Long-term control medications

Many people with asthma need to take long-term control medications daily, even when they don't have symptoms. There are several types of long-term control medications, including the following.

Inhaled corticosteroids

These anti-inflammatory drugs are the most effective and commonly used long-term control medications for asthma. They reduce swelling and tightening in your airways. You may need to use these medications for several months before you get their maximum benefit.

Inhaled corticosteroids include:

• Fluticasone (Flovent HFA)
• Budesonide (Pulmicort Flexhaler)
• Mometasone (Asmanex Twisthaler)
• Beclomethasone (Qvar RediHaler)
• Ciclesonide (Alvesco)

In children, long-term use of inhaled corticosteroids can delay growth slightly, but the benefits of using these medications to maintain good asthma control generally outweigh the risks. Regular use of inhaled corticosteroids helps keep asthma attacks and other problems linked to poorly controlled asthma in check.

Inhaled corticosteroids don't generally cause serious side effects. When side effects occur, they can include mouth and throat irritation and oral yeast infections. If you're using a metered dose inhaler, use a spacer and rinse your mouth with water after each use to reduce the amount of drug remaining in your mouth.

Leukotriene modifiers

These medications block the effects of leukotrienes, immune system chemicals that cause asthma symptoms. Leukotriene modifiers can help prevent symptoms for up to 24 hours. Examples include:

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

In rare cases, montelukast is linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. See your doctor right away if you have any unusual reactions.

Long-acting beta agonists (LABAs)

These bronchodilator (brong-koh-DIE-lay-tur) medications open airways and reduce swelling for at least 12 hours. They're used on a regular schedule to control moderate to severe asthma and to prevent nighttime symptoms. Although they're effective, they've been linked to severe asthma attacks. For this reason, LABAs are taken only in combination with an inhaled corticosteroid.

The most commonly used LABA for asthma is salmeterol (Serevent).

Theophylline

You take this bronchodilator daily in pill form to treat mild asthma. Theophylline (Theo-24, others) relaxes the airways and decreases the lungs' response to irritants. It can be helpful for nighttime asthma symptoms. You might need regular blood tests to make sure you're getting the correct dose. Potential side effects of theophylline include insomnia and gastroesophageal reflux.

Combination inhalers: Corticosteroids and long-acting beta agonists

Some inhaled asthma medication combinations contain both a corticosteroid and a bronchodilator:

• Fluticasone and salmeterol (Advair Diskus)
• Budesonide and formoterol (Symbicort)
• Mometasone and formoterol (Dulera)
• Fluticasone and vilanterol (Breo)