Asthma

What are the different types of asthma treatment?

There are a few different sorts of asthma medication. Inhalers are one of the most commonly used treatments. Some inhalers are used ‘as-needed’ and others are for regular (daily) use. Another type is reliever (blue) inhalers, which used to be first the choice for people with mild or occasional asthma attacks. But nowadays, they’re prescribed less often, and only for people with specific triggers, like exercise.

Tablets, injections and infusions are also available if your asthma is more serious, but you’ll typically need to see a specialist for that.

Some people use a combination of reliever and preventer treatments, and some inhalers even do both at once. These are called combination inhalers.

What are the different types of asthma inhalers?

Current NICE guidelines^[1] recommend that the first-choice treatment for newly diagnosed asthma is an as-needed AIR inhaler. These are only used when symptoms flare up and contain a combination of formoterol (a long-acting beta-agonist or LABA) and a corticosteroid.

If your asthma isn’t well controlled with as-needed use, your clinician may recommend using a combination inhaler daily, which is known as maintenance and reliever therapy (MART).

In the UK, inhalers licensed for AIR and MART therapy in patients aged 12 and over include Symbicort Turbohaler, Fobumix, and Fostair. Luforbec is currently only licensed for MART but can be used off-license as an as-needed AIR inhaler as well. And while the list is relatively short at the moment, more inhalers are expected to be licensed for AIR/MART therapy in the future.

Other combination inhalers containing a corticosteroid and LABA can also be used for daily maintenance therapy:

• Formoterol combinations: Flutiform, DuoResp Spiromax
• Other LABA combinations: Stalpex, Sirdupla, Sereflo, Fusacomb, Seretide, AirFluSal, Relvar Ellipta, and Combisal.

Although they’re less commonly used nowadays, another type of inhaler includes preventer inhalers, usually brown in colour. They contain a low dose corticosteroid, which keeps inflammation and swelling in your airways under control. Because they stop swelling and inflammation from increasing in your airways, there’s less chance of you having a serious reaction to your asthma triggers.

If you do use this type of inhaler, it’s important to use it every day, even when you don’t have symptoms. Most people take their preventer inhaler twice a day, once in the morning and once in the evening.

Reliever or rescue (typically blue) inhalers, which used to be the first choice treatment, are also less often recommended nowadays. They are used for quick relief when you get symptoms (or when you’re having an asthma attack). They’re fast acting and work quickly in the airways to relax the muscles, so that you can breathe more freely. But overusing blue inhalers can actually increase the risk of severe attacks,^[2] which is another reason AIR/MART therapy is now preferred.

To recap, AIR/MART therapy has been proven to lower the risk of asthma attacks.^[1] For this reason, brown and blue inhalers are now prescribed less often, with clinicians often recommending AIR/MART as the preferred option.

What are the best practices for asthma prevention?

As well as using the inhaler as-needed or daily, as prescribed, there are a few things you can do to stop an asthma flare-up from happening. Knowing the signs of asthma and what causes them is important as you can avoid many of the triggers that lead to an attack. These can include things you’re allergic to or even stress.

It may also be helpful to maintain the air quality in your work or home if pollution and allergens are a trigger for you. ^[3]

A clinician will normally help you put together a personal action plan that can make it easier to stay on top of your asthma. This includes how to monitor the condition, what you should do if you have an asthma attack and information about your medicines.