Treatment for Asthma: Controller Meds

Learn about the controller medications your doctor may prescribe for long-term asthma care.

If you have asthma, you most likely take medicine for long-term control of the disease. Controller medicines are different from quick-relief (rescue) medicines. They are not designed to stop an attack once it starts. Instead, they can help you manage your condition over time and improve your quality of life.

Long-term control medicines are usually taken every day and should be taken as prescribed by your physician. If you feel fine, you might think you don’t need them. But you likely need them — so you can continue to feel fine.

These medicines help keep your airways open. How they work depends on the type of medication. They may decrease airway inflammation, mucus production and your body’s reaction to triggers. They may relax the muscles that surround your airways. When you take them, you may not have as many asthma attacks. Or, when you have an attack, it may be milder.

You might take some of these medicines as a pill. Or, you may take them through an inhaler or a nebulizer. Inhalers and nebulizers are devices that help you breathe.

An inhaler is a portable hand-held device that delivers a spray or powdered medicine into your lungs. A nebulizer is larger, and runs on electricity or batteries. It delivers liquid medicine as a mist through a mouthpiece or a facemask.

Types of long-term controller medications

The most effective asthma controller medicines reduce airway inflammation. With less inflammation and swelling, the airways are less likely to react to asthma triggers.

Let’s look at the most common types of controller medicines. Keep in mind that you may not feel the effects of these medicines right away.

• Inhaled corticosteroids. They typically are used every day, whether you have symptoms or not. This type of medicine is the preferred medicine for long-term control. Those who take inhaled corticosteroids usually find that their asthma symptoms are far less frequent and severe. Decreased inflammation in the airways helps prevent the chain reaction that causes asthma symptoms. These types of corticosteroids are generally safe when used as directed by a doctor.
  If your asthma is severe, your doctor may prescribe corticosteroids in liquid or pill form to be taken for a short time to get your condition under control.
• Cromolyn. This medicine is taken through an inhaler or nebulizer, which sends a fine mist to your lungs as you breathe. Like corticosteroids, it also helps prevent airway inflammation. It may be prescribed to reduce asthma triggered by exercise or unavoidable exposure to something you are allergic to. It may also be used an alternative treatment for mild persistent asthma.
• Immunomodulator. Omalizumab, or anti-IgE. Given as a shot once or twice a month, this medicine helps prevent your body from having a reaction to triggers such as dust and pollen. Your doctor may suggest it if you have severe persistent asthma along with allergies, and if other medicines have not worked well enough.
• LABAs. Inhaled long-acting beta-agonists, which open the airways, can be combined with inhaled corticosteroids. They are not used as a primary therapy, but in combination with other controller medicines.
• Leukotriene modifiers. This medication is taken by mouth, in pill or liquid form. It works to reduce asthma symptoms by decreasing inflammation in the airways and relaxing the smooth muscles around the airways.
• Methylxanthine bronchodilators (theophylline). Taken by mouth, this medicine helps open the airways. It is not considered a first choice medication for asthma control. Too much theophylline can be dangerous. Your doctor will need to check the levels of the medicine in your blood to make sure you are getting a safe dose.

Like many medicines, some controller medications may cause side effects. One common side effect for a certain class of controller medications (particularly when taken through an inhaler) is thrush, a mouth infection. Using a spacer or holding chamber with your inhaler can help prevent thrush. Washing out your mouth with water after you use the inhaler can also help. If your doctor prescribes medication, be sure to discuss any possible side effects.

The type of medications prescribed to treat you will depend on how severe, persistent and frequent your asthma symptoms are.

Keep in mind that the goal of your therapy is to provide the least amount of medication necessary to give you the best control of your condition. Medications may be added, adjusted for dose or taken away depending on your symptoms and level of asthma control.

Ask your health care provider if you have questions about the medications you are taking, how to take them or how well they are working. Asthma cannot be cured, but you can gain more control over it.

By Emily Gurnon, Contributing Writer

Sources
National Heart, Lung, and Blood Institute. National Asthma education and prevention program. Expert panel report 3: Guidelines for the diagnosis and management of asthma. Accessed: January 11, 2016.
National Heart, Lung, and Blood Institute. How is asthma treated and controlled? Accessed: January 11, 2016.
Asthma and Allergy Foundation of America. Asthma overview. Treatment. Accessed: January 11, 2016.

Last Updated: January 11, 2016