Asthma medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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Asthma, which is also called bronchial asthma, is a chronic lung disease that affects more than 25 million people in the U.S. currently. It is the most common chronic disease in children, affecting over 6 million in the U.S. alone. Asthma can be life-threatening without treatment it causes almost 1.6 million emergency room visits every year. African-American adults have the highest asthma rates in the U.S. While it is more common in female adults than male adults, it affects male children at a higher rate than female children.

What is asthma?

Asthma is a chronic respiratory disease that causes your airways to become narrow due to inflammation, making it hard to breathe. This also causes asthma symptoms such as shortness of breath, wheezing, and cough. Your symptoms will come and go and may be worse at night or when you exercise.

Asthma causes

It is often difficult to find a single, direct cause of asthma. Several risk factors play an important role in the development of this condition, including:

• Genetics. You are more likely to develop asthma if you have a parent or sibling with it. Atopy, the genetic tendency to develop an allergic disease, can play a big part in developing allergic asthma.
• Allergies. You are more likely to develop asthma if you have other allergic conditions, such as hay fever.
• Respiratory Infections. Respiratory infections in infants and children can cause inflammation and damage to their lung tissue. With their immune systems not fully developed, this can negatively impact their long-term lung function and increase the risk of asthma.
• Environmental factors. Exposure to environmental allergens and irritants is also thought to increase the risk of asthma. This includes tobacco smoke, air pollution, dust mites, molds, and chemicals.
• Obesity. There is an increased risk of asthma in children and adults who are overweight or obese.

Types of asthma

Certain situations seem to cause symptoms of asthma in some people, such as:

• Exercise-induced asthma. Sometimes your asthma symptoms can be brought on by exercise or physical activity. Some people without asthma can get symptoms when they exercise. This tends to be worse in dry or cold air.
• Occupational asthma. This type is a result of exposure to workplace allergens or irritants, such as chemical fumes or dust. Around 21% of working adults with asthma have found that their symptoms are worse at work. This can happen if you work indoors or outdoors.
• Allergy-induced asthma. Airborne allergens such as pollen, mold, cockroach waste, pet dander, and secondhand smoke can cause an asthma flare.

How is asthma diagnosed?

To properly diagnose asthma, your doctor or healthcare professional will look at your symptoms, review your medical history, perform a physical exam, and perform some lung function tests.

Asthma symptoms

Asthma is caused by a combination of:

• Inflammation and swelling in your airways
• Mucus clogging your airways
• Muscle contraction and squeezing around your airways.

This combination can cause symptoms such as:

• Shortness of breath
• Coughing, especially at night or in the morning
• Chest tightness, pressure, or pain
• Wheezing (a whistling sound when you breathe)
• Trouble sleeping due to asthma symptoms

Lung function tests

These tests can be used to diagnose and monitor asthma, including:

• Spirometry. This is the most common test used in asthma. It measures airflow through your lungs to determine if you have any narrowing in your bronchial tubes. It is performed by taking a deep breath and exhaling into a spirometer. It measures how much air you blow out (forced vital capacity or FVC) and how fast you do it (forced expiratory volume or FEV). A low score indicates you have swelling or inflammation in your lungs due to asthma or other lung condition.
• Peak flow. Although they are less accurate than a spirometer, a peak flow meter is a simple way to regularly test your lung function at home. It measures how hard you can push out air. Tracking your readings can help you figure out what triggers make your symptoms worse and how well your treatment is working.

What are some asthma treatment options?

The best way to manage your asthma is to avoid known triggers, prevent asthma attacks through long-term control medications, and use quick-relief medications if you have a flare-up. The National Heart, Lung, and Blood Institute (NHLBI) also recommends having an asthma action plan.

Medications

The two approaches with medications used to treat asthma are to try and prevent the swelling in your airways that lead to symptoms and to use quick-relief asthma inhalers to open airways that are swollen and limit your breathing. These can include:

• Inhaled corticosteroids. They are the most effective long-term control medicines and include Flovent HFA (fluticasone propionate), Pulmicort Flexhaler (budesonide), and Qvar RediHaler (beclomethasone). Many come in a metered dose inhaler (MDI), dry powder inhaler, or nebulizer solution.
• Leukotriene modifiers. Oral medications such as Singulair (montelukast) and Accolate (zafirlukast) help relieve asthma symptoms by relaxing the smooth muscles around your airways.
• Short-acting beta-agonists. Inhaled bronchodilators, such as Ventolin HFA (albuterol) and Xopenex HFA (levalbuterol) are the first choice for quick relief. They act within minutes to reduce symptoms during an asthma attack.
• Anticholinergics. Medications such as Atrovent HFA (ipratropium) reduce mucus secretions and open up your airways and provide quick relief.
• Combination inhalers. Medications such as Symbicort (budesonide/formoterol) and Dulera (formoterol/mometasone) combine a corticosteroid and a long-acting beta-agonist (LABA) to try and prevent asthma symptoms.
• Biologics. These injectable medications target a cell or protein in your body to prevent airway inflammation. They are typically only used in people who have severe asthma. Examples include Xolair (omalizumab) and Nucala (mepolizumab).
• Theophylline. Theo-24 (theophylline) is an oral medication you take daily to relax the smooth muscles that narrow your airways.
• Cromolyn. Gastrocrom (cromolyn) is a mast cell stabilizer that helps prevent airway inflammation caused by allergens or asthma triggers.
• Oral corticosteroids. If you are not responding to other therapies, your doctor may prescribe anti-inflammatory medications such as Medrol (methylprednisolone) or Deltasone (prednisone) to help reduce airway inflammation caused by severe asthma. 

What is the best medication for asthma?

The best medication for the treatment of asthma will depend on the individual’s specific medical asthma, medical history, medications that the individual is already taking that may potentially interact with asthma medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter asthma medications approved by the Food and Drug Administration (FDA).

Best medications for asthma

Your healthcare provider will determine the right dosage based on your response to your treatment plan, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.

What are the most common side effects of asthma medications?

As with all medicines, those used for asthma will have some side effects, depending on the class you are taking.

Some of the oral and inhaled asthma medicines can cause side effects, such as:

• Headache
• Sore throat
• Runny or stuffy nose
• Upper respiratory tract infection
• Oral thrush
• Nausea
• Stomach pain

The injectable medications used in asthma commonly cause:

• Headache
• Injection site reactions
• Fatigue
• Joint pain
• Muscle pain
• Infections

What are some home remedies for asthma?

Along with medications, they are some lifestyle changes and self-care techniques you can use to lessen the possibility of asthma attacks.

Asthma management

• Avoid triggers. Once you figure out what triggers your asthma, take steps to avoid them. Clean regularly to reduce dust, mold, and pet dander. Keep your windows when the air quality is low. If you have a pet, keep them out of your bedroom.
• Get regular exercise. Exercising can help strengthen your heart and lungs which may help reduce asthma symptoms. Always consult with your healthcare provider before starting any exercise plan.
• Maintain a healthy body weight. Asthma is harder to manage in overweight and obese people.
• Quit smoking. Smoking or exposure to secondhand smoke can increase your risk of having an asthma attack.
• Breathing exercises. Research has shown that doing regular breathing exercises may improve asthma symptoms and reduce the amount of rescue medication you have to use.

Frequently asked questions about asthma

Who gets asthma?

Asthma is caused by a combination of factors, including:

• Genetics
• Having other allergic conditions such as hay fever
• Respiratory infections as an infant or child
• Exposure to environmental allergens and irritants
• Obesity

What are some asthma triggers?

Common triggers for asthma can include:

• Viral infections
• Exercise
• Reflux (GERD)
• Environmental allergens
• Certain medications such as aspirin and beta-blockers
• Tobacco smoke
• Insects and plants
• Obesity
• Stress

What are foods to avoid with asthma?

The foods most commonly linked to allergic symptoms include:

• Cow’s milk
• Eggs
• Peanuts
• Soy
• Wheat
• Shellfish
• Tree nuts
• Fish

What medications should be avoided with asthma?

Several medications may trigger asthma attacks and should be avoided. They include:

• Aspirin and other NSAIDs such as Motrin (ibuprofen) and Aleve (naproxen)
• Beta-blockers such as Tenormin (atenolol) and Lopressor (metoprolol)
• ACE-inhibitors such as Prinivil (lisinopril) and Lotensin (benazepril)

Related resources for asthma

• Asthma symptoms and causes. Cleveland Clinic
• Asthma key facts. World Health Organization
• Learn how to control asthma. Centers for Disease Control and Prevention
• Asthma overview. Asthma and Allergy Foundation of America
• What is Asthma? American Lung Association