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Treating asthma

Treatment can help control your symptoms and reduce the risks so you can live well with asthma.

Treatment for asthma is usually using an inhaler. This is a small device that you use to breathe in asthma medicines.

You may need other treatments if inhalers alone do not control your symptoms.

Self-management is also an important part of living well with asthma. For example, avoiding asthma triggers.

Living with asthma

Inhalers

Asthma inhalers include:

  • reliever inhalers - to help relieve symptoms when they happen
  • controller inhalers - to stop symptoms developing
  • combination inhalers - work as both a reliever and a controller
  • MART inhalers - certain combination inhalers used in maintenance and reliever therapy (MART)

Using a spacer with your inhaler improves the amount of medicine that reaches your airways.

How to use different types of inhalers - asthma.ie

To help manage your asthma:

  • always keep your inhaler with you
  • get a new prescription before your inhaler runs out - some inhalers show how many doses are left
  • check the expiry date on your inhaler regularly

Reliever inhalers

Reliever inhalers can contain:

These medicines work quickly to relax your airways and make them wider. This helps you breathe during an asthma attack.

Your GP or integrated care hub (care hub) team will prescribe a reliever inhaler for you. They will tell you how to use your reliever inhaler.

You can get the inhaler in a pharmacy with your prescription.

Reliever inhalers do not have many side effects. But sometimes they can cause shaking or a fast heartbeat. This can happen for a few minutes after you use them.

Non-urgent advice: Contact your GP if:

  • you need to use your reliever inhaler more than 3 times a week

Controller inhalers

Controller inhalers are sometimes called preventer inhalers.

Most people need to take their controller inhaler twice a day, once in the morning and once in the evening. Your GP, asthma nurse or care hub team will tell you how and when to use your controller inhaler.

Always take your controller inhaler as prescribed, even when you feel fine.

Controller inhalers contain steroids. They work by reducing the inflammation in your airways.

Controller inhalers do not work immediately to avoid asthma attacks. Your symptoms can start to improve in 2 weeks for adults. For children, it can take 2 months.

Side effects of steroid inhalers

Steroid inhalers can cause side effects including:

You can help prevent these side effects by:

  • rinsing your mouth after using your steroid inhaler
  • using a spacer

Combination inhalers

Combination inhalers combine 2 medicines in 1 inhaler.

These types of inhalers relax your airways and reduce the inflammation in your lungs.

You can use a combination inhaler if your asthma is not controlled. It can help you manage your asthma better because it's easier to stick to your medicine routine.

Most combination inhalers do not give quick relief if your symptoms get worse or you have an asthma attack. Your GP, asthma nurse or care hub team will tell you if you need to use a reliever inhaler.

MART inhalers

Maintenance and reliever therapy (MART) is an asthma treatment plan where you use a certain type of combination inhaler.

Your GP, asthma nurse or care hub team may prescribe MART if other treatments do not reduce your symptoms.

Most people need to take their MART inhaler twice a day, once in the morning and once in the evening. Your GP or care hub team will tell you how and when to use your MART inhaler.

Not all combination inhalers are suitable for MART.

MART inhalers contain:

These types of inhalers relax your airways and reduce the inflammation. But you can also use your MART inhaler if you get symptoms or have an asthma attack.

Talk to your GP, asthma nurse or care hub team if you’re not sure what type of combination inhaler you use.

Spacers

A spacer is a hollow plastic tube that you attach to your inhaler. It holds the cloud of medicine in the tube long enough for you to inhale it in 5 or 6 breaths.

Brand names for spacers include Volumatic or Aerochamber.

Some spacers are covered by a medical card.

Using a spacer (video)

A person using an inhaler with a spacer. The mask of the spacer is covering their mouth and nose. They are pressing down the canister of the inhaler.
Using a spacer improves the amount of medicine that reaches your airways

Disposing of your inhalers

Do not put your used inhalers in your household bin.

You can:

  • put the plastic part in your recycling bin
  • return the used canister to your pharmacy

Other medicines

You may need to take other medicines if using an inhaler alone does not help to control your symptoms.

Leukotriene receptor antagonists (LTRAs)

LTRAs can help to reduce inflammation in your airways. You usually take them as tablets but they are available in syrup and powder form.

You take them every day to improve your symptoms.

Possible side effects include headaches, tummy aches and sore throat.

Theophylline

Theophylline can help if other treatments do not help control your symptoms.

You take it every day to control your symptoms. Possible side effects include headaches and feeling sick.

Steroid tablets

Your GP or specialist may recommend steroid tablets if other treatments are not helping to control your symptoms.

They may prescribe them as either of the following:

  • short course of treatment after an asthma attack
  • long-term treatment if you have very severe asthma and inhalers do not control your symptoms

Steroid tablets can contain prednisone or prednisolone.

Side effects of steroid tablets

If you need to take steroid tablets as a long-term treatment, your GP or specialist will monitor you often for any problems.

Side effects can include:

  • increased appetite, leading to weight gain
  • bruising easily
  • mood changes
  • fragile bones (osteoporosis)
  • high blood pressure

You are more likely to get infections when you're taking steroid medicine. Tell your GP if you're exposed to infectious illnesses such as chickenpox or shingles.

If you have not had chickenpox before, ask your GP about the chickenpox vaccine.

Treatments for severe asthma

If all other treatments are not helping, you may be offered injections or surgery for severe asthma. These treatments are not suitable for everyone with asthma.

Injections

Some people with severe asthma may benefit from injections of medicines called biologic therapies. An asthma specialist can prescribe this treatment.

Injections are given every few weeks to control asthma symptoms. The main side effect is discomfort where the injection is given. This only lasts 1 or 2 days.

Other treatment options

Your specialist will talk to you about your options if other procedures may be appropriate for you.

A procedure called bronchial thermoplasty may be offered as a treatment for severe asthma.

Bronchial thermoplasty involves passing a thin, flexible tube down your throat and into your lungs. Heat is then used on the muscles around the airways to help stop them narrowing and causing asthma symptoms.

Page last reviewed: 8 December 2023
Next review due: 8 December 2026

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 9.