There is no cure for asthma, but you can treat it and manage your symptoms. With proper asthma treatment, you should be almost symptom-free and enjoy an active life.
Asthma is a chronic disease. This means while the symptoms may come and go, you have it all the time even when you don't feel the symptoms. To stay healthy and safe, follow your asthma action plan every day, even on days when you feel fine.
There are two main families of asthma medications that are used regularly to treat asthma: controller medications and reliever medications. Each family of medication is important as each has a different purpose.
Controller medication: These medications are taken daily to prevent the inflammation and sensitivity of your airways. Controller medications take days to weeks to work fully. There are different types of controller medications. Your healthcare team will work with you to find the best one to prevent your asthma symptoms. Speak to your healthcare team about what you should do if you miss a dose of this medication. Types of controllers include:
Inhaled corticosteroids (ICS) – These medications are taken daily to stop the inflammation in your airways and make the airways less sensitive. These are the most effective controller medication used to treat asthma. Since they are inhaled and go directly into the lung, there are few, if any, side effects at most doses.
Combination inhalers – These medications are generally taken daily to prevent symptoms. They contain an ICS and a medication that works to keep the muscles around your airways relaxed (long-acting beta-agonist). Combination inhalers are used when ICS alone does not prevent asthma symptoms. The side effects are very few as they are inhaled directly into the lungs.
- Anti-leukotriene receptor antagonists (LTRA) – They are taken once a day to help block the chemical leukotriene and reduce the airway’s sensitivity and inflammation. These medications do not work as well as ICS in preventing symptoms. They may be used with ICS or on their own in some cases. There are few side effects with LTRA.
Biologics for severe asthma – These medications are given by injection for people who have asthma that is difficult to control with inhaled medications. Biologics work to block allergy related substances in the blood that cause inflammation and asthma symptoms. There are four biologics used in Canada to treat asthma. Each has its own conditions that must be met to use it. Your healthcare team will work with you to decide if you need a biologic and then which is the best for you. You will need to have blood tests to find out if these medications are suited to you.
Reliever medication: These inhaled medications are taken when needed to relax the muscles around your airways and treat your symptoms. Reliever (also called rescue) medications take minutes to work fully. These medications should not be used regularly. In fact, if you have to use your rescue medication more than twice a week to treat your symptoms, there is a problem with your asthma control.
- Fast acting beta-agonists (FABA) – These are the most common type of reliever. These inhalers are taken only when needed to relieve symptoms. While they begin to work quickly, they should completely relieve symptoms within 10-15 minutes. Side effects of these medications include feeling a tremble or feeling nervous.
- Combination inhaler – There is one combination inhaler that has been approved as a reliever as well as a controller in Canada. The bronchodilator in this inhaler works quickly like a FABA, but it lasts 12 hours.
- This inhaler is called Symbicort®. It contains formoterol fumarate as the bronchodilator and budesonide as the ICS.
Some people think they can skip the controller medicine and only use the rescue medicine. This is dangerous. If you've been prescribed a controller medicine, it is important to use it regularly. The rescue medicine by itself will not control your asthma over the long-term and could result in worsening asthma.
- To make sure you get all your medicine into your lungs, be sure you know how to use your inhalation device.
- Download our comprehensive Asthma Medications guide to learn more about each medication.
Some people with asthma also have allergies. If you have allergies, it can be harder to control your asthma. It can also increase the chance of a severe flare-up of your asthma symptoms. By treating your allergies you can help control your asthma symptoms. If you have allergy symptoms, speak to your healthcare team about the best treatments for you. They can include:
- Allergy shots (called subcutaneous immunotherapy)
- Allergy medications under the tongue (called sublingual immunotherapy)
This surgical treatment is used to help some adults who have very severe asthma. The treatment is only available from specialized treatment centres. It involves three separate treatments using a tube called a bronchoscope. The tube goes down deep into the airways and warms the airway to make the muscles around them loosen.