Find answers to common concerns people with asthma have about their medicines, so you can understand the benefits and risks.
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Why not ask your GP, asthma nurse, or pharmacist, to run through all the benefits of your asthma medicines? You can find out how they work, so you’re clear about why you need to take them.
You could also talk about any side effects you’re worried about and how to cut your risk of getting them.
Try weighing up the pros and cons of taking your medicine. For example:
- if you don't take your asthma medicines you could have have symptoms like breathlessness, wheezing, or coughing at night? Will it mean missing time out with friends, or taking time off work?
- if you do take it, you could benefit from preventer medicine that works quietly in the background, reducing the chance of you reacting to your triggers, or having an asthma attack.
“If you're someone who finds taking inhalers feels like too much of a hassle, talk to your GP or asthma nurse,” says Dr Andy Whittamore, Asthma UK's in-house GP. “For example, if it’s a struggle to give your child their inhaler, your GP or asthma nurse might be able to suggest some techniques to take the stress out of it.
“Or, if it’s more that you find it inconvenient to take medicine twice a day, your GP or asthma nurse might be able to prescribe a medicine you take just once a day, as long as your asthma’s well managed.”
Even if you feel well you still need to take your preventer inhaler as prescribed. Basically, your preventer medicine works away in the background, so you can get on with all the things you want to do without asthma symptoms getting in the way.
Try looking at it this way: if you take your preventer inhaler every day, you’ll be less likely to react to your usual asthma triggers – which means fewer asthma symptoms. It also means you’re less likely to need to use your reliever inhaler.
No one wants to feel like they’re taking medicines unnecessarily, but with asthma it’s so important to keep taking your preventer medicine so you can stay well.
“Don’t stop taking your steroid preventer inhaler before speaking to your GP or asthma nurse,” says Dr Andy. “Not taking it puts you at risk of an asthma attack. If you’re on a high dose of steroid preventer medicine, your body can really miss it if you stop suddenly.”
Ask yourself, how would I feel if I didn’t take my preventer medicine? Am I feeling well because my preventer medicine is working?
A lot of people worry about taking steroids, so you’re not alone. It might help you to know that the steroids used to treat asthma are completely different to the anabolic steroids used by bodybuilders. In fact, they’re corticosteroids, which are a copy of substances the body makes naturally.
The preventer inhaler you take every day contains a low dose of steroids. If you’re taking it in the right way, using a good technique, the medicine will get straight to your airways. This means it’s less likely to cause any side effects and very little medicine is absorbed into the rest of your body.
Why not talk through your concerns with your GP? Together you can look at the benefits versus possible side effects. It’s worth remembering that your GP or asthma nurse will only ever prescribe the lowest possible dose to keep you well.
Perhaps you’ve been prescribed a higher dose of steroids, either in an inhaler or in tablet form, or you need a course of steroid tablets alongside your usual inhalers. This is because you need extra help to deal with your asthma symptoms.
Higher doses of steroids are usually only prescribed short term until you’ve fully recovered from a flare up of your asthma symptoms. And they’ll only be prescribed if your GP or asthma nurse thinks the benefits outweigh the risks.
If you are on a high dose of steroid you should be given a steroid card from your GP.
“If your asthma is still not well controlled in spite of high dose inhaled steroids, keep taking them until you can discuss your treatment with your GP,” says Dr Andy.
Use our severe asthma tool to find out if you need a referral to a severe asthma specialist.
You can call an asthma nurse specialist on our Helpline on 0300 222 5800 (Mon-Fri; 9am-5pm) to talk through any concerns you have about your asthma medicines.
If you think you’re getting side effects, talk to your GP or asthma nurse about them as soon as possible.
There could be a simple way to reduce or treat the side effects, so you can carry on taking the medicine and getting the benefits for your asthma. If this isn’t possible, there may be a different asthma medicine you can try.
If it’s future side effects you’re worried about, it can be helpful to weigh up the pros and cons. Try writing down what worries you. But also jot down the benefits of taking your asthma medicines, like having fewer symptoms, or feeling well enough to exercise or go out with friends and family.
Try asking yourself why you think you’re going to get side effects. Is it because you've had side effects from other medicines? Have you read comments on chatrooms or in the media about others having side effects?
It might help you to bear in mind that everyone is different and reacts differently to their medicines. So just because someone else you know experienced side effects it doesn’t mean you will.
The key thing is don’t just stop taking your medicines. Why not call the Helpline to talk through your concerns?
The long-term use of high doses of steroids has been linked to a risk of thinning bones (reduced bone density).
At your annual asthma review, your GP or asthma nurse can talk to you about your individual risk and what you can do to lower it.
- getting plenty of exercise
- eating well, including lots of foods rich in calcium (leafy green vegetables, dried fruit, tofu, yoghurt) and vitamin D (eggs, milk, oily fish)
- giving up smoking
- avoiding too much alcohol.
You can get more information and advice from the National Osteoporosis Society
“Some people do feel self-conscious about using inhalers in front of people,” says Dr Andy.
“It might help to remember that lots of people have asthma or know someone with asthma. If it really bothers you why not ask your GP or asthma nurse if there’s another kind of inhaler you could use instead, perhaps one you prefer the look of?
“And remember, if you use your preventer inhaler regularly you’re less likely to need your reliever inhaler when you’re out and about anyway.”
Most people with asthma benefit from two asthma inhalers:
- Reliever inhalers are essential in treating asthma attacks because they work so fast – you should keep yours with you all the time.
- Preventer inhalers are essential in controlling the inflammation and swelling in your airways. You should take yours every day as prescribed to avoid asthma symptoms. It will also cut your risk of an asthma attack.
If you’re on the MART regime you may have just one inhaler containing a steroid preventer medicine and a certain type of long-acting bronchodilator medicine which can also be used as your emergency reliever.
If you’ve been prescribed a preventer tablet (Leukotriene Receptor Antagonist or LTRA) it’s because your GP thinks you'll benefit from some extra help with your asthma symptoms.
LTRAs are recommended as an add-on asthma treatment to help with asthma symptoms when your preventer inhaler alone doesn’t seem to be helping enough.
They relax the airways in your lungs to make breathing easier and to help prevent asthma attacks.
They also reduce your body's response to allergens (substances that cause you to have an allergic reaction) and to certain situations which trigger asthma attacks (for example, exercise).
It’s important to keep taking your preventer inhaler as prescribed alongside the tablet. And to go back to the GP four to eight weeks later to check the new medicines are working well for you.
It’s also helpful to go for regular asthma reviews so you can be sure you’re taking the right medicine for you.
There have been reports of people taking the LTRA Montelukast having side effects such as nightmares, sleepwalking, anxiety, depression or irritability. If you notice any of these changes talk to your GP as soon as possible.
Some medicines, when taken together, may interact with each other - this means one medicine may affect how the other one works. Or if one medicine is taken with another medicine it may increase the risk of side effects.
For example, some types of beta-blockers, given to help conditions such as high blood pressure, may interact with asthma medicines.
If you’re on any other prescribed medicine, your GP will monitor you and decide whether the benefits of taking both medicines outweigh the risks, or whether it’s better to consider an alternative.
If you need to take medicines for other conditions as well as your asthma medicine you should always talk to your GP, asthma nurse or pharmacist first, even if it’s just an over-the-counter medicine or any complementary treatments, such as herbal or homeopathic remedies.
You can ask your GP, asthma nurse or pharmacist to check your inhaler technique. It’s very common to have problems but it’s important to make sure you’re using your inhaler properly so you’re getting all the benefits from your medicine.
If you’re finding it hard to get the hang of taking your inhaler, your GP or asthma nurse may suggest you try using a different type of device that’s right for you. Or they may give you a spacer.
When you first start taking your preventer inhaler you won’t notice much difference. This doesn’t mean it’s not working. It's because most preventer medicines take a few weeks to see the benefit.
It’s important to stick with it. You need to take it every day as prescribed for the protective effects to build up. Rather than treating immediate symptoms it works away in the background, helping to calm your airways.
You also need to make sure you’re taking it in the right way. If you’re not sure speak to your GP or asthma nurse and ask them to show you the best inhaler technique.
Soon you’ll notice you’re not reacting to your triggers as much.
“You might even try asking your partner, friends or family if they've noticed the benefits from your medicine – sometimes the people around us see more positive or negative changes than we can see for ourselves,” says Dr Andy.
Using your reliever inhaler regularly could mean that your body starts to get used to the reliever medicine. This could mean you need higher doses for it to work.
You’ll get more long-term benefits, and need to use your reliever inhaler less often, if you take your preventer inhaler every day as prescribed.
This is because your reliever inhaler is just to relieve symptoms as and when they happen. It’s very important you use it whenever you need to, but if you’re using it three times a week or more, speak to your GP or asthma nurse as it may mean you’re at risk of an asthma attack.
If you’re getting more asthma symptoms even though you’re taking your preventer inhaler every day, ask your GP to review your medicines. And also ask them to check your inhaler technique.
“It’s important you feel able to talk openly with your doctor if you’re not sure they’ve given you the right medicine,” says Dr Andy.
“If you don’t feel comfortable discussing your treatment concerns with your GP, see if you can speak to a different GP, or to your asthma nurse. You could also speak to an asthma nurse specialist on our Helpline on 0300 222 5800 (9am-5pm, Monday-Friday). Or you can chat with our asthma nurse team via WhatsApp on 07378 606 728.”
Although it can be expensive, it's important to carry on taking your asthma medicine. It can help you stay well and reduce your risk of an asthma attack.
Don’t be tempted to skip doses so your medicine lasts longer; you’ll be putting yourself at risk of an asthma attack. Talk to your GP or asthma nurse if you’re worried about how to pay for your asthma medicines.
The good news is that lots of people qualify for free prescriptions. If you don’t, and you’re struggling with the costs of your medicine, pre-payment certificates can save you money.
Your doctor or asthma nurse has decided with you the right dose of medicine to help keep your symptoms well managed. Speak to them first before making any changes yourself.
“Make sure you go for your regular asthma review, which you should have at least once a year, or every six months for children,” says Dr Andy.
“Sometimes, if you’ve been symptom-free, and you haven’t needed to use your reliever inhaler for three months, you and your GP or asthma nurse can talk about reducing your medicines.don’t stop taking your preventer medicine as prescribed before seeing your GP or asthma nurse.”
There are lots of reasons why you might find it hard to remember to take your medicine – perhaps you have a lot of other medicines to take as well, or maybe you forget when you’re out of your usual routine.
Think about what might help you remember. For example, would it help to keep your preventer inhaler next to your bed, so you remember to take it morning and evening?
If you have trouble remembering when you need new prescriptions, you could try a reminder app on your phone or ask someone to help you remember.
A steroid card lets health care professionals know you take steroids at a high dose. It is useful in emergency situations, as your body may not produce enough natural steroids to help you deal with illness or injury. In this situation, doctors will need to give you extra corticosteroids.
Your GP or healthcare professional should give you a steroid card if:
- your asthma is difficult to control, or you have severe asthma. This may mean you need to take high doses of steroid medicine (tablets or inhaler) in the long term to keep your asthma under control
- you have had an asthma attack and you’re taking high dose steroid tablets for 5-7 days afterwards or need a further course of steroids to help you recover.
- you need repeated courses of oral steroids to get your asthma under control.
“Some people may also get a steroid card if they’re on medium dose steroid treatments,” says Dr Andy. “See your GP or pharmacist if you’re not sure what steroid dose you’re taking, and whether or not you need a steroid card.”
Make sure you always carry your steroid card with you. If you lose it, you can get a replacement from your pharmacy or GP.
You can return your used inhalers to any pharmacy. This means they can be disposed of in a safe, and environmentally friendly, way.
Last updated December 2020
Next review due September 2021