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Living with asthma can feel like a constant balancing act. One day you’re breathing easily, and the next, a flare-up leaves you coughing and short of breath. Although asthma can’t be cured, remission — periods without active symptoms — may be possible with newer treatments.
Rescue and maintenance medications are the mainstays of asthma care, but other treatment options are available. In this article, we’ll explore four main categories of asthma treatment — including the latest options — and how they may help you breathe easier.
An asthma action plan is a written guide you create with your healthcare provider. It outlines what steps to take when your asthma is:
Asthma action plans are essential for managing asthma at any age.
If you’re an adult living with asthma, keep a copy of your action plan where it’s easy to find — such as in your wallet, on your phone, or posted at home. Share it with your family, roommates, or anyone who might need to help during a flare-up.
If you care for a child with asthma, be sure their action plan is shared with school staff, coaches, babysitters, and other caregivers who may need to respond to symptoms or emergencies.
Asthma medications can be inhaled, taken by mouth, or occasionally given as an injection. Most commonly, asthma medications are inhaled. Both maintenance (daily) and rescue (quick-relief) medications can be delivered through a nebulizer or an inhaler.
An inhaler is a handheld device that releases medicine into your airways to help you breathe. There are three main types:
Nebulizers are larger than inhalers and usually need to be plugged in or powered by batteries. They use a mask or mouthpiece to deliver liquid medication that’s turned into a mist. Using a nebulizer may take several minutes, while inhalers are typically quicker.
Treatment options for asthma include maintenance medications, rescue medications, lifestyle changes, and alternative therapies.
Maintenance medications are taken every day to help keep asthma symptoms under control and reduce the risk of asthma attacks. These treatments include both inhaled and oral medications.
Inhaled corticosteroids (ICS) — often simply called steroids — are some of the most effective long-term treatments for asthma. Taken daily through an inhaler, these medications reduce inflammation in the airways and calm the immune system. Research shows that inhaled steroids improve lung function and lower the risk of asthma flare-ups that require emergency care.
Common inhaled steroid asthma medicines include:
Inhaled steroids tend to have fewer side effects than oral steroids. The most common side effects are coughing, hoarseness, or a sore throat. A yeast infection in the mouth (called thrush) can also occur, but rinsing your mouth after using your inhaler — or using a spacer — can help lower the risk.
Combination medications combine an ICS with a long-acting beta-agonist (LABA). The steroid helps reduce inflammation. The LABA relaxes the muscles around the airways to keep them open.
Examples of combination treatments include:
Like LABAs, anticholinergic medications help keep the airways open by relaxing the smooth muscle. These are usually used as an add-on treatment for moderate to severe asthma. One commonly used option is tiotropium bromide (Spiriva Respimat), which is inhaled. Possible side effects include dry mouth, constipation, or stomach pain.
Anticholinergic medications are also available as combination inhalers with ICSs and LABAs. One example is Trelegy, which includes:
Leukotriene modifiers are oral medications (taken by mouth) that reduce inflammation or swelling and help relax the muscles around the airways. These drugs may be used alone for mild asthma or added to other treatments to help manage moderate or severe cases. They may also allow for lower doses of steroids. Side effects include headache and stomach pain.
Common options include:
In March 2020, the U.S. Food and Drug Administration (FDA) began requiring a boxed warning for Singulair due to the potential for serious mental health side effects.
Biologics are advanced asthma medicines. They block parts of the immune system that drive airway inflammation, which causes wheezing, shortness of breath, and other asthma symptoms. They’re usually reserved for moderate to severe asthma cases that aren’t well controlled by ICSs or other maintenance medicines. Research shows that these shots or infusions can reduce flare-ups and hospital visits.
Headache, sore throat, fatigue, and allergic reaction are possible side effects.
Examples include:
Theophylline (Theo-24) can be used to prevent shortness of breath, wheezing, and chest tightness. It’s been used to treat asthma since the 1930s. Theophylline is available as a pill or liquid. Since it can interact with many other medications, it isn’t usually used as a first-line therapy for asthma.
Bronchial thermoplasty is an outpatient procedure for treating severe, persistent asthma. It’s performed using a bronchoscope (thin, flexible tube with a camera) to see into the lungs. It uses thermal energy to shrink the smooth muscle in the airways that can make breathing difficult. This procedure is done under anesthesia.
Rescue, or quick-relief, medicines work fast to ease asthma symptoms during an attack. They’re taken only as needed — not every day. If you find yourself reaching for your rescue inhaler often, it could be a sign that your asthma isn’t well controlled. You should talk to your healthcare provider about making changes to your treatment plan.
Short-acting beta-agonists (SABAs) are quick-relief bronchodilators. This means they relax airway muscles, easing shortness of breath within minutes. They’re often the first medicine used during an asthma attack. Side effects may include a fast heartbeat or jitteriness.
Examples include:
Rescue anticholinergics relax the airways, making it easier to breathe. They may also help prevent a bronchospasm (sudden airway tightening). Ipratropium (Atrovent) is an anticholinergic rescue medication for asthma. Side effects include dry mouth, nausea, or dizziness.
Anticholinergics are sometimes combined with SABAs for severe flare-ups. On their own, they’re less effective than SABAs but may help people who don’t tolerate them well.
Oral steroids are used for severe asthma attacks to quickly reduce airway swelling and mucus. Common options include:
Doctors may prescribe a short “burst” for five to seven days, though longer courses are sometimes needed. Short-term effects can include fluid retention, mood changes, and high blood pressure.
Healthy habits can make asthma easier to manage, but they don’t replace daily medicines. The goal is to avoid asthma triggers that set off coughing, wheezing, and shortness of breath.
Common culprits include dust mites, mold, and pet dander. Wash bedding weekly in hot water, dust often, and keep stuffed animals to a minimum, as these can collect dust quickly. Try to keep pets out of bedrooms and off upholstered furniture.
Cigarette and wood smoke can trigger flare-ups. Avoid secondhand smoke whenever possible. If you smoke, ask your healthcare provider about smoke-free nicotine alternatives.
Stress can trigger asthma symptoms. Finding ways to manage stress, such as meditation, exercise, or therapy, can help control asthma symptoms.
Food allergies can worsen certain types of asthma. Common allergens include egg, cow’s milk, nuts, soy, and shellfish.
Staying active is also important, even if exercise sometimes triggers asthma. Warm up and cool down, and ask your doctor if you should take medicine before workouts.
Some people find relief using alternative therapies, such as breathing exercises or herbal supplements. Always ask your doctor before adding alternative therapies, since some can interact with medicines. These options may help you relax, but they should never replace asthma medications, which are proven safe and effective.
Asthma care has shifted from just controlling symptoms to aiming for remission. Thanks to newer, more effective medicines like biologics, many people can now remain flare-free for up to a year or more with no daily symptoms or steroid use. While not everyone will reach remission, your healthcare provider will help you build a plan to give you the best chance.
On MyAsthmaTeam, people share their experiences with asthma, get advice, and find support from others who understand.
What asthma treatments have worked best for you? Let others know in the comments below.
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