Long-Acting Maintenance Asthma Inhalers: Know Your Options

Here’s what you need to know.



Inhaled corticosteroids

Inhaled corticosteroid drugs

  • Alvesco (ciclesonide)
  • ArmonAir RespiClick (fluticasone)
  • Arnuity Ellipta (fluticasone)
  • Asmanex HFA (mometasone)
  • Asmanex Twisthaler (mometasone)
  • Flovent Diskus (fluticasone)
  • Flovent HFA (fluticasone)
  • Pulmicort Flexhaler (budesonide)
  • QVAR RediHaler (beclomethasone)

How they work

Inhaled corticosteroids are often a first-line treatment for long-term control of asthma. They work by reducing airway inflammation, which helps you breathe easier. If used every day, they reduce the number and severity of asthma attacks, but they cannot treat an attack once it has started.

Side effects

Side effects of inhaled corticosteroids aren’t generally serious but can include voice changes, yeast infections of the mouth, cavities, pneumonia and headache.



Long-acting beta agonists

Long-acting beta agonist drugs

  • Serevent Diskus (salmeterol)
  • Foradil (formoterol)
  • Vospire ER (albuterol)

How they work

A long-acting beta agonist inhaler, or LABA, works by relaxing the airways in the lungs to help you breathe easier. They are used to both prevent asthma attacks and control asthma symptoms. People using a long-acting beta agonist inhaler tend to have more asthma attacks, so doctors generally prescribe LABAs with a corticosteroid.

Side effects

Common side effects of long-acting beta agonists include hoarseness, throat irritation, headache, rapid heartbeat, nervousness and dizziness.


Long-acting muscarinic antagonists

Long-acting muscarinic antagonist drugs

  • Spiriva Respimat (tiotropium)
  • Spiriva Handihaler (tiotropium)

How they work

Similar to LABAs, long-acting muscarinic antagonist inhalers, or LAMAs, relax the muscles of the airways to help control the symptoms of asthma.

Side effects

Side effects of long-acting muscarinic antagonist inhalers include hives, itching, rash, and swelling of the lips, tongue or throat.



Combination maintenance inhalers

Combination maintenance drugs

  • Advair Diskus (fluticasone/salmeterol)
  • Advair HFA (fluticasone/salmeterol)
  • AirDuo RespiClick (fluticasone/salmeterol)
  • Breo Ellipta (fluticasone/vilanterol)
  • Dulera (mometasone/formoterol)
  • Symbicort (budesonide/formoterol)

How they work

Combination inhalers contain a steroid and a long-acting beta agonist. The inhaled steroid decreases inflammation in the lungs, while the long-acting beta agonist works to relax the airways; both decrease symptoms of asthma. Combination inhalers tend to be more convenient for patients and less expensive, and have fewer side effects.

Side effects

Combination maintenance inhalers have minimal side effects, but some patients may experience headache, nausea, vomiting, insomnia and irritability.


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