Medicines for treating asthma

Relievers or preventers are common medicines for treating asthma. You use relievers when needed during flare-ups. They can help with symptoms. You use preventers daily. They help in the long run to reduce airway swelling. These medicines help improve breathing for people with asthma.

 
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What medicines treat asthma symptoms?

Asthma medicines fall into many groups:

    • Relievers (used when needed). They give quick relief of symptoms during flare-ups (exacerbations).
    • Preventers (used daily). They help improve breathing over the long term. You should use them even if you don’t have any asthma symptoms.
    • Add-on treatments, to manage people with moderate to severe asthma.
    • Other short-term medicines, taken orally to manage flare-ups in severe asthma.

The doctor may give a person with asthma a reliever whether their symptoms are mild, moderate or severe.

The doctor is also likely to give a preventer to people who have moderate or severe asthma symptoms. This is on top of their reliever. A preventer is for daily use. Some people with mild asthma may also need to use a preventer.

For adults with asthma, some inhalers can have both a reliever and preventer. This means that you can use the same inhaler during a flare-up to help with symptoms. You can also use it daily to lower airway swelling even if you are not having symptoms.

People with asthma will use inhalers to take both relievers and preventers. If their asthma symptoms carry on, a doctor may give tablets as well.

Frequent symptoms or flare-ups may carry on in people with severe asthma. They may need add-on treatment on top of their current treatment. You should not use add-on treatments alone or as the first choice.

Inhalers

Inhalers are devices that let a person breathe in medicine. The device delivers it straight into their lungs. There are many types of inhalers for asthma medicine. You can’t use all inhalers the same way.

You or your child may have trouble using an inhaler. A spacer or mask can help.

Ask your doctor, nurse or pharmacist. They can teach you how and when to use an inhaler.

Find out more about inhalers

Watch the National Asthma Council of Australia's videos about using inhalers

Reliever medicines

Most relievers belong to a group of medicine called short-acting beta2 agonists (SABAs). They can have these active ingredients:

  • salbutamol (brands include Airomir, Asmol, Ventolin)
  • terbutaline (Bricanyl).

Reliever medicines help relax the muscles around narrowed airways. They quickly reduce asthma symptoms. They often work within 4 minutes. They can keep airways open for around 4–6 hours.

Inhaler devices for these medicines are often blue or grey. Some people call them 'blue reliever puffers'. A person with asthma should carry a reliever with them at all times. Ask your doctor, nurse or pharmacist. They can show you how and when to use one.

You should see a doctor if you need to used a reliever more than 2 days a week. You should also see a doctor if you are having asthma symptoms more than twice a week. This is a sign that your asthma is not under control or may be getting worse.

Preventer medicines

Preventers have anti-inflammatory medicines called corticosteroids. They lower swelling of the airways. Preventers make the airways less sensitive and irritated. They also help dry out the mucus in the lining of the airways that can lead to breathing problems.

By lowering swelling, these medicines can help keep asthma symptoms under control. They lower the chance of having an asthma flare-up. Children aged 6 years or older can use a low dose of an inhaled corticosteroid as a preventer.

The effect of a preventer medicine on the airways lasts for 12–24 hours. You should take it once or twice a day, as directed by your doctor.

Preventer medicines can have these active ingredients:

  • beclometasone (eg, Qvar Autohaler)
  • budenoside (eg, Pulmicort Turbuhaler)
  • ciclesonide (eg, Alvesco 160)
  • fluticasone (eg, Flixotide Accuhaler).

The inhaler devices that have these medicines are often brown, orange, rust or yellow.

A certain type of inhaler may suit one person, but not others. Things to keep in mind include:

  • the person’s hand strength and coordination. Some inhalers may be harder for people with weak hands or arthritis to use
  • the type of active ingredient. Some medicines only come in certain types of devices.

Combination preventer medicines

Combination preventer medicines often have both long-acting beta2 agonists (LABA) and inhaled corticosteroids packaged in one inhaler. These medicines can help treat asthma in the long term. They may be a good option if a single-ingredient preventer medicine can’t control asthma symptoms.

If children who are 6 years or younger are having problems controlling their asthma symptoms, they need to see a specialist. The specialist will decide if they need a combination medicine.

The combination of medicines will be:

  • a LABA (to ease shortness of breath, coughing and wheezing) and
  • an inhaled corticosteroid (a preventer medicine, to lower swelling of the airways).

You need to take these daily, either once or twice. It depends on the medicine.

For adults with mild asthma, doctors may give a combination inhaler that has both a reliever and preventer. In this case, you use it when needed for symptom relief. You do not need to use it on a daily basis.

These medicines include:

  • Symbicort (taken with a Turbuhaler or Rapihaler)
  • DuoResp (taken with a Spiromax)
  • Seretide (taken with an Accuhaler or MDI)
  • Breo.

Preventer medicines in tablet form

You can sometimes use other preventer medicines to reduce asthma symptoms that carry on. They are not the same as the inhaled corticosteroids discussed above.

One such medicine is montelukast (Singulair). It comes as a tablet (including a tablet you can chew).

You can use montelukast when you can’t control asthma symptoms with the use of a reliever and a preventer together.

Some side effects can be:

  • headache
  • stomach pains
  • loose bowel movements.

Some rare but more severe side effects can be:

  • feeling anxious or nervous
  • not sleeping well
  • feeling depressed
  • having suicidal thoughts and actions.

Even though they are rare, you need to be aware of these side effects. If you or your child take montelukast and are having suicidal thoughts seek urgent medical help.

Find out more about montelukast

Add-on treatments

If you have moderate or severe asthma symptoms, your doctor may give you an add-on treatment. This is on top of your current treatment.

Add-on treatment can be:

  • a long-acting muscarinic antagonist (LAMA) on its own such as tiotropium (Spiriva Respimat). It helps relax the airways. It comes in an inhaler that delivers a mist of medicine into the lungs.
  • a LAMA as part of a triple therapy FDC (fixed-dosed combination) inhaler which also has an inhaled corticosteroid and LABA.
  • a monoclonal antibody. It blocks the pathway that leads to airway swelling. These need treatment from a specialist.

A specialist may give a LAMA to children 6 years or older if:

  • their asthma symptoms are severe
  • a combination medicine alone can’t control their asthma symptoms.

Tiotropium may give you, or your child:

  • a fast or irregular heartbeat
  • shortness of breath
  • swelling on any part of the body
  • a rash, hives or itchy skin.

If this happens, talk to your doctor straight away or go to the nearest emergency department.

Find out more about tiotropium

Side effects

Like all medicines, asthma medicines can have side effects.

  • Side effects from LABAs can be shaky hands (tremors) and a fast heartbeat.
  • Inhaled corticosteroids have side effects such as a sore throat, hoarse voice, and sore raised patches in the mouth (a fungal infection called thrush).
  • Tiotropium side effects can be a dry mouth, cough, dry skin, feeling dizzy, or having trouble sleeping. Some more severe side effects can be blurred vision, high pressure in the eye, trouble swallowing, heartburn, finding it hard or painful when passing urine, constipation and worsening of breathing problems. Tell a doctor if these occur.

Rinse your mouth out with water straight after using an inhaler that has a corticosteroid. This is because medicine left in the mouth can cause thrush.

If someone is having side effects from their asthma medicine, they should not stop taking it. Stopping asthma medicine can cause more problems than side effects. It can lead to an asthma attack. These side effects may be of concern or causing problems for you. Speak with a health professional as soon as you can.

A person is less likely to have side effects if they take these medicines as directed by their health professional.

Having an asthma action plan

All people with asthma should have a written asthma action plan from a doctor. This will help to manage asthma symptoms and see the signs if their asthma worsens.

An asthma action plan will tell you how and when to use medicines. It will tell you which medicine to use from the ones your doctor prescribed. It will also instruct you on what to do in the event of an asthma flare-up.

It’s important to update the asthma action plan if there are any changes to your asthma treatment.

Find out more about asthma diagnosis and management

Find out more

    • For more information on asthma medicines, see the Consumer Medicine Information for your brand of medicine. You can find it on our Medicine Finder page or from your pharmacist or doctor.
    • If you have any questions about medicines, you can speak to one of our pharmacists at Medicines Line. Call 1300 633 424 Monday to Friday, 9am to 5 pm AET (excluding NSW public holidays).
    • For non-medicine products, such as inhaler devices, you can get further details from the manufacturer.
    • For more about living well with asthma, managing asthma in school children and community-level education and support visit Asthma Australia.

MedicineWise app

MW app iPhone

NPS MedicineWise has developed the MedicineWise smartphone app. It can help you keep an up-to-date list of all the medicines you take. It can also remind you on how and when to take your medicines.

Find out more about the MedicineWise app and how it can help you.