If you or a loved one has asthma, you should know about the best treatments for short-term relief and long-term control. This will help you and your doctor manage the symptoms. If you have symptoms or an asthma attack, it's important to know when to call your doctor to prevent an emergency.
You might need to use fast-acting rescue medicines, long-term treatments, or both.
Rescue inhalers (or quick-relief inhalers)
You use these medications to ease asthma symptoms. They relax the muscles that tighten around your airways. This helps open them up so you can breathe easier. If you’re using this type of medication more than 2 days a week, see your doctor.
- Short-acting beta-agonists are the first choice for quick relief of asthma symptoms. They include albuterol (ProAir HFA, Proventil HFA, Ventolin HFA), epinephrine (Asthmanefrin, Primatene Mist), and levalbuterol (Xopenex HFA).
- Anticholinergics such as ipratropium (Atrovent) lessen mucus in addition to opening your airways. They take longer to work than short-acting beta-agonists.
- Oral corticosteroids such as methylprednisolone ands prednisone lower swelling in your airways.
- Combination quick-relief medicines have both an anticholinergic and a short-acting beta-agonist.
Preventive long-term medications
These treat symptoms and prevent asthma attacks. They reduce swelling and mucus in your airways so they’re less sensitive and less likely to react to asthma triggers.
- Inhaled corticosteroids are the most effective long-term control medicines. These aren’t the same as anabolic steroids that people use to grow muscle. They include beclomethasone (Qvar RediHaler), budesonide (Pulmicort Flexhaler), ciclesonide (Alvesco), fluticasone (Flovent HFA), and mometasone (Asmanex Twisthaler).
- Inhaled long-acting beta-agonists open your airways by relaxing the smooth muscles around them. You’ll take this medication along with an inhaled corticosteroid. They include formoterol, salmeterol, and vilanterol.
- Combination inhaled medicines have an inhaled corticosteroid along with a long-acting beta-agonist, and sometimes also an anticholinergic. This is an easy way to take them together. They include Advair, Breo, Dulera, Symbicort, and Trelegy Ellipta.
- Biologics target a cell or protein in your body to prevent airway inflammation. They may be shots or infusions you get every few weeks. They can be expensive, so you usually get them if other medications don’t work. Biologics include benralizumab (Fasenra), dupilumab (Dupixent), mepolizumab (Nucala), omalizumab (Xolair), and reslizumab (Cinqair).
- Leukotriene modifiers relax the smooth muscles around your airways and ease swelling. You can take them as pills or liquids. These include montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo).
- Cromolyn prevents your airways from swelling when they come into contact with an asthma trigger. It’s a non-steroid medicine that comes in an inhaler.
- Theophylline (Theo-24, Theo-Dur) relaxes the smooth muscles that narrow your airways. It comes as a tablet, capsule, solution, or syrup.
- Tezepelumab-ekko (Tezspire) injection is a first-in-class medicine indicated for the add-on maintenance treatment of adult and pediatric patients aged 12 years and older.
- Long-acting bronchodilators. You might use tiotropium (Spiriva) along with corticosteroids if you have ongoing asthma symptoms even though you take a daily inhaled steroid. Never use long-acting bronchodilators alone as a long-term asthma treatment.
- Corticosteroids. If no other medicine can get your asthma attacks under control, your doctor might have you take these medications for a couple of weeks. They come in pills or liquids.
How Do You Take Asthma Medications?
Asthma inhalers are the most common and effective way to deliver asthma medicine to your lungs. They’re available in several types that work in different ways. Some deliver one medication. Others contain two or three medications. Your doctor might give you:
- A metered-dose inhaler, which uses a small aerosol canister to push out a short burst of medication through a plastic mouthpiece
- A dry powder inhaler, which releases the medicine only when you take a deep breath
If you’re having trouble using small inhalers, your doctor may recommend a nebulizer. This machine changes asthma medications from a liquid to a mist so it’s easier to get the medicine into your lungs. It also has a mouthpiece or mask that makes it a good option for infants, small children, older adults, or anyone who has trouble using inhalers with spacers. It takes a few more minutes to use than an inhaler.
Side Effects of Asthma Medications
Many medications have side effects. For example, inhaled steroids can cause mild problems, such as thrush infections and a sore throat, or more serious ones including eye disorders and bone loss. Keep your doctor up to date with how well your treatment is working and whether you have side effects. They’ll work with you to keep your asthma under control with as little medicine as possible.
Other Asthma Treatments
Medications aren’t the only way to control asthma. Your doctor might also try a condition called bronchial thermoplasty.
People with asthma often have extra smooth muscle in their airway walls. In this procedure, your doctor uses a small tube called a bronchoscope to send heat to the walls and reduce the smooth muscle. You’ll get the treatment over three visits about 2 or 3 weeks apart.
Asthma Action Plan
You and your doctor will work together to create an action plan. It can be on paper or online. Either way, it will boost your efforts to control your condition with information and directions on:
- How to know if your symptoms get worse
- Medicines to take when you’re doing well and when symptoms get worse
- What to do in an emergency
- Doctor contact info for an emergency
- How to control asthma triggers
Track your symptoms
You might need to keep track of your symptoms as part of your asthma action plan. Plans usually include three sections:
- Green. You don’t notice any symptoms, or you have them under control. You can use your regular medications.
- Yellow. Your symptoms happen more often or are worse. You might need to change treatments or use more medicine.
- Red. You have severe symptoms that need treatment right away, usually with several medicines.
Asthma Lifestyle Home Remedies
In addition to following your treatment plan, you can try:
- Breathing exercises. These can lower the amount of medication you need to control your symptoms.
- Herbal and natural remedies. Things that may help improve asthma symptoms include:
- Black seed oil (Nigella sativa). Some studies have shown that it can help open airways.
- Caffeine. It’s a mild bronchodilator, meaning it can open your airways, but it doesn’t work as fast as medications. Avoid caffeine for several hours before any medical appointment that might include a lung function test.
- Choline. This helps your body work the way it should. You can get it in meat, liver, eggs, poultry, fish, shellfish, peanuts, and cauliflower, or from a supplement.
- Pycnogenol. You can get this pine bark extract as a supplement.
Avoid Asthma Triggers
Many things in the world around you can set off an asthma attack. By keeping them under control, you can lower your chances of problems. Common triggers include:
- Pet dander. If you can’t live without a pet, at least keep them out of your bedroom.
- Dust mites. Wash your bedding in hot water, vacuum your furniture, and get rid of carpets if you can. Get someone else to vacuum if you can. Use a dust mask if you do it.
- Pollen and outdoor mold. Keep windows closed. Stay inside from late morning to afternoon.
- Tobacco smoke. If you smoke, get help to quit. Don’t let others smoke in your home or car.
- Cockroaches. Keep food and garbage in closed containers, and treat your house for pests. Stay out of the room until fumes go away.
- Cold air. Cover your mouth and nose in cold weather.
- Indoor mold. Fix leaky pipes, and clean moldy surfaces with bleach.
Treatment for Allergy-Induced Asthma
If allergies trigger your asthma, your doctor might give you medications such as:
- Omalizumab (Xolair). It targets proteins in your body that increase when you come into contact with something you’re allergic to. You get it as a shot every 2 to 4 weeks.
- Immunotherapy. These allergy shots or drops that you hold under your tongue build up your tolerance to allergy triggers over time. They might even get rid of the allergy.
Talk to Your Asthma Specialist
If you’ve been diagnosed with asthma but your treatment doesn’t seem to work anymore, it’s time to see your doctor again. Likewise, if you’re having to use your rescue inhaler too often, see your doctor. You may need to change your asthma treatment for better control.
Though asthma is common, it’s a serious condition that needs a diagnosis and treatment. Talk to your doctor for asthma support, and find the medications that work best for you.