Treating and Managing Asthma

These medicines are taken routinely to help control asthma by correcting the underlying changes in the airways, such as swelling and excess mucus.  They can be one or a combination of medicines. These medicines can work in a number of different ways to relax the muscles around the airways (bronchodilators, anticholinergics, or leukotriene modifiers) or reduce the swelling and mucus production inside the airways (anti-inflammatory – corticosteroids). Add-on therapy with biologics may also be considered for asthma that is uncontrolled; these treatments work by targeting the underlying cause of inflammation in asthma, which can trigger airway swelling and symptoms.

• Bronchodilators³ are long-acting and should not be used for quick relief even though they are inhaled. Examples of some long-acting bronchodilators include salmeterol, formoterol, and olodaterol.
• Anticholinergics³ are a medicine that can be inhaled using a metered-dose inhaler or nebulized from a solution. This medicine is usually used in combination with an inhaled corticosteroid and should be taken daily for long-term control. They are often added on to treatment to relieve cough, mucus production, wheeze or chest tightness; some common anticholinergics are ipratropium and tiotropium.
• Leukotriene modifiers³ are medications taken in pill form that block the effect of leukotrienes or stop your body from producing them. This blocking helps your breathing tubes relax and also make less mucus; common leukotriene modifiers include montelukast, zafirlukast, and zileuton.
• Corticosteroids¹ (or steroids) are most often inhaled; it is important to rinse out your mouth with water immediately after using them to avoid getting thrush, a yeast infection in your throat. Common inhaled steroids include budesonide, beclomethasone, fluticasone, and mometasone. Some corticosteroids come in pill form and are usually used for short periods of time in special circumstances, such as when your symptoms are getting worse.³ Oral corticosteroids have serious long-term side effects compared to inhaled corticosteroids, so their use is limited. Common oral steroids include prednisone, prednisolone and dexamethasone.
• Add-on therapy² includes biologics, which are shots or infusions given every few weeks. They work by targeting a cell or protein in your body to prevent airway swelling. They are for moderate to severe asthma that is hard to treat with other medicines, or for people with asthma who are dependent on oral corticosteroids. They are for specific types of asthma and will not work for everyone. With adding a biologic, inhaled and oral steroids might be able to be reduced or discontinued over time.⁴