Asthma medication: what to use and how to use it

When breath gets tight, the right medicine matters fast. Knowing which asthma medication does what — and how to use it — cuts panic and keeps you out of the ER. Below I break down the common options, simple safety tips, and clear signs that you need help from a clinician.

Relievers vs controllers — quick rules

Reliever inhalers (short-acting beta2 agonists like albuterol/salbutamol) stop an attack fast. Keep one handy and use it when you feel wheeze, tightness, or sudden breathlessness. Don’t overuse it: needing a reliever more than twice a week usually means your asthma isn’t controlled.

Controller medicines reduce inflammation and prevent attacks over time. Inhaled corticosteroids (ICS) like budesonide are the backbone for daily control. Combination inhalers (ICS + LABA such as budesonide-formoterol) often work better and, in some treatment plans, can be used both as daily controller and as an as-needed reliever for flare-ups.

Other options include leukotriene receptor antagonists (montelukast) for allergy-driven symptoms, long-acting muscarinic antagonists (LAMA) for add-on therapy, and biologic injections (omalizumab, mepolizumab) for severe, eosinophilic asthma that doesn’t respond to inhalers. Oral steroids help severe exacerbations but aren’t a long-term fix because of side effects.

How to use inhalers right

Technique matters more than you think. For a pressurized metered-dose inhaler (pMDI): shake, breathe out, put the mouthpiece between your lips, press once and inhale slowly, then hold your breath for about 10 seconds. If you struggle with coordination, use a spacer — it makes every puff count.

For dry powder inhalers (DPI): don’t shake. Load the dose, exhale away from the device, then inhale quickly and deeply. After using an ICS inhaler, rinse your mouth or spit to reduce the risk of thrush and hoarseness. Store inhalers away from heat, check expiry dates, and keep a spare inhaler where you can reach it.

Track your symptoms and peak flow if your doctor recommends it. If your peak flow slips below 80% of your personal best, follow your action plan — usually that means stepping up controller therapy or contacting your provider.

Watch for side effects: tremor and palpitations from relievers; oral thrush or hoarseness from steroids; mood or sleep changes from oral meds like montelukast. Report anything new or worrying to your clinician.

When buying meds online, always use a licensed pharmacy, keep prescriptions current, and check that the product name and dose match what your doctor prescribed.

Final quick checklist: have a reliever available, take your controller every day as prescribed, master your inhaler technique, avoid triggers you can control (smoke, strong fumes, pets if allergic), and contact your doctor if you need reliever more than twice a week, wake at night with symptoms, or your peak flow falls sharply. Small daily habits give big control over asthma.