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Adult Information

Medications
The way we use medications and devices in Canada may differ from other countries.  Asthma medication advice, movies and illustrations found on this website are consistent with the latest Canadian Asthma Consensus Guidelines, based on the highest levels of scientific evidence.

Most asthma medications are inhaled and must be taken regularly, according to your doctor’s instructions.  There are two basic types of medications, “preventers/controllers” and “relievers.” 

To view a handy "Respiratory Inhaler Quick Reference Guide" click here.

Preventers/Controllers
Preventer/controller medications must be used regularly to help heal and prevent swelling in the airways.  These medications are often taken even when there are no symptoms, and help keep your asthma under control.  There are a number of different types of preventer/controller medications (see below).

Inhaled Corticosteroids are the most commonly used preventer/controller medications to keep asthma under good control.  These are not the same type of steroids that some athletes use to build muscle and they are not addictive.  Inhaled corticosteroids prevent swelling and decrease mucous or phlegm in the airways.  Corticosteroids have been used for many years to treat asthma and are very safe.  

For more information:
Inhaled Corticosteroids in Asthma written by Dr. Richard Leigh.
Risks of Not Treating Asthma written by Dr. Sheldon Spier  

    
When regular use of preventer medication does not control your asthma, your doctor may add a second type of preventer/controller medication to enhance the effect of the first.

Leukotriene Receptor Antagonists (LTRAs) are available in chewable pill form.  These can be taken in conjunction with an inhaled corticosteroid.  Some people with very mild asthma may be able to take only the pill to control their asthma symptoms, however, Canadian Asthma Guidelines suggest that almost all patients should be started on inhaled corticosteroids first.  LTRAs block the release of Leukotrienes, which cause swelling in the airways of the lungs.  
-Singulair:  4, 5 and 10 mg tablets

Long Acting Beta Agonists (LABAs) may be used when the regular use of an inhaled corticosteroid alone does not control your asthma. Your doctor may add a LABA to enhance the effectiveness of the corticosteroid.   LABAs always should be used in conjunction with an inhaled corticosteroid medication and should be taken regularly, like inhaled corticosteroids.  LABAs  relax the muscles surrounding the airways in the lungs for about 12 hours - this is much longer than rescue medications:

Combination Medications are convenient if your child needs to take both an inhaled corticosteroid and an LABA medication because they may be taken at the same time in a single device.  Current combination medications include Advair (Flovent + Serevent) and Symbicort (Pulmicort + Oxeze).       

Relievers/Rescue Medication
Relievers are short-acting medications that temporarily relax the muscles around the airways and are used as “rescue” medicine.  They bring relief in 5 to 10 minutes  that lasts for about 4 hours when you have symptoms like coughing, wheezing, breathlessness or chest tightness.  If you or your child use a reliever medication more than 4 times a week, it may indicate that there is uncontrolled swelling in the airways that must be treated with a preventer/ controller medication to gain control of asthma.  A reliever medication does not treat the swelling in the airways which is the main problem in asthma.  Relievers can be compared to taking Tylenol for a fever; Tylenol only lowers the fever (treats the symptom), but does not treat the underlying cause of the fever. 

To be sure the asthma medication reaches your lungs, it is important to use the proper technique.  Each type of medication device requires a different technique.  Your doctor and your pharmacist can demonstrate the proper device technique and teach you how to help your child take asthma medications correctly.  You can also view proper asthma device technique clicking here.   

Oral Corticosteroids
Sometimes asthma flare-ups cannot be controlled with your inhaled corticosteroid medications.  At these times, people with asthma may be prescribed an add-on corticosteroid therapy in a pill or liquid form, usually taken for 5 days.  As the term “add-on” implies, these oral medications are taken in addition to your regular inhaled corticosteroids.  Some common names for oral corticosteroids for asthma are Prednisone, Pediapred or Decadron/ Dexamethasone. (See Oral Corticosteroid Medicine Tips for Parents below.) 

Oral corticosteroids can usually get asthma under control quite quickly, allowing you to start feeling well sooner.  Once the flare-up is controlled, you go back to your regular treatment of inhaled corticosteroid medications.  Oral corticosteroids are not usually taken regularly, but are reserved to treat severe asthma flare-ups.

Oral corticosteroid medications are safe and effective when taken for short periods of time. Side effects of oral corticosteroids are rarely seen if you are taking a typical 5-day course of the medication. You may notice some mood changes or increased appetite,  but these disappear when the medications are stopped.  Prolonged use of oral corticosteroids may cause side effects such as weight gain, skin thinning or bruising, osteoporosis, delayed growth and glaucoma.

If you have had several episodes where oral corticosteroids were necessary, this may indicate that your regular maintenance medication of inhaled corticosteroids may need to be increased or changed to help avoid the severe flare-ups from occurring.  It may also mean that it is time to review when and how much inhaled corticosteroid you should be using with your doctor.

If you have any concerns about how often you have had to use oral corticosteroids, or are unsure about when, how much, or how to properly take your regular inhaled corticosteroid, talk to your doctor.  Together, you should be able to come up with an Asthma Action Plan to control your asthma and avoid severe asthma flare-ups.  Call your doctor for an appointment to talk about your asthma.

Oral Corticosteroid Medicine Tips for Parents
Oral corticosteroid pills and liquid medications have a bitter taste.  Kids describe them as “yucky.”

Tablets
If they are old enough to swallow them, tablets seem to be less offensive to children.  A tablet in a spoonful of jam (or chocolate syrup) seems to go down well!  While a tablet seems to be the easier medication to take, it is not always the first to be prescribed in the hospital setting.  Ask your doctor if it is available and appropriate.

Liquids
Liquid corticosteroids have a tendency to cause some children to vomit.  Prednisone is commonly prescribed in hospital.  Pediapred is a flavoured option and is reportedly not as ‘yucky."  Dexamethasone (Decadron) is another liquid corticosteroid that is available in some pharmacies and has a more pleasant taste.  If your child vomits within 30 minutes of taking liquid corticosteroid medication, it has not had a chance to be absorbed by the body and the dose must be repeated.  If the liquid corticosteroid is repeatedly vomited, talk to your doctor about the alternatives.

Page Last Updated July 2009