Understanding your asthma medicines

Asthma medicines will be prescribed by your doctor according to your individual symptoms and severity of asthma. Reliever inhalers are used to treat acute asthma symptoms, though many people with asthma are given preventer medication, which is usually taken long term and works to prevent asthma symptoms from developing. Other asthma medicines include symptom controllers, combination medicine, and steroid tablets or liquid.

Why is medicine usually given by inhaler?

Most asthma medicines come in an inhaler, because this is the best way to get the medicine straight to your lungs. There are many different types of inhalers, and your doctor, nurse, pharmacist, or asthma educator will help you decide which one is best for you.

What are the main types of asthma medicine?

There are four main groups of asthma medicines:

• preventer inhalers
• reliever inhalers
• symptom controllers
• combination inhalers.

How do preventer medicines work?

Preventer medication is your most important asthma medicine, because it prevents swelling and narrowing inside the airways and reduces the likelihood of an asthma attack.

Preventers work slowly so you won’t notice any immediate change in how you feel. Your preventer controls your health for the months ahead. To be effective, preventer inhalers need to be taken everyday, even when you are well.

Preventer medicines usually come in brown or orange inhalers. Examples of preventer medicines are Beclazone, Flixotide, Intal, Pulmicort, Tilade and Vicrom.

Rinse your mouth out with water or clean your teeth after taking preventer medication to avoid getting side effects such as a sore throat or thrush in the mouth.

Steroid tablets

Sometimes your doctor may give you a short course of steroid tablets (usually prednisone), or for children a steroid liquid, in addition to your preventer inhaler. Oral steroids are very useful in bringing asthma attacks under control quickly. They do this by rapidly reducing the swelling in the lining of the airways and reducing the amount of mucus produced.

A short course of prednisone is safe with no lasting side effects. You can discuss possible short-term side effects and any other concerns with your doctor or pharmacist. Some people may notice a change in mood, energy level or appetite while they are taking oral steroids.

How do reliever medicines work?

Reliever medicine brings short-term relief from asthma, by relaxing the tight bands of muscle around your airways. This helps air flow in and out of your lungs more freely.

Relievers can help wheezing, coughing or tightness in the chest. Many people rely on their blue inhaler to feel better immediately, but they do not treat the underlying cause of their asthma (swollen and inflamed airways), by regularly using their preventer.

See a doctor or asthma nurse if you take your reliever more than three to four times a week, you wake at night or early morning with asthma symptoms, or asthma symptoms impact on your daily activities. This means your asthma is not under control and you may need to start or increase your preventer medication.

Reliever medicines generally come in blue inhalers. Examples of relievers are Atrovent, Bricanyl, Respigen, Salamol and Ventolin.

Some side effects of reliever medicines include mild shaking, headaches, a racing heart and restlessness.

How do symptom controllers work?

A symptom controller is long-acting reliever medicine for people whose asthma is not controlled by regular use of a preventer. It is taken twice a day to keep the airway muscle relaxed. The effect of each dose lasts 12 hours.

Symptom controllers are used in addition to the preventer inhaler. They do not replace preventer inhalers, which must be taken at the same time.

A symptom controller should not be used for immediate or emergency use. Your blue reliever inhaler should be used when you are having an asthma attack. It is, therefore, important to carry your reliever inhaler with you ‘just in case’.

Symptom controller medicines generally come in green or light blue inhalers. Examples of symptom controller medicines are Foradil, Oxis and Serevent. Some side effects of symptom controllers include mild shaking, headaches, a racing heart beat or restlessness.

What is a combination inhaler?

Combination inhalers contain both preventer and symptom-controller medicine in one inhaler.

Combination inhalers are prescribed for people who continue to have trouble with their asthma, despite regular use of high doses of an inhaler preventer and symptom controller. Ask your doctor if you may benefit from a combination inhaler. Examples of combination medicines are Seretide and Symbicort. (Symbicort may also be used in an emergency situation.)

Some of the unwanted side effects of combination inhalers are mild shaking, headaches, a racing heart beat, a sore throat or thrush in the mouth. Rinse your mouth out with water or clean your teeth after taking your combination medication to avoid getting a sore throat or thrush in the mouth.

Can you reduce your medicines?

If your asthma has been well-controlled for six months, you may want to talk to your doctor about reducing your medication dose. This will depend on the severity of your asthma and any side effects you may experience. When you start to reduce your medication it is advisable to still keep a supply of your medicine close at hand, just in case something triggers your asthma again.

Whenever you reduce your preventer medication you should monitor your peak flow and your symptoms. If either starts to get worse, you will need to increase or start your preventer medication again. It is important to follow your Self Management Plan and your doctor’s directions when changing medications.

Complementary therapies

Some people try complementary methods to control their asthma in addition to their medication, such as buteyko, homoeopathy, acupuncture, special diets, massage or traditional medicines. Many of these methods have not been tested scientifically for their effectiveness or potential to cause side effects.

Talk to your doctor, nurse, pharmacist or asthma educator if you are thinking of trying a complementary treatment. It is important to continue using your asthma medicines.

Related topics

Also see: Keeping your asthma under control

Original material provided by The Asthma Foundation of New Zealand, June 2009. Reviewed by everybody, October 2010.