For most people, taking a preventer medicine every day and occasionally using a reliever inhaler is enough to manage their asthma. But sometimes people need 'add-on' asthma treatments too.
There are several different medicines that fall into this category and they work in various ways, alongside your inhalers, to help you manage your asthma. Examples of add-on treatments for asthma include:
When will I need an add-on asthma treatment?
If you’re having asthma symptoms and your preventer doesn’t seem to be helping, it’s important to see your GP for an asthma review. An add-on asthma treatment may help.
Before prescribing an add-on treatment, your GP or asthma nurse will check you're using your inhaler as prescribed, and using the right technique. This is to make sure you're getting the full benefits of your usual medicine first, before prescribing something else as well.
Your GP may also talk to you about your asthma triggers for example cigarette smoke, or hay fever, to see if certain triggers might be making your asthma harder to manage.
Which add-on treatment will be prescribed?
If you and your GP decide you might benefit from an add-on treatment your GP will talk through the best option for you, based on your symptoms, and on latest clinical guidelines.
For many people the first add-on treatment is likely to be an LTRA tablet to use alongside your preventer inhaler. Alternatively, another inhaled medication might be added.
Checking the new medicines are working for you
Whenever your GP makes a change to your usual prescription, latest clinical guidelines recommend you get another appointment four to eight weeks later, either in the surgery or over the phone. It’s a good idea to follow up on this so you can make sure the medicines are working and are right for you.
If the add-on therapy you’ve been prescribed improves your asthma up to a point, but you still have some symptoms, you may be offered an additional add-on therapy. Or your GP or asthma nurse might decide to increase your dose of preventer medicine.
Your GP or asthma nurse will work with you to find the right combination of treatments to help you manage your asthma well.
Common add-on treatments your GP might prescribe
LTRAs
These are medicines that are sometimes called 'preventer' tablets, but unlike your preventer inhaler, they don't contain steroid medicine. They work by blocking one of the chemicals that's released when you come into contact with an asthma trigger. They may be particularly effective if your asthma is triggered by exercise or allergies.
Theophylline
Theophylline works by relaxing the muscles that surround the airways, making it easier to breathe. It's usually prescribed as a tablet that you take twice a day. If your GP or asthma nurse prescribes this medicine, you'll need regular blood tests to check the levels in your body are neither too high nor too low.
Long-acting reliever inhalers
There are two different types of long-acting reliever inhalers, long-acting beta agonists (LABA) and long-acting muscarinic receptor antagonists (LAMA). Long-acting reliever inhalers keep your airways opened up by relaxing the muscles around them. This helps you breathe more easily.
In addition to this, long-acting muscarinic receptor antagonist (LAMA) inhalers have also been shown to reduce the amount of mucus produced in your airways. If your GP or asthma nurse prescribes this medicine, it's very important that you use it alongside your usual preventer inhaler.
Last updated January 2018
Next review due January 2021
