Maintenance and Reliever Therapy (MART)

Some people with asthma are prescribed Maintenance and Reliever Therapy (MART) for extra help with their asthma symptoms.

Maintenance and Reliever Therapy is when you're prescribed a combination inhaler to be used as both your preventer and your reliever as part of a specific treatment regime. You need to take your MART inhaler every day, even when you're feeling well. 

Your GP, asthma nurse or pharmacist should show you how to use your inhaler in the best way so that every dose is effective. 

Not everyone using a combination inhaler is on a MART regime. If you're not sure about the treatment you're on, and how it helps your asthma, speak to one of the asthma nurse specialists on our Helpline on 0300 222 5800 (9am - 5pm; Mon - Fri). 


Who might get benefits from Maintenance and Reliever Therapies?

Your GP or asthma nurse might consider MART for you if you're still getting difficult asthma symptoms even though you're taking your preventer inhaler as prescribed, and you've tried a leukotriene receptor antagonist or a combination inhaler.

Maintenance and Reliever Therapies are mainly prescribed to adults (aged 18 or over). But some children over 12 may sometimes be prescribed a Symbicort MART inhaler on the MART regime, when their asthma is not well controlled.

What Maintenance and Reliever Therapies are there?

Ask your GP or asthma nurse if you are on a MART regime. If you've been prescribed Symbicort your GP might refer to this as a SMART regime. Both MART and SMART regimes help your asthma in the same way - they are just made by different companies.

Common brands in the UK include:

  • Symbicort MART Regime (also known as SMART)
  • Fostair MART Regime
  • DuoResp Spiromax MART Regime.

How do Maintenance and Reliever Therapies help asthma?

Whichever MART therapy you're on, you'll follow a specific action plan for that therapy. This plan will help your asthma by:

  • preventing inflammation in the airways, so that you're less likely to react to your asthma triggers
  • relieving on-going asthma symptoms
  • relieving any symptoms when they come on.

If your symptoms get worse at any point during the day you can take up to the maximum dose you've discussed with your GP or asthma nurse. This should be written in your MART action plan.

Do you need a reliever inhaler as well if you're on these regimes?

One key difference when you're on a Maintenance and Reliever Therapy is that you don't need another reliever inhaler (usually blue) for emergency symptoms. This is because your MART inhaler also acts as a reliever.

Instead of using a reliever inhaler, when your symptoms get worse you increase the dose of your SMART or MART inhaler, according to what's written in your MART action plan, as discussed with your GP.

Is the Asthma UK asthma attack advice the same for MART regimes?

No. Asthma UK's asthma attack information is not designed for people using the MART regimes. You should have been advised by your GP or asthma nurse about what to do in an asthma attack and given a written asthma action plan specifically for your therapy. If you have not been advised or still feel unclear, speak to them as soon as possible.

Possible side effects of Maintenance and Reliever Therapies

As with the combination inhalers, there's not as much evidence about side effects specifically for MART regimes and it's likely that any side effects will be the same as for the preventer and reliever inhalers.

However, people on MART regimes may be on higher doses of asthma medicines and being on a higher dose can increase the risk of having side effects from the medicine. It's really important to go to your annual asthma review and other regular appointments so that your GP or asthma nurse can go through your asthma action plan with you and check how well your asthma is being controlled.

If you have any further questions about MART regimes, please speak to your GP or asthma nurse, or call our asthma nurse specialists on 0300 222 5800 (9am - 5pm; Mon - Fri).

Last updated January 2018

Next review due August 2019