Respiratory

Medicines for Asthma

A long-term condition where the airways become inflamed and narrow, causing wheeze, cough and breathlessness — controlled mainly with a regular preventer inhaler and a reliever for symptoms.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Asthma?

Asthma is a long-term condition in which the airways are sensitive and prone to inflammation. When they are triggered — by viral infections, allergens such as pollen or pets, cold air, exercise, smoke or some medicines — the airway lining swells, the surrounding muscle tightens and extra mucus is produced, narrowing the airway.

  • How it is treated: The goal is good control with the lowest effective treatment: no day-to-day symptoms, no night waking, no limits on activity, and few or no flare-ups.
  • Self-care: Not smoking and avoiding second-hand smoke, reducing exposure to known triggers, keeping active, maintaining a healthy weight and having the annual flu vaccine all help.
  • When to seek help: Call 999 for a severe attack: too breathless to speak in full sentences, lips or fingers turning blue, the reliever not helping or wearing off quickly, or rapidly worsening symptoms.

What it is

Asthma is a long-term condition in which the airways are sensitive and prone to inflammation. When they are triggered — by viral infections, allergens such as pollen or pets, cold air, exercise, smoke or some medicines — the airway lining swells, the surrounding muscle tightens and extra mucus is produced, narrowing the airway. This causes wheeze, cough, chest tightness and breathlessness, often worse at night or early in the morning. Symptoms come and go, and many people are well between flare-ups, but the underlying tendency to inflammation remains, which is why the most important medicine is the one that treats inflammation continuously rather than the one that relieves a sudden attack. Asthma is usually diagnosed with a combination of symptom pattern and breathing tests that show variable airflow obstruction.

How it is treated

The goal is good control with the lowest effective treatment: no day-to-day symptoms, no night waking, no limits on activity, and few or no flare-ups. Treatment is built around the difference between a preventer and a reliever. The preventer — an inhaled corticosteroid — is taken regularly to calm the underlying inflammation, and is the cornerstone of control; it works over days and weeks rather than instantly. The reliever opens the airways quickly during symptoms. UK guidance now favours regimens that combine an inhaled corticosteroid with the reliever so that every reliever puff also delivers anti-inflammatory treatment, rather than relying on a reliever alone. Treatment is stepped up if control is poor and stepped down once stable. Inhaler technique and adherence are checked at every review, because a well-chosen medicine fails if it is not inhaled correctly.

For this condition, these medicines

Medicine classes used for Asthma

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Short-acting bronchodilators Respiratory The short-acting reliever inhaler that opens the airways quickly during symptoms; needing it often is a warning sign of poor control. Inhaled corticosteroids Respiratory The preventer inhaler and cornerstone of treatment; taken regularly to control the underlying airway inflammation. Long-acting bronchodilators Respiratory An add-on for ongoing symptoms — but in asthma always used together with an inhaled corticosteroid, never on their own. Leukotriene receptor antagonists Respiratory An oral add-on that can improve control, sometimes helpful where there is associated allergy or exercise-triggered symptoms. Theophylline Respiratory A specialist add-on for selected people whose asthma is not controlled by inhaled treatment, needing monitoring.

Symptom checker

Symptoms that can point to Asthma

Asthma can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Shortness of breathA feeling of not being able to get enough air, breathing faster or harder than normal, or …CoughA reflex to clear the airways that is usually caused by a viral infection and settles with…WheezingA high-pitched whistling sound when breathing, usually as air moves through narrowed airwa…Blue lips or skinA bluish or grey tinge to the lips, tongue, face or skin that means the body is not gettin…Breathlessness when lying downBecoming short of breath when lying flat, and needing to prop up on pillows or sit to brea…Barking cough in a childA harsh, barking cough in a child, often worse at night and sometimes with a rasping noise…

By active ingredient

Specific medicines used for Asthma

Dose-free guides to individual active ingredients used in asthma — what each is, how it works, how to take it, and its advantages and disadvantages:

SalbutamolA fast-acting "reliever" inhaler that opens the airways within minutes to ease wheeze and …BeclometasoneAn inhaled steroid "preventer" that calms airway inflammation in asthma (and some COPD) — …MontelukastA once-daily tablet that helps control asthma and hay fever by blocking inflammatory chemi…PrednisoneAn oral steroid that damps down inflammation and the immune system — used mainly in the US…PrednisoloneThe usual oral steroid in the UK, used to reduce inflammation in many conditions — from as…FluticasoneAn inhaled steroid "preventer" that calms airway inflammation in asthma (and some COPD) wh…TiotropiumA once-daily long-acting inhaler that keeps the airways open in COPD, and is used as an ad…SalmeterolA long-acting bronchodilator (LABA) for asthma and COPD; in asthma it must always be combi…BudesonideAn inhaled steroid "preventer" for asthma and COPD, used regularly to calm airway inflamma…FormoterolA long-acting inhaled bronchodilator that keeps the airways open, used regularly in asthma…CiclesonideA preventer inhaler that calms airway inflammation in asthma when used regularly.…Fluticasone furoateA once-daily inhaled or nasal steroid used to control asthma or to ease allergic rhinitis …VilanterolA once-daily long-acting bronchodilator, always part of a combination inhaler, used in ast…TerbutalineA short-acting reliever that opens the airways quickly in asthma and some other lung condi…BambuterolAn oral once-daily medicine for asthma that turns into terbutaline; not a quick reliever.…DupilumabAn injected biologic that blocks the IL-4 and IL-13 allergic signals, used for moderate to…OmalizumabAn injected biologic that targets the allergy antibody IgE, used for severe allergic asthm…MepolizumabAn add-on injection for severe eosinophilic asthma that reduces flare-ups by targeting a s…BenralizumabAn add-on injection for severe eosinophilic asthma that reduces flare-ups by clearing eosi…DepemokimabA long-acting biologic injection used as an add-on for severe eosinophilic asthma.…TezepelumabA regular injection used as an add-on treatment to help control severe asthma in people wh…House dust mite extractAn allergen treatment that gradually trains the immune system to react less to house dust …MethylprednisoloneA steroid medicine used to reduce inflammation and calm the immune system, given as tablet…IpratropiumAn inhaled bronchodilator that relaxes and opens the airways in COPD and asthma, also used…ZafirlukastA tablet used regularly to help prevent asthma symptoms, not to treat a sudden attack.…AminophyllineAn airway-opening medicine used in asthma and COPD, given into a vein in hospital or as sl…ZileutonA tablet used to help prevent asthma symptoms, used mainly outside the UK.…ReslizumabA specialist add-on biologic for severe asthma driven by a type of white cell called eosin…TheophyllineA tablet that helps open the airways in asthma and COPD — effective but with a narrow safe…

Beyond medication

Lifestyle and self-care

Not smoking and avoiding second-hand smoke, reducing exposure to known triggers, keeping active, maintaining a healthy weight and having the annual flu vaccine all help. A written personal asthma action plan, agreed with your nurse or GP, helps you recognise and respond to worsening symptoms early.

When to get help

When to see a doctor

Call 999 for a severe attack: too breathless to speak in full sentences, lips or fingers turning blue, the reliever not helping or wearing off quickly, or rapidly worsening symptoms. If you are using your reliever inhaler three or more times a week, or waking at night with asthma, book a review — your control needs improving even if you feel mostly well.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Asthma: frequently asked questions

What medicines are used for asthma?

The two key types are a preventer (an inhaled corticosteroid) taken regularly to control inflammation, and a reliever (a short-acting bronchodilator) for symptoms. Add-ons include long-acting bronchodilators (always combined with an inhaled corticosteroid in asthma), leukotriene receptor antagonists, and, rarely, theophylline. The right combination depends on how well your asthma is controlled.

What is the difference between a preventer and a reliever inhaler?

The preventer is taken every day to calm the underlying airway inflammation and prevent attacks; it works gradually. The reliever opens the airways quickly when you have symptoms. The preventer is what keeps asthma under control — the reliever only treats symptoms once they appear.

Is it bad to use my reliever inhaler a lot?

Yes — needing your reliever three or more times a week, or relying on it instead of a preventer, is a key warning sign that your asthma is not well controlled and your risk of a serious attack is higher. It usually means your preventer treatment needs reviewing, not that you simply need more reliever.

Why is a long-acting bronchodilator never used on its own in asthma?

Using a long-acting bronchodilator alone can mask worsening inflammation and is linked to worse outcomes in asthma. For this reason it is always combined with an inhaled corticosteroid — usually in a single inhaler — so the underlying inflammation is treated at the same time.

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Sources

Where this is drawn from

  • NICE NG245: Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE and SIGN).
  • NICE CKS: Asthma.

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