Dr. William Berger, MD, FAAAAI, FACAAI


Physician
Allergy

Specialty

Pediatric Allergy


William Berger MD, FAAAAI, FACAAI
8229 Boone Blvd
Suite 260
Vienna, Virginia 22182 [MAP]
For an appointment , call (949) 364-2900
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Asthma Control with Long-Term Medications

If used in an appropriate, consistent manner, long-term control medications can reduce existing airway inflammation and may also help prevent further inflammation. However, your doctor should make sure you understand that these types of drugs aren’t advisable for rescue relief of a severe asthma episode. For this reason, your asthma management plan should also include a prescribed quick-relief medication (most often a quick-relief bronchodilator, as I explain in “Relieving asthma episodes with quick-relief products.” 

Long-term control medications include the following categories of drugs:

  • Anti-inflammatory drugs, such as inhaled corticosteroids (beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, mometasone, triamcinolone), oral corticosteroids (methylprednisolone, prednisolone, prednisone), and inhaled mast cell stabilizers (cromolyn and nedocromil). These drugs are available in metered-dose inhaler (MDI), dry-powder inhaler (DPI), or compressor-driven nebulizer (CDN) formulations.
  • Long-acting bronchodilators, such as inhaled salmeterol, formoterol, and oral forms of albuterol. Although most long-acting bronchodilators require at least 10 to 30 minutes to begin providing relief and four to six hours to reach full effect, a newer DPI formulation of formoterol (Foradil), approved by the FDA in 2001, starts working in most patients within one to three minutes.
  • A combination of the inhaled corticosteroid fluticasone with the long-acting bronchodilator salmeterol, approved by the FDA in 2000. This product, available under the brand name Advair Diskus, treats both airway constriction and inflammation and is one of the most commonly prescribed asthma medications in the United States.
  • Sustained release methylxanthine bronchodilators, such as oral theophylline.
  • Leukotriene modifiers, such as oral montelukast, zafirlukast, and zileuton, available as tablets. If your physician decides that this category of drugs is suitable for your condition, you may benefit from the ease and convenience of taking tablets, which may help you more effectively adhere to the pharmacotherapy aspect of your asthma management plan. (The FDA has also approved montelukast in pediatric formulations as chewable tablets and oral granules for young children and babies.)
  • Anti-IgE antibodies, which represent an exciting new development in asthma treatment. Omalizumab/rhuMAb-E25 (Xolair), which physicians administer by injection, is the first drug in this class to be approved by the FDA.

Excerpted from "Asthma for Dummies" by William E. Berger, MD