Preventer medications make the airways less sensitive, reduce redness and swelling and help to dry up mucus. Preventers need to be taken every day to reduce symptoms and asthma attacks, and it may take a few weeks before they reach their full effect. Your doctor will adjust your preventer medication to the lowest dose you need to keep your asthma well-controlled. Preventer medications are currently the drugs most likely to significantly improve your symptoms.
What are inhaled corticosteroids?
These are anti-inflammatory medications, and are the most common of the preventer medications. They reduce inflammation in your airways, and can help airway cells repair and return to normal. These are not the same as steroids used for other diseases or for performance enhancement in sport, and are used at much smaller doses than when used in tablet form. Inhaled corticosteroids are commonly used in combination inhalers such as Seretide or Symbicort, where they work along with a long-acting bronchodilator (symptom controller).
For answers to frequently asked questions about inhaled corticosteroids, check our side effects page.
Do I need a preventer?
If you have asthma symptoms occurring more than two or three times per week your doctor will prescribe preventer medication. In children, preventers are usually used only for those with more frequent symptoms and episodes of asthma.
Preventers come in different strengths, so it is helpful to know which strength your preventer is, not just how many puffs you take. The strength (number of micrograms) is marked on the medication, and some medications have slightly different colours to indicate different strengths.
The medications shown in the image below are different in strength and formulation, so don’t try to compare doses between different types of preventer medication. Your doctor will choose a medication that is right for you, based on strength, formulation, and the type of device in which it is available.
Are there any side effects?
Possible side effects include:
- sore throat
- hoarse voice and/or
- oral thrush
These may be reduced by using a puffer and spacer, and rinsing your mouth and spitting after each dose.
Systemic side effects (caused through bloodstream absorption of the medication) are rare, but may include:
- skin bruising
- cataracts
- glaucoma
- adrenal suppression
- growth suppression and/or
- osteoporosis
Different types of preventers
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| Flixotide 50µg Puffer |
Flixotide 125µg Puffer |
Flixotide 250µg Puffer |
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| Flixotide junior 100µg Accuhaler |
Flixotide 250µg Accuhaler |
Flixotide 500µg Accuhaler |
Flixotide contains a drug called fluticasone. It is available in a puffer or accuhaler. It can be prescribed for both adults and children.
Pulmicort contains a drug called budesonide.
It is available only as a turbuhaler, and therefore cannot be used with a spacer. Budesonide may also occasionally be taken through a nebuliser.
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| Qvar 50µg Puffer |
Qvar 100µg Puffer |
Qvar 50µg Autohaler |
Qvar 100µg Autohaler |
Qvar contains a drug called beclomethasone dipropionate-HFA. It is available in a puffer or an autohaler.
It is used for adults and children 5 years and over.
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| Alvesco 80µg Puffer |
Alvesco 160µg Puffer |
Alvesco contains a drug called ciclesonide. It is available only in a puffer.
This medication is different from other inhaled corticosteroids, as it produces finer particles, so less of the medication stays in your mouth and throat. This can mean less side effects occur. It is approved for use in adults and children aged 6 and over.
This type of medication has anti-inflammatory effects. It tends to be quite effective in managing exercise-induced asthma particularly in children, or in a particular subtype of asthma in adults who have nasal polyps, aspirin sensitivity, and allergic asthma. It is most commonly prescribed for children who need preventer medication, but in most adults it is not as effective as inhaled corticosteroids.
Leukotriene receptor antagonists may also be used to treat the symptoms of hayfever (allergic rhinitis).
Are there any side effects?
Side effects are uncommon, but may include muscle or joint pain, gastrointestinal disturbances, headache and/or mood changes.
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Singulair tablets 10mg OR 4mg, 5mg chewable tablets
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This medication contains a drug called montelukast sodium. It is available in tablets or a chewable form for children. Generally it is taken at night (with or without food).
These are medications that have anti-inflammatory effects, and work by reducing the release of histamine (which triggers inflammatory responses) in the airways. They are particularly useful in the management of exercise-induced asthma, and asthma which is triggered by allergens. Some people who only get asthma symptoms in response to very specific allergens might use these medications when they know they are going to be exposed to these allergens (e.g. when visiting a relative with a cat).
Using this medication is only effective for those people with mild asthma and infrequent attacks, and who have been able to identify specific allergic asthma triggers.
Cromones are quite ‘sticky’ and can cause blockage of the inhaler, so it is very important to wash your inhaler regularly to make sure you are getting the full dose. Two inhaler ‘sleeves’ usually come in a pack so you can use one, while cleaning and drying the other. See our inhalers section for information on cleaning inhaler devices.
Cromones are used for both children and adults, but seem to be of little benefit to children under 5 years of age.
Are there any side effects?
Side effects are rare, but may include headache, throat irritation, nausea, cough. Around 20% of people find Tilade (see below) has an unpleasant taste.
Intal
Intal puffer 1mg, 5mg
This medication contains a drug called sodium cromoglycate. It is available in a puffer or (rarely) a spinhaler.
Tilade
Tilade 2mg Puffer
This medication contains a drug called nedocromil sodium. It is available only in a puffer.
Tilade can be effective in treating cough in people with and without asthma.
Anti-immunoglobulin therapy
Xolair (Omalizumab)
Xolair is an antibody that helps decrease allergic responses in the body. It is used to treat moderate to severe asthma that is caused by allergies in adults and children 12 years and older. It is usually only given after other asthma medications have been tried without successful treatment of symptoms.
Xolair works by blocking a substance called immunoglobulin E. Your doctor will measure the amount of this substance in your blood to help decide what dose you should have. Xolair is given by injection, every 2 to 4 weeks, usually only in a hospital clinic following a respiratory specialist’s advice.
Are there any side effects?
Possible side effects include : bruising, redness or pain at the injection site, mild skin rash, headache, tiredness, hair loss, joint pain, joint swelling, muscle pain.
Up to 2 in every 1,000 people may have a severe, life-threatening allergic reaction (anaphylaxis) to this treatment, either immediately, or several hours later. This reaction can also occur after you have had this medication for a year or more. For this reason you will usually be asked to stay in the hospital clinic for an hour or more after the injection.