What are the best asthma medications?

Asthma medications include those that you can buy over the counter (OTC), such as epinephrine, and drugs that doctors prescribe, such as the inhaled medication, albuterol.

Treatment aims

Asthma medication works to address symptoms and provide fast relief and long-term management. 

Asthma is a chronic condition making breathing difficult. It’s an inflammatory disease in which your airways swell, and narrow, making it difficult for air to reach your lungs. Symptoms include coughing, tightness in the chest, and shortness of breath. 

The treatment plan for asthma depends on your triggers and the severity of your symptoms.

Asthma medications 

According to the Food and Drug Administration (FDA), asthma medications are classified in two ways:

• Quick-relief medications: These drugs immediately treat asthma symptoms to provide rapid relief and are usually inhaled. The drugs include bronchodilators, such as albuterol, and oral steroids. Other quick-relief asthma drugs include short-acting beta-agonists and anticholinergics.
• Long-term control medications: These medications aim to reduce inflammation and constriction in the airways. The drugs, which you take on a regular basis, include anti-inflammatory drugs, like ​​fluticasone, and others including:
  • corticosteroids (inhaled or oral)
  • leukotriene modifiers
  • long-acting beta2-agonists (LABAs)
  • theophylline
  • cromolyn sodium and nedocromil

Depending on what triggers your asthma, medications to help relieve symptoms and manage the condition can also include:

• antibiotics and antivirals
• medications to treat severe asthma
• combination medications
• biologics

Doctors can prescribe asthma medications, or you can buy them over the counter. Asthma drugs come in several forms, such as oral tablets, injections, liquids, and inhalers. 

You can take some of these medications through an inhaler or a nebulizer.

Albuterol

Albuterol is a type of bronchodilator known as a short-acting beta agonist. It relaxes the muscles around your airways, helping you breathe. It is inhalable to ensure the medication reaches your airways as quickly as possible.

Albuterol is available by prescription only. It’s sold under the brand names ProAir and Ventolin.

Side effects

Albuterol can cause some side effects, such as:

• nervousness
• coughing and chest tightness
• headache
• throat irritation
• excitability
• nasal irritation
• shaking hands or legs
• dizziness

Albuterol can also cause more serious side effects, like an increased heart rate and breathing difficulties. If you experience these symptoms, contact your doctor or healthcare professional as soon as possible.

Montelukast sodium

Montelukast sodium is an anti-inflammatory drug. It is a leukotriene modifier. It is a long-term control asthma medication and is available by prescription only.

The drug helps manage asthma symptoms by blocking leukotrienes that cause air passages to constrict. 

Montelukast sodium has the brand name Singulair and comes in tablet form.

Side effects

In 2020, the FDA issued a boxed warning that Singulair may cause serious side effects relating to mental health. These include:

• anxiety
• agitation 
• irritability
• depression
• suicidal thoughts

Other side effects may include:

• muscle pain
• headache
• stomach pain
• coughing
• running nose
• fever

Mometasone and formoterol

Mometasone, a corticosteroid, and formoterol, a LABA, make up a combination asthma drug often sold under the brand name Dulera. It helps relax airway muscles when inhaled.

Doctors prescribe LABAs with corticosteroids because, when taken on their own, they can increase your risk of severe asthma episodes. 

Side effects

Dulera may cause side effects, which include:

• headache
• common cold 
• sinus infection
• oral thrush 
• hyperglycemia
• allergic reactions

Fluticasone 

Fluticasone is an inhaled corticosteroid that helps reduce inflammation. Also known as fluticasone propionate, it’s sold under the brand name Flovent HFA. It is prescription-only.

Fluticasone propionate may interact with other drugs. Be sure to talk with your doctor about other medications you’re taking.

Side effects

Fluticasone may cause some side effects, including:

• sinusitis
• headaches
• throat irritation 
• inflammation
• coughs
• bronchitis

Prednisone

Prednisone is an oral, prescription-only corticosteroid that helps reduce inflammation in your airways. There are two brand-name versions of the drug. Rayos is a tablet, and Prednisone Intensol is a liquid.

Side effects

The side effects of prednisone in both oral tablet and liquid form include:

• insomnia
• weight gain
• indigestion
• excessive sweating
• mild changes in mood

You may sometimes experience more serious side effects, including:

• confusion
• high body temperature
• breathlessness
• swelling of your limbs
• vision problems
• agitation
• blurred vision
• changes in behavior

If you experience these side effects, be sure to contact your doctor or healthcare professional.

OTC asthma medications

Some asthma medications don’t require a prescription. However, you should still speak with your doctor before considering using an OTC medication.

OTC asthma medications include:

• epinephrine (EpiMist inhaler)
• ephedrine (Bronkaid and Primatene)
• racepinephrine, which is an inhaler sold under the brand name Asthmanefrin

If you experience any of these side effects, talk with your doctor or healthcare professional.

Costs

Prices can often vary depending on your insurance type and any other discounts.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

Here’s a table with a rough price guide for each of the most common asthma medications mentioned above.

Summary

Asthma medications aim to address symptoms, including coughing, shortness of breath, and tightness in the chest.

Asthma drugs are classified as quick-relief or long-term control and include bronchodilators, like albuterol, and leukotriene modifiers, like montelukast sodium.

Your treatment plan will depend on your asthma triggers and symptoms, and their severity.

Asthma drugs come in inhalable form, sprays, liquids, or tables. Most require a prescription but some are over-the-counter.

Asthma medications can have side effects, some severe. Be sure to contact your doctor if you experience adverse effects, such as rapid heart rate, breathlessness, or changes in mood.