Asthma medication

About asthma

Uncontrolled or untreated asthma can make you at risk of having more asthma attacks and can damage your lungs. You and your doctor can make a plan to control your asthma that includes the correct prescribed medication and when to seek help.

The most important part of asthma management is preventer medication treatment. Preventer medication tries to prevent symptoms, prevent asthma attacks, maintain good lung function and improve quality of life. Reliever treatment is used when you experience symptoms and need relief immediately.

Your doctor will develop a written asthma action plan for you or your child. An asthma action plan is like an instruction manual for your asthma written by your doctor. These instructions will tell you how to use your asthma medications based on your symptoms. Do not change the use of asthma medication (for you or a child in your care) without checking the instructions on the plan or speaking to your doctor.

Everyone with asthma should have an asthma action plan, no matter how old you are or how mild your asthma might feel.

Types of asthma medication

Asthma can be well controlled with the appropriate medication in almost all people. The main types of medication are:

• Preventers – that slowly make the airways less sensitive to triggers by reducing swelling and mucus inside the airways. This medication is taken daily.
• Relievers – that act quickly to relax the tight muscles around the airways and are used when symptoms breakthrough, despite good asthma management. This medication is used during an asthma attack. Relievers can also be used to prevent exercise-induced asthma when prescribed by a doctor.
• Combination preventers – that contain 2 to 3 different medications and act to reduce inflammation as well as relax the airway muscles.
• Dual purpose relievers – that are used to treat breakthrough symptoms and work by relaxing airway muscles and providing anti-inflammatory action at the same time.

Some people with asthma require additional medication to maintain good health, including ‘add-on’ medications and injectable medications for people with asthma which is difficult to control. Asthma Australia’s website provides more detailed information about the different types of asthma medications.

Reliever – asthma medication

If you have asthma, you need to carry reliever medication at all times.

Relievers contain a ‘brochodilator’, which simply means that it opens the airways by relaxing tight airway muscles.

They are only used when you have asthma symptoms or if your doctor recommends using it before exercise.

You should avoid overusing reliever medication and if you notice you need it more than 2 days a week, make an appointment with your doctor to discuss your asthma control.

Asthma Australia has asthma educators who can also assist you in understanding your asthma – book a call.

Preventer – asthma medication

Preventer medication is usually taken once or twice daily. The most effective preventers are inhaled. These are known as inhaled-corticosteroids (ICS). There is a preventer which is also available in tablet form, sometimes used for children and some adults.

Most adults and children can achieve good control of asthma symptoms with a low dose preventer. It is important that preventers are taken every day as prescribed, even if you feel well. Preventer medication is the key to keeping well with asthma.

Preventers reduce swelling and mucus in the airways and reduce your risk of severe asthma symptoms or flare-ups.

Depending on the triggers of asthma symptoms, some people may need to change their dose of preventer medication during a particular season. For example, in spring if you are allergic to pollen or in winter if viruses are a trigger. Best medical practice is to give only the smallest doses of medication to keep symptoms under control, but you should never reduce the dose of medication without speaking about it with your doctor. Have any changes to your preventer medicine updated on your written asthma action plan.

Combination preventer – asthma medication

If inhaled corticosteroid alone has not controlled your asthma, your doctor may prescribe a combination preventer. Or occasionally combination preventers may be prescribed when asthma is diagnosed.

Combination preventer medication is taken in one device and usually includes an inhaled corticosteroid (ICS) or preventer to reduce inflammation and sensitivity, and a medication to relax the airways (a ‘bronchodilator’, which in this case is called a ‘long-acting beta-agonist' or LABA).

Some combination preventers now have 3 ingredients, called triple therapy. They have an inhaled corticosteroid (ICS) and 2 medications to relax the airways: a long-acting beta-agonist (LABA) and a long-acting muscarinic antagonists (LAMA). The 2 airway relaxing medications work in different ways to open the airways and make it easier to breathe. Triple therapy medications are often used for more difficult to control asthma or if asthma is in combination with another breathing condition, such as emphysema or chronic obstructive airways disease.

Dual purpose reliever – asthma medication

Dual purpose reliever refers to a combination medication used as a reliever, to treat symptoms as needed, when they happen. This medication is prescribed for people with mild asthma, where symptoms are infrequent and not severe.

‘Dual purpose’ means having 2 aims. The dual purpose reliever aims to give a rapid relief of asthma symptoms from the action of the ‘bronchodilator’ (to relax the airways). The second aim is to reduce swelling and mucus from action of the inhaled corticosteroid (to reduce inflammation). The use of this combination product as needed to relieve symptoms has been found to reduce the risk of life-threatening flare-ups.

Unwanted effects of asthma medications

All medication has the potential to cause side effects. If you experience side effects from your asthma medication, it is important to discuss these with your doctor and pharmacist before stopping any medications.

The most common side effects of inhaled preventer medication (inhaled corticosteroids) are a hoarse voice, sore mouth and throat, and fungal infections of the throat. You can reduce the risk of these side effects by rinsing and gargling the mouth with water, and spitting it out, after using the preventer. If your preventer is a metered-dose-inhaler, it can be used with a spacer, and that reduces the risk of side effects further.

The most common side effects of reliever medications include tremor, rapid heartbeat and headache. These usually go away quickly. Once again, using a spacer can help with reducing unwanted effects. It is cheap and easy, and something you can do to keep using medication and limit side effects.

The only preventer treatment available by tablet, called Montelukast, can cause serious mood and behavioural side effects in a very small number of children who take this medicine. If your child is prescribed this medicine, inform your doctor immediately if you notice a change in their behaviour or mood.

If you are worried about any side effects of asthma medication, do not stop your dose of medication or those of a child in your care without speaking about it with your doctor. Stopping medication could lead to an asthma attack or asthma emergency that is worse than any potential side effects, and they may be preventable if discussed with your health professional.

Asthma attacks

During an asthma attack, follow your written asthma action plan. In an asthma emergency, call triple zero (000) and ask for an ambulance. Tell the operator that someone is having an asthma emergency.

While waiting for the ambulance, give 4 separate puffs of blue reliever medication with a spacer, taking 4 breaths for each puff, every 4 minutes.

If you do not have a blue reliever and you have a different reliever puffer learn how to use it in an asthma first aid or an asthma emergency.

Asthma Australia has advice about asthma first aid for adults and children.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• National Home Doctor Service – for after-hours home doctor visits (bulk billed) Tel. 13 SICK (13 7425)
• Asthma Australia Tel. 1800 ASTHMA (1800 278 462)
• National Asthma Council Australia Tel. 1800 032 495
• Allergy and Anaphylaxis Australia Tel. 1300 728 000
• The Royal Children's Hospital – videos to help you better understand and manage your child's asthma.