Asthma Medicines for Long-Term Control

There are two groups of medications that can help manage your child's asthma symptoms. These include quick-relief medicines to treat asthma symptoms as needed, and controller medicines to prevent symptoms.

What is an asthma controller medication?

Controller medications are for ongoing, daily use. They work by reducing inflammation or relaxing airway muscles. Your child's symptoms will not improve right after taking a dose of a controller medicine. However, their symptoms should gradually improve over time after starting a controller medicine.

How to know if your child needs controller medicines for asthma

Children with symptoms and/or who use albuterol more than twice per week—or who wake up from sleep more than twice per month—should take controller medicines (or see their doctor to have their treatment adjusted).

Based on your child's specific needs, their doctor may recommend certain types of asthma controller medicines.

Types of controller medicines for asthma include:

• Inhaled corticosteroids, also called steroids. These work by treating the inflammation in your child's lungs. This helps reduce asthma flare-ups and decrease symptoms of asthma. When used in the recommended dose, inhaled corticosteroids are safe for most children. Although these medicines have few side effects, the mouth should be rinsed after taking inhaled steroids to prevent thrush (a yeast infection of the mouth lining).

• Combination inhalers contain both corticosteroids and long-acting bronchodilators, also known as long-acting beta agonists (LABA). LABAs are similar to albuterol in that they work quickly to open up the airway, but they last much longer. Your doctor may prescribe a combination inhaler when inhaled steroids alone aren't keeping your child's asthma controlled.

• Leukotriene receptor antagonists. Also known as leukotriene modifiers, leukotriene receptor antagonists work by decreasing the effects of an inflammatory chemical made by the body called leukotrienes. They come in tablet form; for young children, chewable tablets or granules are available.

• Biologic injections. If your child has severe asthma and other medications aren't keeping it under control, your child's doctor may recommend adding an injectable medicine called a biologic. Biologics help treat inflammation that can lead to problems with your child's asthma.

Ask your child's doctor about which controller medicine would be best for your child.

Single maintenance and reliever therapy (SMART)

SMART therapy for asthma, or maintenance and reliever therapy (MART), is another option recommended for children 4 years and older. With SMART, instead of using an inhaled steroid every day along with a second quick-relief medicine as needed, your child can use just one combination inhaler.

This combination inhaler contains a corticosteroid and a specific long-acting beta-agonist (LABA) called formoterol. The formoterol relieves your child's symptoms quickly while the corticosteroid helps keep their asthma under control. Your child can use the same inhaler once or twice a day as directed by their doctor, as well as when they need quick relief for asthma symptoms.

The advantages of SMART include only needing one inhaler and overall decreased exposure to oral corticosteroids. Ask your child's doctor if SMART is a good option for your child.

Examples of controller medicines

Note: Products are mentioned for informational purposes only and do not imply an endorsement by the American Academy of Pediatrics. Your doctor or pharmacist can provide you with important safety information for the products listed and can let you know about medicines that are no longer available or new medicines.