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Asthma

Do I Need my Asthma Meds All the Time?

08/09/2010

Question:

It seems like one day I am ok, the next not so bad. Do I really need to take my asthma medication all the time? I take as needed. I don’t like to take them long term as they make me tired and weak, substantially affecting my quality of life on a daily basis. I especially had a bad response with Symbicort, got so weak I knew one day I would not be able to get out of bed if I continued taking it. Can I just go on cruise control when I need to?

Answer:

As you probably know, the treatment of asthma is centered around the use of two main forms of medications: 1. controllers [designed to be used on a regular basis to prevent asthma symptoms] and 2. rescue inhalers [designed to be used as needed only when you are having symptoms]

Asthma controller medications including Symbicort (or other inhalers with inhaled steroids in combination with long-acting beta-agonists, inhaled steroids alone, or oral leukotriene modifying agents) work by decreasing the inflammation in the airway, thereby preventing asthma symptoms when used on a regular basis.

Current asthma guidelines recommend adjusting your treatment regimen to find the lowest effective dose of these medications which prevent you from having symptoms. Because most of these agents may take several weeks to reach full effect, it is usually recommended that they are used on a regular basis without interruption. There may be exceptions in patients who have asthma symptoms for a few months out of the year (for example, during the spring allergy season), but are fine the rest of the time. In that case, it may be appropriate to use them for a few months and then stop, but it is not usually effective to use them for a few days at a time and then stop.

As a general rule, if you are using your rescue inhaler such as albuterol more than two times per week or you are waking up more than two nights per month with asthma symptoms, your asthma is not as well controlled as it should be. In that case, you should actually talk with your asthma care provider about increasing your asthma therapy. Similarly, if you are experiencing side effects from your medications that are making it difficult for you to take them on a regular basis, you should discuss that with him/her as well.
 

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Response by:

Jennifer  McCallister, MD Jennifer McCallister, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University