Table of ContentsView AllTable of ContentsLifestyle ChangesMedicationsOTC TherapiesProceduresComplementary Therapy
Table of ContentsView All
View All
Table of Contents
Lifestyle Changes
Medications
OTC Therapies
Procedures
Complementary Therapy
Asthmais a complicated condition, one that has multiplecauses, varying degrees of severity, and no cure. Therefore, treating asthma is a matter of managing it to ward off symptoms and prevent exacerbations (asthma attacks), typically with inhaled medications called controller inhalers, and relieving symptoms when they do occur with rescue inhalers.
Other management strategies include avoiding triggers, which are unique for each individual who has asthma and taking other lifestyle measures. For people with allergic asthma, allergy shots sometimes can help.
This article will provide an overview of the various types of asthma treatments.
Asthma symptoms do not simply happen—they occur in response to exposure to a trigger of some sort that causes thebronchi(airways) to constrict and the production of mucus to go into overdrive, inhibiting the flow of oxygen to the lungs. There are several things you can do in your daily life to help prevent this from happening.
Self-Monitor
An important part of identifying and understanding your asthma triggers is measuring and tracking your asthma symptoms. You can monitor your asthma using two different methods:
Create an Asthma Action Plan
An asthma action plan is a written plan you create with your healthcare provider to help you obtain and maintaingood asthma control.
What’s in an Asthma Action Plan?In general, your plan should include the following things:Your asthma symptomsA list of triggers that cause your asthma symptomsA list of asthma medications and instructions on when to take themYour normal PEFREmergency telephone numbersPlans should be updated at least once a year.
What’s in an Asthma Action Plan?
In general, your plan should include the following things:Your asthma symptomsA list of triggers that cause your asthma symptomsA list of asthma medications and instructions on when to take themYour normal PEFREmergency telephone numbersPlans should be updated at least once a year.
In general, your plan should include the following things:
Plans should be updated at least once a year.
Asthma action plansare generally divided into three zones: green, yellow, and red. Each zone relates to a different level of asthma control and what to do when you find yourself in those states.
Steer Clear of Triggers
The more able you are to avoid those things that set off or worsen your asthma symptoms, the better off you’ll be.
Common asthma triggers include:
Before you banish your pup or attempt to battle dust mites, however, it’s important to remember two key things, according to the National Institutes of Health (NIH) recommendations for asthma management:
Different types of asthma medicines help with different types of symptoms. The two most common types of asthma medications are controller medicines and quick-relief medicines. What you use and when depends on several factors, including how severe your asthma is.
Verywell / Emily Roberts
Controller Medications
Asthma controller medicinesare a variety of long-term asthma control medications. Some are used alone, while some are combined with other drugs.
Inhaled Corticosteroids
People who have moderate or severe persistent asthma must use ICS medications daily.
Sometimes, high doses of ICSs aren’t enough to controleosinophilic asthma(EA), a type of severe asthma common in Black Americans.Long-acting beta-agonists may be a better treatment option for people with EA.
ICSs are safe and effective and have a low risk of side effects.They can be prescribed alone or as a combination product with two different medications.
Commonly used ICSs include:
Long-Acting Beta-Agonists
Long-acting beta-agonists(LABAs) are inhaled medications that open the airways, acting as bronchodilators. They are preferred when inhaled steroids do not adequately control symptoms.
LABAs are not used as a single asthma medication but as an add-on therapy and often are combined with another asthma medication in a single inhaler. They should not be used for an acute asthma attack as they can mask a worsening of your asthma.
LABAs include:
Leukotriene Modifiers
Leukotriene modifiers are an alternative treatment for patients with mild persistent asthma. They can be used alone to treat mild persistent asthma or along with inhaled steroids to treat moderate to severe persistent asthma. One use is in controlling exercise-induced asthma. They are not used for short-term relief during a sudden asthma attack.
They include:
Some people have reported psychological reactions to leukotriene modifiers, so any unusual symptoms should be discussed with your healthcare provider.
Add-on Controller Medications
Cromolyn sodium may be used as an add-on controller medicine and alternative treatment option for treating asthma. Although inhaled steroids are the treatment of choice, some people like these medications because they have a low incidence of side effects.
Long-Acting Muscarinic Antagonists
Long‐acting muscarinic antagonists (LAMAs) are a class of long-acting bronchodilators initially developed to treat COPD. They may be prescribed for people with uncontrolled persistent asthma that doesn’t respond to ICS therapy, but only if adding a long-acting beta-agonist is not appropriate for some reason.
Spiriva (tiotropium) is an example of a LAMA that may be used in asthma treatment.
Although LAMAs have been found to be as effective as LABAs, they are associated with side effects, especially for people who are Black.
Biologics
Most often given to people who have severe asthma, biologics alter the immune system so inflammation in the airways is reduced. They are shots or infusions given every few weeks. One such drug isXolair (omalizumab).
Signs Your Asthma Is Not Well ControlledYour asthma action plan may need to be adjusted if you:Need to use your rescue inhaler more than twice per weekExperience symptoms more than two days per weekWake up at night more than twice per month due to your asthma symptoms
Signs Your Asthma Is Not Well Controlled
Your asthma action plan may need to be adjusted if you:Need to use your rescue inhaler more than twice per weekExperience symptoms more than two days per weekWake up at night more than twice per month due to your asthma symptoms
Your asthma action plan may need to be adjusted if you:
Quick-Relief Medications
Quick-relief medications, also called short-term relief orrescue medications, relieve asthma symptoms within minutes. You take them at the first sign of symptoms.
Most often these medications are taken with an inhaler. Inhalers allow the drug to go directly to the lungs without affecting other systems in the body. They can be prescribed to be used alone or in conjunction with long-term, controller medications.
Quick-relief medications should only be used on an as-needed basis.
Short-Acting Beta-Agonists
Albuterol (Proair, Proventil, Ventolin) and levalbuterol (Xopenex) are the two most commonly prescribed SABAs.
Some people who have mild persistent asthma may have the option of using an ICS on an as-needed basis rather than daily, along with a SABA, according to the NIH recommendations.Talk to your healthcare provider about whether this guideline may be appropriate for you.
Anticholinergics
Anticholinergic drugs act as a bronchodilator and are often used in combination with SABAs in the acute treatment of asthma symptoms in the emergency room or hospital. An example of an anticholinergic is Atrovent (ipratropium).
Oral Corticosteroids
Oral steroids are used for moderate and severe asthma exacerbations to help improve symptoms and to prevent the late-phase response of the allergic cascade.
Oral steroids are used only as a controller medication after multiple other medications fail. They can have significant side effects.
Inhaled vs. Oral Corticosteroids
Over-the-Counter (OTC) Therapies
There are two commonly used OTC asthma inhalers: Primatene MIST HFA and Asthmanefrin (racepinephrine).
Remember, you should never stop your current asthma treatment or start an OTC asthma medication without talking to your healthcare provider first.
Guide to Over-the-Counter Inhalers for Asthma
Primatene MIST HFA
While this OTC inhaler can temporarily relievemild intermittent asthmasymptoms, it does not reduce the inflammation that leads to asthma symptoms. Only prescription beta-agonist medicines can help control inflammation.
Primatene Mist should only be used for mild symptoms of intermittent asthma. It is not for people with moderate or severe asthma.
Asthmanefrin
Asthmanefrin (racepinephrine), on the other hand, is designed to treat the inflammation that leads to asthma attacks. Unlike Primatene MIST HFA, Asthmanefrin is not FDA-approved to treat asthma.
But this OTC asthma inhaler isn’t for everyone. You shouldn’t use it if you are taking monoamine oxidase inhibitors (MAOIs) or have certain medical conditions, including heart disease, diabetes, and thyroid issues.
Specialist-Driven Procedures
If medications alone aren’t able to control your asthma well enough, some procedures might help.
Allergy Shots
You get the shots regularly—every week at first, then once a month for several years. Over time, you react less to those allergen triggers.
Everything You Need to Know About Immunotherapy for Allergies
Bronchial Thermoplasty
Bronchial thermoplasty (BT) is an outpatient bronchoscopic procedure that helps prevent airways from constricting in response to an asthma trigger. It is available for people withsevere persistent asthmathat is not well controlled withinhaled corticosteroidsandlong-acting beta-agonists.
In a BT procedure, a special catheter is inserted into the medium-sized airways of the lung duringbronchoscopy. Heat energy is released to reduce the amount of smooth muscle in those airways. The procedure is repeated on three or more days, each day treating a different area of the lung.
Studies have found the benefits of BT rarely outweigh the risk of short- and long-term side effects, however. For this reason, the NIH does not recommend the treatment for people over 18.
Complementary and Alternative Medicine (CAM)
The National Center for Complementary and Integrative Health notes that conventional medical treatments are best for effectively managing asthma symptoms. They report that there are no complementary health approaches that have good evidence that they can relieve asthma.
Breathing exercises are aimed at reducing hyperventilation and regulating breathing. An example isButeyko breathing. The exercises focus on decreasing both the volume and the number of breaths you take per minute. Some studies toward benefits of these breathing exercises. However, conclusions can’t be made because the studies used different methods.
While some complementary therapies may work simply due to the placebo effect, experts warn this can be dangerous in the case of asthma.
A 2011 study found that patients reported fewer asthma symptoms after taking a placebo inhaler and a simulated acupuncture treatment. However, their lung function did not improve, leaving them at risk.Even actual acupuncture has shown no difference over sham acupuncture in relieving asthma symptoms.
Summary
There is no cure for asthma, but it’s possible to control the condition and prevent flare-ups using a combination of treatments. Lifestyle changes, such as avoiding triggers, and using controller medications can reduce symptoms. Asthma attacks can be treated with rescue medications.
Prescription and over-the-counter options are available, but it’s important to follow a healthcare provider’s treatment plan—don’t try to manage your asthma on your own. Monitoring your symptoms and having an asthma action plan can help you stay on top of your condition and know what to do when flare-ups arise.
It’s no doubt that having asthma makes life more difficult. But with good asthma treatment, most people can do almost anything they want day-to-day. You need to educate yourself about your asthma treatment and begin developing your treatment team. Then, lean on them to evolve your treatment plan so that it works best for your life and your symptoms.
Frequently Asked Questions
You can use the “rule of twos” to tell if your asthma control is working: If you have symptoms or have to use your inhaler more than twice a week, if you wake up from sleep with symptoms more than twice a month, or if you refill your quick-relief medication more than twice a year, you may have uncontrolled asthma.Over time, uncontrolled asthma can lead toirreversible changesin your lungs and breathing as well as other serious health problems.
Biologics are a newer class of drugs that are generally reserved for people with severe asthma. By blocking specific aspects of the body’s immune system and inflammation response, biologics can reduce asthma symptoms and improve quality of life.Examples include Xolair, Dupixent, and Nucala.
What Is Asthma?
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program.Expert Panel Report 3 (EPR3): Guidelines for the diagnosis and management of asthma.
Dharmage SC, Perret JL, Custovic A.Epidemiology of asthma in children and adults.Front Pediatr. 2019;7:246. doi:10.3389/fped.2019.00246
Cloutier MM, Baptist AP, Blake KV, et al.2020 focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program coordinating committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003
Nyenhuis SM, Krishnan JA, Berry A, et al.Race is associated with differences in airway inflammation in patients with asthma.J Allergy Clin Immunol. 2017;140(1):257-265.e11. doi:10.1016/j.jaci.2016.10.024
Barnes PJ.Inhaled corticosteroids.Pharmaceuticals (Basel). 2010;3(3):514-540. doi:10.3390/ph3030514
Beasley R, Martinez FD, Hackshaw A, Rabe KF, Sterk PJ, Djukanovic R.Safety of long-acting beta-agonists: urgent need to clear the air remains.Eur Respir J.2009;33(1):3-5. doi:10.1183/09031936.00163408
Gadde D, Creticos P, Beakes D, et al.Adverse effects associated with leukotriene antagonist therapy.Journal of Allergy and Clinical Immunology.2010;125(2). doi:10.1016/j.jaci.2009.12.266
Sorkness CA, Schend VA.Monitoring for side effects from treatment.Clinical Asthma.2008:313-319. doi:10.1016/b978-032304289-5.10035-9
Ramsahai JM, Wark PA.Appropriate use of oral corticosteroids for severe asthma.Med J Aust.2018;209(S2):S18-S21. doi:10.5694/mja18.00134
U.S. Food and Drug Administration.FDA statement on approval of OTC Primatene Mist to treat mild asthma.
U.S. National Library of Medicine.Asthmanefrin.
Wilhelm CP, Chipps BE.Bronchial thermoplasty: A review of the evidence. AnnAllergy Asthma Immunol. 2016;116:92-98. doi:10.1016/j.anai.2015.11.002
NIH National Center for Complementary and Integrative Health.Asthma and complementary health approaches: what you need to know.
Freitas DA, Holloway EA, Bruno SS, Chaves GS, Fregonezi GA, Mendonça KP.Breathing exercises for adults with asthma.Cochrane Database Syst Rev.2013;(10):CD001277. doi:10.1002/14651858.CD001277.pub3
U.S. Food and Drug Administration.FDA warns consumers about the potential health risks of over-the-counter asthma products labeled as homeopathic.
Wechsler ME, Kelley JM, Boyd IO, et al.Active albuterol or placebo, sham acupuncture, or no intervention in asthma.N Engl J Med. 2011;365(2):119-26. doi:10.1056/NEJMoa1103319
American College of Allergy, Asthma, and Immunology.Recognizing uncontrolled asthma is your first step in controlling it.
American Academy of Allergy, Asthma & Immunology.Biologics for the management of severe asthma.
Centers for Disease Control and Prevention.Asthma.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
