Other treatments and 'add-on therapies'

Long-acting reliever inhalers

As the name suggests, long-acting relievers work in a similar way to your usual reliever inhaler but the effects last for longer - around 12 hours instead of four. Long-acting relievers open up the airways by relaxing the muscles that surround the airways and are generally taken twice a day. Long-acting reliever inhalers should only be used if you are also taking a steroid preventer inhaler. They are an add-on therapy and should not be used on their own to treat asthma.

Combination inhalers
Combination inhalers contain both a long-acting reliever and a steroid preventer. They should be taken regularly, every day as prescribed, even when you are feeling well.

One of the combination inhalers available can now be used both as a preventer and as your reliever. This is because the long acting reliever medicine in this particular combination inhaler has been shown to relieve asthma symptoms as quickly as short-acting relievers. If you have been prescribed a combination inhaler your doctor or asthma nurse should explain to you how it works.

Leukotriene receptor antagonists

These are medicines that are sometimes referred to as ‘preventer’ tablets, but unlike your preventer inhaler they do not contain steroid medicines. If your doctor or asthma nurse prescribes you preventer tablets, they should be taken in addition to your usual preventer inhaler.

Preventer tablets work by blocking one of the chemicals that is released when you come into contact with an asthma trigger. They may be particularly effective if your asthma is triggered by exercise or allergies. Preventer tablets are usually taken once or twice a day, even when you are feeling well. However, if you are prescribed preventer tablets, your doctor or asthma nurse should discuss with you how often you need to take them. If they have no effect after four to six weeks, then they are probably not the right medicine for you and you should discuss other treatment options with your doctor or asthma nurse.

Theophylline

Theophylline works by relaxing the muscles that surround the airways. It is usually prescribed as a tablet and is generally taken twice a day. It is important that your doctor gives you the dose of this medicine that is exactly right for you, so you should have regular blood tests to monitor the levels of theophylline in your blood. If your blood level of theophylline is too low the medicine won’t work, but if it is too high it can cause unpleasant side effects. If you are taking other medicines, these can affect how well theophylline works. Smoking can also stop theophylline from working the way it should.

Ensure you tell your doctor if you are taking prescribed, complementary or over the counter medicines or if you are exposed to cigarette smoke. Different brands of theophylline may provide different doses so it is important to check that your pharmacist gives you the exact brand that you have been prescribed. You should continue to take the same brand unless your doctor discusses a change with you.

Xolair

Xolair is the first in a new generation of drugs for severe, difficult-to-control allergic asthma, where patients have an oversensitive immune system. It is a steroid free medication which is given by injection every two or four weeks.

Xolair has been shown to reduce emergency admissions to hospital, improve lung function and reduce asthma symptoms. It is suitable for people over the age of 12 years who have moderate to severe persistent asthma symptoms despite taking regular inhaled corticosteroid treatment.

There are 520,000 people with asthma in the UK for whom existing treatments do not work, and Xolair can provide a solution for around 6,000 of them.

Xolair is only available through respiratory clinics within the hospital following an assessment which will include a blood test to see if it will be suitable. People with persistent asthma symptoms and who have had two or more hospital admissions for asthma over a year may be considered for Xolair.