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Breathe Deeply: 5 Things to Know About Inhaled Medications for Asthma, Allergies and COPD

Debra Gordon

Last updated: October 20, 2016 7:31 pm

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If you’re one of the 25 million Americans with asthma, 50 million with allergies, or more than 10 million with chronic obstructive pulmonary disease (COPD), you’re probably using some form of inhaler or spray medication 1. The beauty of these treatments is that they deliver the medicine to where it’s needed most. That usually means your lungs if you have asthma or COPD, and your nasal passages if you have allergies.

Here are five things you should know about these treatments.

1. There are two types of inhaled medications.

Asthma inhaler medications include those that are for short-acting or rescue purposes, for use when you feel you can’t breathe; and long-acting ones, for use at least once a day to keep your asthma or COPD in check.

Too often people don’t take the long-acting maintenance medication as directed because it doesn’t make them feel any different. Though of course this is the goal of taking these long-term medications — to keep your airways healthy so you don’t need the rescue medication.

If you have allergies alone, you don’t need inhalers for asthma. Allergies don’t affect your airways, just your nasal passages and eyes, although some can cause serious whole-body reactions, known as anaphylaxis, which can be a life-threatening emergency.

2. You should track how often you use rescue medication.

If you need this type of medicine for your asthma more than twice a week, it could mean your maintenance medication isn’t working well enough.

Talk with your doctor about whether you need different inhalant drugs or an adjustment in your dosage.

3. There are several classes of inhaled and spray medications. 2 3

Corticosteroids: These drugs help reduce inflammation. Reducing inflammation is key for all three of these conditions. If you have asthma or COPD, your doctor may have prescribed Flovent Diskus (fluticasone), Pulmicort (budesonide), Asmanex Twisthaler (mometasone), Qvar (beclomethasone) or Alvesco (ciclesonide).

If you have allergies, your doctor may recommend a steroid nasal spray to treat your allergy symptoms such as runny nose, sneezing and congestion. These nasal sprays include Beconase (beclomethasone), Dymista (azelastine and fluticasone), Flonase (fluticasone), Nasacort (triamcinolone) and Nasonex (mometasone). Flonase and Nasacort are available over the counter.

Bronchodilators: These medications relax your airways to help you breathe and reduce inflammation. They are a mainstay of treatment for asthma and COPD. There are several types of these inhalers for asthma.

Short-acting or rescue bronchodilators include albuterol, levalbuterol and Atrovent (ipratropium). Atrovent nasal spray is also used to reduce runny noses in people with allergy symptoms.

Beta-agonist inhalers such as Serevent (salmeterol) and Foradil (formoterol) are usually combined with an inhaled corticosteroid for people with asthma, but may be used on their own for those with COPD. Another long-acting bronchodilator in this category is Brovana (arformoterol), used for COPD.

Leukotriene modifiers are drugs that reduce inflammation by preventing the actions of inflammatory immune system chemicals called leukotrienes. They include Singulair (montelukast), Accolate (zafirlukast) and Zyflo (zileuton).

Non-steroidal anti-inflammatories such as Nasalcrom (cromolyn) also reduce inflammation. This is one of the most commonly used nasal sprays for allergies.

Several combination drugs are available for asthma and COPD, including Symbicort (budesonide and formoterol), Advair (fluticasone and salmeterol), Breo Ellipta (fluticasone and vilanterol) and Combivent Respimat (ipratropium and albuterol).

4. Inhaled corticosteroids can have less severe side effects than oral steroids.

Many people cringe when they hear they need to take “steroids” for their asthma or COPD, given that long-term use of oral steroids (i.e., pills) can have severe side effects like cataracts and osteoporosis. The most common side effects of inhaled corticosteroids include possible growth reduction in children, and a mouth infection called thrush.

Your doctor may instruct you to rinse, gargle, and spit after inhaling a steroid. This is an important step to rid your mouth of any remaining medication and avoid thrush. A spacer or holding chamber can also reduce the risk of this infection.

5. You have several choices of inhalers for asthma and COPD.

Metered-dose inhalers (MDIs) are pressurized canisters of medication that “push” the drug into your lungs via a propellant. They are often used with a spacer, which can make it easier to time your breathing with the delivery of the medication. There are warnings, however, regarding use of a spacer with beta-agonist inhalers.

Nebulizers deliver the medication as a fine mist you breathe in through a facemask. Brovana is one of the inhalers for asthma delivered via a nebulizer.

Dry powder inhalers work like MDIs, but are not pressurized. They can be a bit more challenging to use, however, requiring that you inhale very quickly.

Inhalers can be tricky to use. If you don’t use them correctly, you’re wasting your medication, so ask your doctor to show you the right way to use them.

Taking your medication as prescribed is the best way to keep your asthma and COPD under control and avoid visits to the emergency room or hospitalization.

  1. American College of Allergy, Asthma, & Immunology. Statistics and Facts. http://acaai.org/news/facts-statistics

  2. American Academy of Allergy, Asthma, & Immunology. AAAI Allergy & Asthma Medication Guide. http://www.aaaai.org/conditions-and-treatments/drug-guide/inhaled-corticosteroids.aspx 

  3. MedlinePlus. Chronic obstructive pulmonary disease – control drugs. http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000025.htm.