There are a number of medicines for available for the treatment of asthma. It may take time for you and your doctor to determine which medicines work best for you, and in what dosage. Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go directly to your lungs. Ask your health care provider to show you the right way to use an inhaler when you first start using it, and at every visit thereafter.

Quick-Relief Medicines

When an asthma attack occurs, it may be necessary to use quick-relief medications to re-open the airways and allow for regular breathing.

• Inhaled short-acting beta2-agonists are the first choice for quick relief. These medications give immediate relief for patients experiencing asthma symptoms by relaxing tight muscles around the airways. Carry your quick-relief inhaler with you at all times, and use it when you notice symptoms. The NIH advises that you talk with your doctor if you are using this medicine more than two days a week. If your child has asthma, make sure that anyone caring for her or him has the child’s quick-relief medicine and knows how to use it and when to get medical help.

Don’t use quick relief medications instead of long-term control medicines, the NIH says, because these short-term solutions don’t reduce inflammation and may not help reduce the frequency of attacks.

Long-Term Control Medicines

Most people who have severe asthma need to take some form of regular medication to help prevent attacks. The most effective long-term medicines reduce inflammation of the airways. These medicines help prevent symptoms from starting but do not provide quick symptom relief.

• Inhaled corticosteroids are the most commonly used medicine of this type, because they work for long-term relief of inflammation and swelling. The NIH experts say that most people find that inhaled corticosteroids greatly reduce the severity of symptoms. Generally, they’re safe when taken as prescribed. And they are not habit-forming. But they can have side effects, including thrush, a mouth infection. Like many other medicines, though, inhaled corticosteroids can have side effects. Most doctors agree that the benefits of taking inhaled corticosteroids and preventing asthma attacks far outweigh the risk of side effects. One common side effect from inhaled corticosteroids is a mouth infection called thrush. The NIH says this could be avoided if you use a “spacer” or “holding chamber” on your inhaler that can prevent medicine from landing in your mouth or the back of your throat. Check with your doctor to see whether that’s right for you. The NIH also suggests rinsing your mouth with water after taking inhaled corticosteroids. Asthma patients who have especially severe cases may need to take corticosteroid liquid or pills for a short time. However, if you take them for long periods, these medicines can increase risk of cataracts and osteoporosis. Your doctor may suggest taking calcium and vitamin D pills to protect your bones.

Other long-term control medicines include:

• A device called a nebulizer sends a fine mist of medicine to your lungs as you breathe in. Like inhaled corticosteroids, it helps prevent inflammation of airways.
• Omalizumabexternal (anti-IgE). According to the NIH, this medicine is injected once or twice a month. It blocks a reaction to asthma triggers. However, a rare but potentially dangerous reaction, anaphylaxis, might occur. Ask your doctor if you are at risk for anaphylaxis, what the signs are and what you should do if you have an attack.
• Inhaled long-acting beta2- agonists. These medicines, which help open the airways by relaxing the tighten airway muscles, might be added to inhaled corticosteroids for improved results, the NIH says. But inhaled long-acting beta2-agonists should never be used on their own for long-term asthma control—instead, they must be used with inhaled corticosteroids.
• Leukotriene modifiers. These oral medicines help block inflammation in the airways.
• Theophylline. Another oral medication, theophylline helps open the airways.

The NIH experts advise that if your doctor prescribes a long-term control medicine, take it daily. If you stop, your symptoms will likely return or get worse. You should also talk to your doctor about the possible side effects of these various medications and the steps that can be taken to control or avoid them. Depending on the medication you’re taking, your doctor can check its level in your blood to determine the proper dosage. This is done with some medicines, including theophylline.