Treating Asthma When Inhaled Corticosteroids Don't Work

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Usually, when you are diagnosed with asthma, your doctor's first step will be to prescribe you a rescue inhaler and a corticosteroid inhaler. The rescue inhaler you use when you're having an attack, and the corticosteroid inhaler you use daily to prevent attacks. But what if these measures alone are not keeping your asthma under control? Then, you need to let your doctor know. There are some other medications they can prescribe — and often do prescribe — when these preliminary measures don't work.

Long-acting Beta-Agonists

Long-acting beta-agonists are a type of medication that can be prescribed alongside corticosteroids when the corticosteroids alone are not giving you enough relief. The most common of these medications are formoterol fumarate and salmeterol xinafoate. Both are generally taken via inhaler every 12 hours, or twice a day. These medications work by relieving spasms in your bronchi, thereby preventing your bronchi from closing due to spasms. In other words, they relax the muscles in your respiratory tract.

Long-acting beta-agonists are generally safe, but they can cause side effects like dry mouth, headache, and insomnia in some patients. Often, these side effects subside after the first week or two as the body adapts to the medication.

Leukotriene Modifiers

Leukotriene modifiers work by blocking the actions of leukotrienes, which are chemicals your body produces in response to allergens, leading to airway swelling, mucous production, and the other symptoms of asthma. These medications are often prescribed for allergy-induced asthma. Your doctor may or may not have you continue taking the corticosteroid alongside the leukotriene modifiers. 

The most common leukotriene modifier for asthma is montelukast. It comes in a pill form to be taken once a day. You will need to take it for several days before its full effects kick in. Side effects include body aches, sore throat, and a dry mouth and throat.

Cromolyn Sodium

This medication helps alleviate asthma by blocking the action of various chemical modulators that cause inflammation in the body, and more specifically, in the bronchi. It's a common choice for patients whose asthma is induced by environmental pollutants, dry air, or exercise. Cromolyn sodium usually comes in an inhaler, and it needs to be taken four times a day. There are also nebulizer formulas of the medication that can be prescribed for more serious cases. 

Cromolyn sodium rarely causes side effects, but it may not be safe for patients with certain heart or liver conditions.

If corticosteroids alone are not working to alleviate your asthma, do not give up! Talk to your doctor about other asthma treatment options.