Long-term-controller asthma medications help control the inflammation of your airways, which is directly associated with asthma. They prevent your airways from reacting to whatever it is that triggers your asthma. Long-term controller asthma medications are effective if taken every day, as directed by your doctor.
Drug manufacturers have taken very different approaches to providing long-term relief to asthma sufferers. I’ll be discussing five of these here:
Cromolyn
Cromolyn (brand name Intal) and Nedocromil (brand name Tilade) are inhalants that are designed to prevent mild to moderate asthma episodes. They are not effective for everyone, but have shown promise in the prevention of exercise triggered asthma attacks.
Inhaled Corticosteroids
Inhaled corticosteroids are anti-inflammatory asthma medications. They are the most effective medications for the long-term treatment of asthma. Corticosteroids are designed to decrease the amount of your asthma attacks and reduce the need for any other asthma medications you may use. Inhaled corticosteroids deliver anti-inflammatory asthma medication directly to your airways and effectively control most forms of asthma.
When used as directed, inhaled corticosteroids have a low risk of side effects and can help minimize your need for oral corticosteroids (which have a higher risk of side effects). Brand names include:
- Advair (fluticasone + salmeterol)
- AeroBid (flunisolide)
- Azmacort (triamcinolone)
- Flovent (fluticasone)
- Pulmicort (budesonide)
- Qvar (beclomethasone)
Leukotriene Modifiers
Leukotriene modifiers or anti-leukotrienes are asthma medications designed to block the action of or reduce the production of leukotrienes. Leukotrienes are substances released by cells in your lungs that cause the lining of your airways to become inflamed. Once your airways are inflamed you begin to wheeze, you are short of breath and your body begins to produce mucus.
Generally, anti-leukotrienes are not as effective as inhaled corticosteroids, although used in conjunction with other medications, especially inhaled corticosteroids, leukotriene modifiers may help prevent more asthma episodes. They are certainly an option if you have mild asthma and do not want to use inhaled corticosteroids. Brand names include:
- Accolate (zafirlukast)
- Singulair (montelukast)
- Zyflo (zileutin)
Inhaled Long-acting beta2-Adrenergic Agonists (LABA’s)
Inhaled long-acting beta2-adrenergic agonists (LABA’s) are bronchodilators — asthma medications designed to open up your airways. They normally have a positive effect on your asthma symptoms for at least 12 hours. Your doctor may decide to recommend this type of asthma medication to you to prevent nighttime asthma symptoms.
They are normally only prescribed to control moderate to severe asthma symptoms. These can be used in combination with inhaled corticosteroids and should never be used as the main treatment for your asthma. Brand names include:
- Foradil Aerolizer (formoterol)
- Serevent Diskus (salmeterol)
* The Food and Drug Administration issued a public health advisory for three LABA asthma medications. On November 18, 2005 the FDA issued a warning that the three asthma medications identified may in fact increase the risk of severe asthma episodes and could possibly lead to death if a severe asthma attack occurs. The three LABA’s are:
- Advair (fluticasone + salmeterol)
- Foradil Aerolizer (formoterol)
- Serevent Diskus (salmeterol)
If you are experiencing asthma attacks, and you are taking one of these medications, please discuss the FDA’s public health advisory with your doctor.
Theophylline
Theophylline is an oral bronchodilator. It comes in a pill form and may be helpful in relieving your nighttime asthma symptoms. Theophylline has been associated with some severe side effects. You may experience severe abdominal pain, acid reflux, nausea and vomiting, diarrhea, confusion, nervousness, and a fast or irregular heartbeat. Brand names include:
- Slo-bid
- Theo-Dur
- Theo-24
- Uni-Dur
Most long-term controller asthma medications have proven to be very effective and safe to use everyday. As always, be sure to discuss all of your treatment options with your doctor.
John Dowling says
I have taken most of the medication recommended above for my mild asthma.Recently I have had quite a severe attack and my Doctor has suggested that my liking of red wine has probably triggered my recent attack. I had asthma as a child but grew out of it as a teenager only to have it return in my fifties. Can this love of wine be a factor in asthma attacks.
Cody Wells says
Hi John,
Thanks for dropping by! I’m not a doctor or a medical practitioner of any kind, but I had written an article on “Sulfites & Asthma” which may help you understand why your doctor told you that it may have been the wine.
Just as an aside, many folks experience an asthma attack in their 30’s, 40’s or 50’s, without experiencing any breathing issues in their youth. I’m not at all sure why, but your experience certainly doesn’t seem to be uncommon.
Thanks again for dropping by and I wish you well!
~Cody
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