Medications for Asthma

Bronchodilators are inhaled medications that work to relax the muscles that surround the airways. Short-acting “rescue” bronchodilators can be prescribed for use when asthma becomes worse or during asthma attacks; they work within minutes and last up to four hours. Other bronchodilators are inhaled twice a day to help manage symptoms of asthma.

Usually, bronchodilators are taken by inhaling the medication directly into your lungs through a small metered-dose canister, commonly known as an inhaler. Some short-acting bronchodilators come in the form of a liquid that turns into a mist with the help of an electric or battery-powered machine called a nebulizer. These are sprayed into your mouth and then inhaled.

If you find that you need to use a rescue inhaler more than two or three times a week, your asthma may not be under control, and your doctor may suggest a different treatment.

Corticosteroids are used for severe asthma that is getting progressively worse or not responding to other therapies. Commonly known as steroids, these medications help to decrease inflammation by suppressing the activity of the white blood cells in the immune system. Taken by mouth or inhaled, steroids may be prescribed alone or in combination with a bronchodilator. 

Long-term use of steroids—over a period of a few weeks or months—sometimes causes serious side effects, such as cataracts, osteoporosis, weight gain, or high blood sugar, among others. Steroids are used with caution and under the supervision of your doctor, who decides the frequency and dosage of the medication based on your symptoms.

Leukotriene inhibitors are medications that are most effective for people with allergy-induced or exercise-induced asthma but can help with other types of asthma as well. Leukotriene inhibitors work by stopping the action of a chemical called leukotriene, which plays an important role in the development of airway inflammation. 

These medications are usually taken once a day in pill form. Side effects may include headache and nausea.

For people with severe, persistent asthma despite the use of corticosteroids, NYU Langone doctors may prescribe omalizumab, which is sold as Xolair^®. This medication works by blocking the action of an antibody called immunoglobulin E, more commonly referred to as IgE, which is a natural chemical in the body commonly produced in people with allergic asthma. Doctors administer omalizumab as an injection every two to four weeks, and it can be taken indefinitely, depending on how you respond to it. 

Although rare, one possible side effect of omalizumab is anaphylaxis, a severe, life-threatening allergic reaction. Each person prescribed omalizumab also receives an EpiPen^® as a precaution. An EpiPen^® is an injection device you keep with you; in the event of a life-threatening allergic reaction, you can immediately administer epinephrine, a chemical that narrows blood vessels and opens the airways in the lungs, for relief.