Your GP or asthma nurse will prescribe you treatment based on the latest clinical evidence and guidelines. It can sometimes take time to find the right treatment for you, so it’s important to keep in touch with your GP or asthma nurse and go back to review any new medicines you’ve been given.
Taking the right medicines as prescribed, and in the right way, will reduce the inflammation and sensitivity in your airways so you’re less likely to get symptoms.
When your asthma medicines are working well you can expect to notice:
- you’re not getting daytime symptoms
- you’re not waking up at night because of your asthma
- you don’t need your blue reliever inhaler
- you’re not having asthma attacks
- you’re getting on with daily life (including exercise) without asthma symptoms getting in the way.
Asthma treatment 'pathways'
Different treatment pathways are recommended for adults (aged 17 and over), for children aged 5-16, and for children under five. But in all cases the goal is to make sure asthma is as well managed as it can be, using the lowest doses of asthma medicine possible.
Whenever your GP makes a change to your usual prescription you should get another appointment four to eight weeks later, either in the surgery or over the phone, to check the new medicines are working and are right for you.
Before changing your medicines or increasing the dose your GP will need to talk to you about:
- how regularly you’re taking your preventer medicine
- your inhaler technique
- any triggers you might be exposed to such as cigarette smoke – which will make managing your asthma a lot harder
- anything else going on, such as hay fever.
It may be that with the right support in finding a good routine and improving your inhaler technique, as well as managing your usual asthma triggers, you’ll be able to control your asthma symptoms without needing to be prescribed higher doses.
If you’ve been diagnosed with severe asthma, please visit our severe asthma section, which has lots of advice and information especially for you.
Asthma 'treatment pathway' for adults
The treatment you’re prescribed will depend on how often you’re having asthma symptoms.
1. Just a reliever inhaler
If you only have very mild symptoms, for example if you occasionally come into contact with a particular, known trigger your GP may just prescribe you a reliever inhaler to use when you get symptoms.
But, if you notice you’re using your reliever inhaler three times a week or more, or you’re getting symptoms most weeks, go back to your GP or asthma nurse to talk about getting a preventer inhaler too.
“There are a very few people who just need to be prescribed a reliever inhaler for when they get symptoms. Most people with asthma benefit from a regular preventer inhaler taken every day to prevent symptoms coming on.” Dr Andy Whittamore, Asthma UK’s in-house GP.
2. A reliever inhaler and a preventer inhaler
If you’re having asthma symptoms three or more times a week, or symptoms are waking you up at night, you need a preventer inhaler too. Your preventer inhaler keeps you well with your asthma over time by preventing the inflammation in your airways.
3. A reliever inhaler and a preventer inhaler and an LTRA tablet
If you’re still having symptoms even though you’re taking your preventer inhaler every day as prescribed, and in the right way, your GP might prescribe you a Leukotriene Receptor Antagonist tablet (LTRA). This is to take every day as well as your preventer inhaler. LTRAs help stop your airways getting inflamed. Your GP will check how you’ve responded to this treatment in four to eight weeks.
4. A combination inhaler
If the LTRA is still not completely controlling your symptoms, then your GP might offer a combination inhaler containing both a preventer and a long-acting reliever. At the same time, they will consider whether or not to continue with the LTRA.
Depending on how you respond to treatment your GP might increase the dose in the combination inhaler.
5. Other add-on treatments
If this still doesn’t fully control your asthma symptoms your GP may consider a higher dose combination inhaler as well as other add-on treatments. For example, a different kind of long acting reliever or another add-on treatment called theophylline.
You may be referred to an asthma specialist for extra support at this stage if your asthma is still not fully controlled
Reducing your asthma medicines
Sometimes your GP may recommend reducing your medicines dose or how often you take them. Before they do, though, it’s important for them to consider:
- what symptoms you’re getting and how often you’re getting them
- the side effects of the treatment
- how long you’ve been taking the current dose
- the benefits of your current dose
- your wishes, or concerns about cutting down treatment.
You’re more likely to be able to cut down on the medicine you’re taking if your asthma has been well managed and you’ve had no symptoms for at least three months. For example, you may be prescribed just a reliever inhaler for when symptoms come on.
You’ll still need keep an eye on things and go back to your GP if you notice:
- you need your reliever inhaler three or more times a week
- you’re coughing, wheezing or waking in the night
- you have a lower than usual peak flow score, or your score is up and down.
The GP may need to increase your medicines again to stop your airways being so sensitive and inflamed and causing symptoms.
Reviewing your medicines
At different times of your life, or even at different times of the year, your GP or asthma nurse may prescribe more, or less, treatment depending on your symptoms.
This is why it’s so useful to go to your asthma review, so you and your GP can see how your asthma’s been and change medicines if needed.
You don’t have to wait for your next review before booking in to see your GP or asthma nurse.
Book an appointment if:
- you notice your asthma symptoms are getting worse (for example, you’re using your blue reliever inhaler more often than usual or you’re coughing, wheezing or feeling breathless or waking up at night). Your GP or asthma nurse may increase your medicines or change the kind of inhaler device you’re using.
- you haven’t had any asthma symptoms for at least three months. Your GP or asthma nurse may consider reducing your medicines.
Make sure your GP makes a note of any changes to the medicines you need to take on your asthma action plan.
Last updated January 2018
Next review due October 2019