Long-term control medications
Preventive, long-term control medications reduce the inflammation in your child's airways that leads to symptoms. In most cases, these medications need to be taken daily.
Types of long-term control medications include:
Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex HFA), ciclesonide (Alvesco), beclomethasone (Qvar Redihaler) and others. Your child might need to use these medications for several days to weeks before getting the full benefit.
Long-term use of these medications has been associated with slightly slowed growth in children, but the effect is minor. In most cases, the benefits of good asthma control outweigh the risks of possible side effects.
- Leukotriene modifiers. These oral medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo). They help prevent asthma symptoms for up to 24 hours.
Combination inhalers. These medications contain an inhaled corticosteroid plus a long-acting beta agonist (LABA). They include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), fluticasone and vilanterol (Breo Ellipta), and mometasone and formoterol (Dulera).
In some situations, long-acting beta agonists have been linked to severe asthma attacks. For this reason, LABA medications should always be given to a child with an inhaler that also contains a corticosteroid. These combination inhalers should be used only for asthma that's not well-controlled by other medications.
- Theophylline. This is a daily pill that helps keep the airways open. Theophylline (Theo-24) relaxes the muscles around the airways to make breathing easier. It's mostly used with inhaled steroids. If you take this drug, you'll need to have your blood checked regularly.
- Immunomodulatory agents. Mepolizumab (Nucala), dupilumab (Dupixent) and benralizumab (Fasenra) might be appropriate for children over the age of 12 who have severe eosinophilic asthma. Omalizumab (Xolair) can be considered for children age 6 or older who have moderate to severe allergic asthma.
Quick-relief medications quickly open swollen airways. Also called rescue medications, quick-relief medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your child's doctor recommends it.
Types of quick-relief medications include:
- Short-acting beta agonists. These inhaled bronchodilator medications can rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex HFA). These medications act within minutes, and effects last several hours.
- Oral and intravenous corticosteroids. These medications relieve airway inflammation caused by severe asthma. Examples include prednisone and methylprednisolone. They can cause serious side effects when used long term, so they're only used to treat severe asthma symptoms on a short-term basis.
Treatment for allergy-induced asthma
If your child's asthma is triggered or worsened by allergies, your child might benefit from allergy treatment, such as the following, as well:
- Omalizumab (Xolair). This medication is for people who have allergies and severe asthma. It reduces the immune system's reaction to allergy-causing substances, such as pollen, dust mites and pet dander. Xolair is delivered by injection every two to four weeks.
- Allergy medications. These include oral and nasal spray antihistamines and decongestants as well as corticosteroid, cromolyn and ipratropium nasal sprays.
- Allergy shots (immunotherapy). Immunotherapy injections are generally given once a week for a few months, then once a month for a period of three to five years. Over time, they gradually reduce your child's immune system reaction to specific allergens.