The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.

Prescription Medications

Short-acting rescue medications

  • Beta-2-agonists
  • Ipratropium bromide (Atrovent)
  • Corticosteroids (oral form or intravenous)

Long-term control medications

  • Corticosteroids (inhaler form)
  • Corticosteroids (oral form)
  • Nonsteroidal anti-inflammatory inhalers
  • Long-acting Beta-2-antagonists
  • Methylxanthines
  • Leukotriene modifiers
  • Combination agents (inhaled steroid and long-acting beta-2-agonist)

Short-acting Rescue Medications

Short-acting rescue medications are used to treat acute asthma symptoms.

Beta-2-agonists (Inhalers):

Asthma Inhaler for a Child

© 2008 Nucleus Medical Art, Inc.

Note: Children will be more likely to benefit from inhaled medications if a spacer device is used with metered dose asthma inhalers. The University of Arizona, College of Medicine, Dept. of Pediatrics, provides a comparison of spacer devices. Available at: http://www.peds.arizona.edu/allergyimmunology/southwest/devices/spacers/spacer.html .

Common names of beta-2-agonists (inhalers) include:

  • Albuterol (Proventil, Ventolin)
  • Levalbuterol (Xopenex MDI)
  • Pirbuterol (Maxair)
  • Terbutaline (Brethine)

These drugs are bronchodilators, meaning they open the airways by relaxing the muscles around bronchial tubes. This can provide quick relief of acute symptoms. They can also be used as preventive medications prior to exercise. You must be careful not to overuse these drugs and contact your doctor immediately if your symptoms are not controlled.

Common side effects include:

  • Fast heartbeat
  • Headache
  • Nervousness
  • Tremor

Ipratropium Bromide (Atrovent)

Ipratropium ( I-pra-TROE-pee-um) is a bronchodilator (medicine that opens up narrowed breathing passages). It is taken by inhalation to help control the symptoms of lung diseases, such as asthma , chronic bronchitis , and emphysema . Ipratropium helps decrease coughing, wheezing, shortness of breath, and troubled breathing by increasing the flow of air into the lungs.

When ipratropium inhalation is used to treat acute, severe attacks of asthma, bronchitis, or emphysema, it is used only in combination with other bronchodilators.

Common side effects include:

  • Cough
  • Dryness of mouth
  • Unpleasant taste

Corticosteroids (Oral)

Common names include:

  • Methylprednisolone (intravenous)
  • Prednisone (oral)
  • Prednisolone (oral)

These drugs are sometimes used for a short duration to prevent the progression of moderate or severe symptoms, reverse inflammation, speed recovery, and reduce the risk of relapse.

Possible side effects include:

  • Indigestion
  • Lowered resistance to infections

Long-term Control Medications

Long-term “control” medications are used to achieve and maintain long-term management of symptoms and reduce inflammation.

Corticosteroids (Inhaler)

Common names include:

  • Beclomethasone (Beclovent, Vanceril, Qvar)
  • Budesonide (Pulmicort)
  • Flunisolide (AeroBid)
  • Fluticasone (Flovent)

These drugs suppress, control, and reverse inflammation. They can reduce the need for oral corticosteroids.

Possible side effects include:

  • Oral thrush

Corticosteroids (Oral)

Common names include:

  • Methylprednisolone (Medrol)
  • Prednisolone (Pediapred, Orapred)
  • Prednisone (Deltasone, Orasone)

These drugs help reduce inflammation and prevent escalation of symptoms. Oral corticosteroids can produce more side effects than inhaled corticosteroids. Long-term use of oral corticosteroids is not generally recommended. However, your doctor may prescribe oral corticosteroids for long durations only when other treatments have failed to restore normal lung function and the risks of uncontrolled asthma are greater than the side effects of the medication.

Possible side effects include:

  • Indigestion, nausea, and possibly bleeding in the stomach
  • Lowered resistance to infections
  • Growth suppression (in children)
  • Obesity
  • Diabetes mellitus
  • Hypertension (high blood pressure)
  • Osteoporosis (thinning of the bones)
  • Cataracts

Nonsteroidal Anti-inflammatory Inhalers

Common names include:

  • Cromolyn sodium (Intal)
  • Nedocromil (Tilade)

These drugs are used for long-term prevention of symptoms. They may modify inflammation and can be used as preventive treatment prior to exercise.

Possible side effects include:

  • Unpleasant taste

Long-acting Beta-2-agonists

Common names include:

  • Salmeterol (Serevent)
  • Formoterol (Foradil)

These drugs provide long-term prevention of symptoms, especially nighttime symptoms, and are often added to anti-inflammatory therapy. They may also be used as preventive treatment prior to exercise or contact with a known allergen. However, they should not be used during an acute attack.

Possible side effects include:

  • Rapid heart beat
  • Tremor
  • Difficulty sleeping, nervousness

A recent study showed that long-acting inhalers, like salmeterol, may increase the risk of a life-threatening asthma attack and asthma-related death if taken for more than three months. Note: If you have any concerns, be sure to discuss them with your doctor.

Methylxanthines

Common names include:

  • Theophylline (Theo-Dur, Uniphyl, Slo-bid)

This type of drug provides long-term control and prevention of symptoms, especially nighttime symptoms. It works by opening the airways and relaxing the muscles around the bronchial tubes. It also increases the ability to clear mucus out of the airway.

Possible side effects include:

  • Headache
  • Fast heartbeat
  • Increased urination
  • Nervousness
  • Trouble sleeping

Leukotriene Modifiers

Common names include:

  • Zafirlukast (Accolate)
  • Zileuton (Zyflo)
  • Montelukast (Singulair)

These drugs provide long-term control and prevention of symptoms in mild, persistent asthma. They work by blocking the action of leukotrienes—chemicals that play a role in inflammation and allergic reactions.

Elevation of liver enzymes has been reported with Zileuton. Fewer adverse effects have been reported with Zafirlukast, but a potential for adverse reactions exists (since it is a new drug).

Combination Drugs

Common names include:

  • Fluticasone and salmeterol (Advair)

These drugs provide long-term control and prevention of symptoms by combining the effects of a long-acting beta-2-agonist and inhaled steroid. Therefore, its effects are similar to both agents used alone combined in one convenient formulation.

The side effects of Advair are similar to those described above for both fluticasone and salmeterol.

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your healthcare provider.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your healthcare provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.