic asthma.

WebMD Medical Reference Reviewed by Dan Brennan, MD on January 29, 2019

Sources

SOURCES:

CDC: "Asthma."

Asthma and Allergy Foundation of America: "Asthma Facts and Figures."

Jill Poole, MD, University of Nebraska Medical Center.

American Academy of Asthma, Allergy and Immunology: "Asthma Treatment and Management," "Leukotriene Modifiers."

Dermatology Online Journal: “Omalizumab: A recombinant humanized monoclonal IgE-blocking antibody.”

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