Anti-inflammatory drugs may be used to treat lung disorders, including asthma. Information about these medications represent an average range for treatment. The precise effective dosage varies from person to person and depends on many factors. Do not make any changes to your medication without consulting your doctor.
- AeroBid (flunisolide, standard)—2 inhalations 2x/day
- AeroBid-M (flunisolide, menthol)—2 inhalations 2x/day
- Aerospan (flunisolide HFA)—2 inhalations 2x/day
- Alvesco (ciclesonide)—1-2 inhalations 2x/day
- Asmanex Twisthaler (mometasone)—1 inhalation 2x/day or 2 inhalations 1x/day
- Flovent HFA (fluticasone)—1-4 inhalations 2x/day
- Pulmicort Flexhaler (budesonide)—1-2 inhalations 2x/day
- QVAR (beclomethasone)—1-4 inhalations 2x/day
As of June 30, 2011, AeroBid and AeroBid-M have been phased out because they contain ozone-depleting chlorofluorocarbons. Talk to your doctor about switching to an environmentally friendly alternative. If using these medications twice a day, use morning and evening. If using once a day, use in the evening. If using a bronchodilator, taking it first will improve effectiveness. Do not use Aerospan with external spacer.
Long-acting corticosteroids improve lung function by suppressing inflammation in the respiratory passages. They help reduce the need for oral medication. These drugs are not for immediate relief of asthma attack and may take several weeks to reach maximal effect. You may require oral medication when under stress or for a severe asthma attack. Long-term use may cause or aggravate cataracts. Gargle with water after inhaler use to avoid mouth infection. Alvesco and QVAR may cause adrenal insufficiency and decreased bone mass.
Side effects include
- sore throat
- oral candidiasis (thrush in the mouth)
Call your doctor if you have have a severe asthma episode, feel weak or lightheaded, develop white spots or sores in your mouth or are exposed to chickenpox or measles. If you are taking Alvesco or QVAR, call your doctor if you develop worsening asthma symptoms, white spots or sores in your mouth, long-lasting cold or infection, or vision problems.
- Medrol (methylprednisolone)—4-48 mg at first, may be increased; take with food or milk
- Sterapred (prednisone)—5-60 mg at first, may be increased; take with food or milk
Short-acting corticosteroids inhibit immune reactions that cause inflammation and trigger asthma attacks. These medications are not for immediate relief of asthma attack. May reduce resistance to infection, raise blood pressure, or cause cataracts or glaucoma. Do not stop taking without first talking to your doctor. Side effects include increased appetite, insomnia, indigestion, rise in blood pressure, weight gain, osteoporosis and fluid retention. Call your doctor if you experience frequent urination or mental or mood changes.
Leukotriene modifiers, nonsteroidal
- Accolate (zafirlukast)—20 mg 2x/day; take at least 1 hour before or 2 hours after meals
- Singulair (montelukast)—10 mg/day; take at night, with or without food, to prevent exercise-inducedasthma, take at least 2 hours before exercise
- Zyflo (zileuton)—600 mg 4x/day—take with or without food
Leukotriene modifiers inhibit immune reactions that cause inflammation and reduce constriction of bronchi. They are not for immediate relief of asthma attack. If you are taking Accolate or Zyflo, tell your doctor if you are a heavy drinker or have had liver disease. These drugs may (rarely) cause liver damage. If you are taking Singulair, tell your doctor if you have aspirin sensitivity, and avoid taking aspirin and NSAIDs while taking Singulair.
Side effects of Accolate and Zyflo include headache, flu-like symptoms, abdominal pain, diarrhea, indigestion and rash. Side effects of Singulair include stomach pain, gastrointestinal upset, heartburn, tiredness, fever,stuffy nose and cough.
If you are taking a leukotriene modifier, contact your doctor if you have:
- flu-like symptoms
- loss of appetite
- unusually dark urine
- yellowing skin
- worsening asthma
- tingling or numbness in the arms or legs
- severe sinus inflammation
- behavioral or mood-related changes (agitation, depression, anxiety, suicidal thoughts)
- trouble sleeping