What are medicines for asthma?

Asthma is a chronic (long-term) lung condition that can cause chest tightness and breathing problems.

You may need to use one or more medicines to manage your asthma, especially if your symptoms are severe.

If you have asthma you should have a written asthma action plan from your doctor. This plan is to help you notice when your symptoms get worse and know how to respond. You might need to change how you take your asthma medicines during a flare up.

It's very important to follow advice from your doctor or pharmacist when using asthma medicines.

What types of medicines might I be prescribed for asthma?

Asthma medicines are usually grouped into 'relievers' and 'preventers'.

• Relievers are used only when needed to relieve symptoms.
• Preventers are used regularly to prevent asthma symptoms.

Asthma relievers include inhaled salbutamol and terbutaline.

Asthma preventers include:

• inhaled corticosteroids
• long-acting bronchodilators
• montelukast tablets
• biologic injections

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How do asthma medicines work?

The most common way to take medicines for asthma is by using a handheld inhaler (also known as a 'puffer'). Sometimes, your asthma medicine can be given as a vapour (mist) through a machine called a nebuliser.

Inhalers and nebulisers deliver your asthma medicine to your lungs where they help to open your airways.

Some asthma preventers come as tablets. If you have severe asthma that is difficult to control your doctor might recommend an injection.

Using a spacer with your asthma inhaler

To get the best control of your asthma, use your puffers the way you have been told.

If you are using a puffer, you may benefit from using a spacer. This is a plastic container with a mouthpiece or mask at one end. You can get a spacer from your pharmacy. Using a puffer with a spacer helps more of your asthma medicine reach your lungs.

Learn more about how to use an asthma inhaler.

How do asthma relievers work?

Relievers (also called 'bronchodilators') are fast-acting asthma medicines. They provide quick relief from the symptoms of asthma, such as:

• wheeze
• chest tightness
• cough
• shortness of breath

Relievers relax your airway muscles and open up your airways, making it easier to breathe. They work within minutes and the effects last for up to 4 hours.

If you have asthma, you should always carry a reliever with you. Relievers usually come in a blue or grey inhaler (puffer) device. There are different types of relievers. The most common short-acting bronchodilator is salbutamol.

If you have exercise induced asthma you can use your reliever before exercising.

During an asthma flare-up, your doctor may prescribe an oral corticosteroid tablet such as prednisolone. You can take this for a few days to help relieve your symptoms.

What are the side effects or risks of asthma relievers?

For some people, relievers can cause side effects such as:

• palpitations (a fast heartbeat)
• shaking hands
• feelings of anxiety or nervousness

These feelings should pass quickly. Speak to your doctor or pharmacist if you are concerned about the side effects of using your inhaler.

Nearly everyone with asthma will also benefit from using a preventer medicine.

How do asthma preventers work?

Preventers help control asthma symptoms and prevent attacks. These medicines reduce the inflammation (redness and swelling) in the airways that can contribute to asthma symptoms.

Inhaled corticosteroids

Many people who get asthma symptoms use a preventer inhaler. Here are some examples of inhalers that deliver a low dose of corticosteroid to your lungs.

• beclometasone
• budesonide
• ciclesonide
• fluticasone

Your doctor will probably suggest a corticosteroid preventer inhaler if you:

• have had asthma symptoms 2 times or more in the last month
• sometimes wake up from sleep at night because of your asthma symptoms
• have had a flare-up in the past year that resulted in an urgent visit to a doctor or emergency department

Preventers take several days or even weeks to work, so they're not for the quick relief of symptoms. To work properly, your preventer needs to be used every day, even when you have no symptoms.

Combination inhalers

Some preventers contain 'long-acting bronchodilators' in addition to a corticosteroid. These are combination inhalers.

The long-acting bronchodilator helps to relax your tightened airway muscles. They allow your airways to open so more air can reach your lungs. Some names of long-acting bronchodilators are formoterol or salmeterol.

If you have an inhaler containing formoterol with budesonide (or beclomethasone) this can also be used as a reliever.

Montelukast

You may be prescribed a preventer called montelukast, which comes as a tablet. This can be used alone or together with an inhaled preventer.

If you or your child experience changes to your mood, sleep or behaviour while taking montelukast, tell your pharmacist or doctor.

Biologic injectable therapy

If you have severe asthma that is difficult to control, your doctor can refer you to a respiratory specialist (lung doctor).

The specialist might recommend trying an injection that helps reduce inflammation in your lungs.

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What are the side effects or risks of asthma preventers?

Inhaled corticosteroid preventers can have side effects such as:

• a sore throat
• hoarse voice
• oral thrush

You can reduce the chance of getting these side effects by using a spacer with your puffer, and by rinsing your mouth out with water after taking the medicine.

If you are using a biologic injection for hard to control asthma, ask your doctor about the benefits and risks.

Montelukast safety

If you take montelukast (also known as Singulair) you can get side effects which can be serious such as:

• agitation
• feelings of aggression
• sleep disturbance or nightmares
• depression or anxiety
• suicidal thinking

If you are taking montelukast and have severe symptoms such as suicidal thinking or behaviour, seek urgent medical attention.

If a child or adolescent is taking montelukast and has a change to their behaviour seek urgent medical attention.

For more information, read the Therapeutic Goods Administration's safety alert or the Consumer Medicine Information (CMI).

How long will I need to take asthma medicines?

Everyone's asthma is different. The type and dose of medicines you need will vary depending on your circumstances and asthma triggers.

Asthma is a long-term (chronic) condition, you are likely to need to take medicines for months or years.

Your doctor may need to adjust your asthma medicines so that your symptoms stay well controlled. They will aim to use the lowest dose of medicine that works to control your asthma.

When should I see my doctor?

It's important to see your doctor regularly to review your asthma medicines and your asthma action plan.

Adults should see their doctor for a review at least every 6 to 12 months, and children should be reviewed every 3 to 6 months. You should see your doctor for a review even if your asthma is well-controlled.

You should also see your doctor:

• after a flare-up
• about a month after starting a new medicine or having a dose change

See your doctor for a review any time your asthma is not well-controlled. Signs that you may need your asthma treatment adjusted include:

• needing to use reliever medicines more than 2 times a week
• needing to limit your activities due to asthma symptoms
• nighttime symptoms of asthma, such as cough or waking up from sleep feeling breathless
• daytime asthma symptoms on more than 2 days a week

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Resources and support

For more information and support, try these resources.

Asthma Australia has more information on the treatment of asthma.

Call Asthma Australia on 1800 278 462 to connect with an asthma educator and ask for advice.

Watch National Asthma Council's how-to videos to learn how to use your inhaler, spacer or nasal spray.

Use National Asthma Council's My Asthma Guide for practical strategies to help you understand and manage your asthma.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.