Allergy Capital

Asthma Medicines

Asthma medicines may be used to control symptoms of as needed or used regularly when cough & wheeze occurs more frequently.

Revised 24 August 2003

IMPORTANT The information provided is of a general nature and should not be used as a substitute for professional advice. If you think you may suffer from an allergic or other disease that requires attention, you should discuss it with your family doctor.

Reliever Medications
"Reliever" asthma treatment medications are also known as beta agonists or bronchodilators. Examples include salbutamol, fenoterol and terbutaline (Ventolin, Airomir, Bricanyl). They are normally pacakged in blue/grey containers. They work within minutes when inhaled to relax the muscle around the bronchial tubes. This makes it easier to breathe for a few hours. In patients with occasional and mild asthma, this may be all that is needed.

Preventative Medications
"Preventer" asthma medication reduces inflammation in the airways. When used regularly, the irritability of the bronchial tubes is reduced in line with a reduction in inflammation. It normally takes a few weeks before symptoms start to improve, but the inflammation continues to improve over several months. They do not cure asthma, although the dose can usually be reduced with time to the lowest amount needed to maintain good control.

Preventer medicines may be divided into three groups:

Non-steroid puffers (e.g. cromoglycate [Intal], nedocromil [Tilade]). These are useful in mild asthma, particularly as initial therapy in children. They are also very effective in helping to bloc exercise-triggered asthma.
Cortisone / steroid puffers (e.g. budesonide [Pulmicort], fluticasone [Flixotide], beclomethasone [Becloforte, Becotide, Qvar]). These are very effective anti-inflammatory drugs. When taken in standard doses, steroid sprays do not make you fat, diabetic or give you soft bones, bruising or make you put on weight. Nevertheless, your doctor will try to keep you on the smallest dose needed to keep your asthma under control. The main side effects are a husky voice or sore throat. This can be minimised by using a spacer device or by gargling with water after use.
Leucotriene antagonists. This new class of asthma medication became available in Australia in 1999. Taken as a once or twice daily tablet, medications like zafirlukast and montelukast (Singulair) reduce inflammation in the airways by blocking the effect of chemicals known as "leucotrienes". They are not related to steroids or cortisone.

Symptom Controllers
These drugs are normally taken twice daily to control asthma symptoms in patients already on a high dose of "preventer" puffers. Examples include eformoterol and salmeterol. They splint open the airways for up to12 hours at a time. They are used regularly and should not be used to treat asthma attacks. "Reliever" puffers should still be used in the usual way if needed. Examples include Oxis, Serevent, Foradile.

Combination drugs
In recent years, medications combining an asthma preventer with a symptom controller have appeared. Those currently available in Australia are Seretide (Flixotide + Serevent) and Symbicort (Pulmicort + Oxis).

Other Medications

Other medications such as theophylline tablets are sometimes used.
Steroid (or cortisone e.g. prednisone) tablets are also useful in patients with severe asthma.
Puffers containing ipratropium bromide can also be used to open up the airways.

Immunotherapy
Immunotherapy may also be effective in selected cases of asthma to reduce the severity of allergy and the need for medication.