Managing your asthma symptoms may sometimes require medication. You have many prescription medication choices to consider. Your healthcare professional can advise what may work best for you based on your asthma symptoms and lifestyle.
Choosing a medication that helps relieve your asthma symptoms can be an important part of your care journey.
Finding the right medication depends on many factors, including age, symptoms, triggers, and how your body responds. Your choices may range from a quick-relief inhaler or rescue treatment to longer-term medication taken daily.
Knowing what medications are available can help you work with your doctor to create your treatment plan. This guide will help you better understand the many types of asthma drugs available today, what symptoms they’re designed to treat, and what side effects you may experience.
Are over-the-counter medications OK for asthma?
Effective asthma medications, including those recommended by the American Lung Association, aren’t available over the counter (OTC). Generally, OTC asthma medications are discouraged. Your doctor can prescribe the medication that’s best for you.
Many medications are sprays or powders that must be inhaled deep into the lungs. You can take them using an inhaler or a nebulizer.
Both can deliver fast-acting or long-term medications. The device you use won’t change the drug’s effectiveness. It’s often a matter of preference, and each method has pros and cons.
Inhalers
These handheld devices are used to pump medication into your lungs.
Inhalers are small, light, and portable but can also be easily lost. If you or your child uses an inhaler, be sure to have backups.
Inhalers come in two types:
- Metered dose inhalers (MDI): An MDI delivers a measured spritz of medication when you press the inhaler. Some MDI inhalers count the doses used so you know when the medication is about to run out. You can also use a spacer with an MDI inhaler, which attaches to the inhaler and “holds” the medication in a small chamber to inhale it when you’re ready. This works well for young kids and babies. You can attach either a mouthpiece or a face mask to the spacer for easy inhalation.
- Dry powder inhalers (DPI): A dry powder inhaler releases medication in powder form. To use it, you inhale powder forcibly out of the inhaler. This method requires a bit more work on the user’s part and generally isn’t the best choice for young kids.
Read more about asthma inhalers.
Nebulizers
Nebulizers are plug-in or battery-powered devices that turn liquid asthma medications into a mist that’s easy to inhale. They allow the lungs to quickly and easily absorb the medication.
To receive the medication, wear the nebulizer’s mouthpiece or face mask and then slowly breathe in the mist.
It usually takes 5 to 10 minutes to breathe in the medication from the nebulizer.
The downside is that the machines need a power source and are less portable than inhalers. They can also be bulky and loud.
Learn more about asthma nebulizers.
Bronchodilators are a rescue therapy that can offer rapid relief from asthma flare-ups or more serious attacks.
They target the tightened muscles in your lungs that are restricting your airways. These drugs help relax the lung muscles, widening your airways and making it easier for you to breathe.
Read more about bronchodilators for asthma.
Short-acting beta agonists
These inhaled medications provide near-instant relief during an asthma attack, and the relief can last for several hours. Short-acting beta agonists are the drugs of choice for treating exercise-induced attacks. Examples include:
- albuterol (ProAir HFA, Ventolin HFA)
- levalbuterol (Xopenex HFA)
The more common side effects of these drugs include:
- shakiness
- excitability
- headache
- throat irritation
- fast heart rate
In rare and serious cases, these drugs may cause heart arrhythmias.
Anticholinergics
Anticholinergics are another class of fast-acting, inhalable bronchodilators that can provide quick relief from an asthma attack. One example is ipratropium bromide (Atrovent HFA).
The more common side effects of anticholinergics include:
- trouble breathing
- nosebleed
- nasal dryness
- nasal irritation
- dry mouth
Rare but serious side effects include bronchospasms, which are muscle spasms in the lungs that narrow your airways. Rare side effects also include worsening of preexisting heart arrhythmias.
Long-term asthma control medications are taken daily. They’re used to prevent asthma symptoms rather than treat sudden asthma attacks.
Anti-inflammatory agents target inflammation in your lungs. They reduce lung swelling and irritation, which helps improve your breathing. Anti-inflammatory drugs are used for daily maintenance to help prevent asthma symptoms.
For long-term treatment, your doctor may also decide to prescribe an anti-inflammatory drug, a bronchodilator, or a combination of the two.
Long-term asthma control medications are divided into the following groups.
Inhalable corticosteroids
These anti-inflammatory drugs are the strongest and most commonly prescribed long-term asthma drugs. Examples of these drugs include:
- beclomethasone (QVAR)
- budesonide (Pulmicort Flexhaler)
- flunisolide (Aerospan)
- fluticasone (Flovent Diskus, Flovent HFA)
- mometasone (Asmanex)
The more common side effects of inhalable corticosteroids include:
- throat irritation
- nosebleed
- headache
- nose irritation
- oral thrush
Rare but serious side effects can include:
- bronchospasm
- vision problems
- increased blood pressure in the eyes
- decreased growth in children
Oral corticosteroids
Corticosteroids are systemic drugs, which means they affect your entire body.
They can be used to treat severe asthma symptoms. These drugs are anti-inflammatories, and they work by relieving swelling and inflammation in your airways. Oral corticosteroids are taken by mouth.
Examples of these drugs include:
- prednisone
- methylprednisolone
- hydrocortisone
Treating severe asthma attacks
You can learn more about managing more severe asthma attacks and symptoms, and what specific medications and lifestyle hacks may help you be best prepared for these situations.
The more common side effects of these drugs include:
- weight gain
- high blood sugar levels
- trouble sleeping
- slow wound healing
Long-term use of corticosteroids can cause side effects that may be serious. That is why these drugs should only be used for short periods of time, such as during an asthma flare-up. Examples of serious side effects include:
- peptic ulcers
- osteoporosis
- glucose intolerance
- weight gain
Long-acting beta agonists
Long-acting beta agonists (LABAs) are bronchodilators.
They help prevent asthma attacks and are typically taken twice daily using an inhaler. They’re always used along with an inhalable corticosteroid. While these drugs are fast-acting, they may provide relief for up to 12 hours.
Examples of these drugs include:
- formoterol (Perforomist)
- salmeterol (Serevent Diskus)
The more common side effects of these drugs include headache and muscle pain. Rare but serious side effects can include bronchospasm and throat spasms.
Combination inhalers
Combination inhalers are common prescriptions for asthma. They include a combination of a corticosteroid and a LABA. Combinations available in the United States include:
- budesonide and formoterol (Symbicort)
- fluticasone and salmeterol (Advair Diskus)
The more common side effects of these drugs include headache and throat infection. Rare but serious side effects can include heart arrhythmias, increased blood pressure, and bronchospasm.
Leukotriene modifiers
Leukotriene modifiers are considered anti-inflammatory drugs, but they work differently from corticosteroids. They come in tablet form and work by blocking the action of leukotrienes. Leukotrienes are substances in your lungs that cause the air passages to constrict. They also cause your lungs to make excess mucus.
Examples of leukotriene modifiers include:
- montelukast (Singulair)
- zafirlukast (Accolate)
- zileuton (Zyflo, Zyflo CR)
The more common side effects of these drugs include headache, stomach pain, and muscle pain.
More serious side effects can include liver damage, blood disorders, and seizures. Montelukast in particular can also
Methylxanthines
Methylxanthines are bronchodilators that are also thought to have some anti-inflammatory effects. These drugs come as pills. One example of a methylxanthine is theophylline (Theochron, Theo-24, Elixophyllin).
These drugs are rarely prescribed. This is because they require close monitoring to make sure that the amount of drug in your body stays within a narrow range. If the amount goes above that range, it puts you at risk of serious side effects such as heart arrhythmias and seizures.
The more common side effects of these drugs include:
- headache
- trouble sleeping
- nausea
- vomiting
Immunomodulators
Immunomodulators are also called biologics. They affect your immune system, blocking substances that cause asthma attacks. These drugs are typically only prescribed for people who can’t control their asthma symptoms with other types of asthma medications. Examples of these drugs include:
- mepolizumab (Nucala)
- omalizumab (Xolair)
- reslizumab (Cinqair)
Each of these drugs can cause different side effects, but the common ones include:
- headache
- tiredness
- injection site reactions
- muscle and joint pain
- infections
More serious side effects can include:
- hypersensitivity reactions, which can include anaphylaxis
- bronchospasm
- heart attack
- stroke
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You have many options for asthma medications. But so much depends on your asthma journey.
If you’re considering a new or different asthma medication, here are some questions you may want to ask your healthcare team and doctor:
- Am I using my asthma medication correctly?
- Why is my asthma getting worse?
- How long do I wait before switching asthma medications or dosages?
- Are there options beyond medication?
- Do any meds have side effects that aren’t worth the risk?
- What exercises can I do to help with my asthma instead of medications?
The American Lung Association offers other resources for people with asthma to keep in mind, from information on asthma medications to finding support from others in the asthma community.
There are many medication options for treating your asthma symptoms. The type of medication you take and how you take it depends on factors such as age, the severity of your symptoms, triggers, and lifestyle.
Keeping current on the medications available will help you best manage your asthma. Talk with your doctor regularly about your symptoms and how each medication works for you. They can continue to help you tailor your treatment plan.