From the Guidelines
If you're using your rescue inhaler more than twice a week, your doctor would likely recommend adding a controller inhaler containing an inhaled corticosteroid (ICS) to reduce airway inflammation and prevent asthma attacks. The most effective treatment options for someone using their rescue inhaler too often include ICSs such as Flovent (fluticasone), Qvar (beclomethasone), Pulmicort (budesonide), or combination medications like Advair (fluticasone/salmeterol), Symbicort (budesonide/formoterol), or Breo (fluticasone/vilanterol) 1. These medications are typically taken once or twice daily, regardless of symptoms, and work by reducing airway inflammation over time, addressing the underlying cause of asthma rather than just treating symptoms.
Some key points to consider when using a controller inhaler include:
- Using the lowest dose of ICS that maintains asthma control to minimize potential side effects 2
- Rinsing the mouth after inhalation to prevent thrush 2
- Evaluating the patient's inhaler technique and adherence, as well as environmental control measures, before increasing the dose 2
- Considering adding a LABA, or alternative adjunctive therapy, to a low or medium dose of ICS rather than using a higher dose of ICS to maintain asthma control 2
It's essential to continue using your controller inhaler even when feeling well and to maintain regular follow-ups with your healthcare provider to adjust your treatment plan as needed. By adding a controller inhaler to your treatment regimen, you can reduce your reliance on rescue inhalers, improve lung function, and decrease the risk of hospitalization due to asthma exacerbations.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Recommended Inhaler for Frequent Rescue Inhaler Use
- For individuals using their rescue inhaler too often, a combination therapy with an inhaled corticosteroid (ICS) and a long-acting β agonist (LABA) is recommended 3, 4, 5.
- Studies suggest that fixed-dose combinations of ICS/LABA, such as fluticasone propionate/salmeterol, are effective in maintaining asthma control and reducing the need for rescue inhalers 3, 4, 6.
- The choice of ICS/LABA combination may depend on individual patient needs and responses to treatment, with some studies suggesting that formoterol/fluticasone may have a faster onset of action and improved lung function compared to other combinations 6.
- However, it is essential to note that the use of ICS/LABA combinations as initial controller therapy may not always be consistent with asthma management guidelines, and patients should be evaluated for asthma severity and treatment response before initiating therapy 7.
Available ICS/LABA Combinations
- Several ICS/LABA combinations are available, including fluticasone propionate/salmeterol, formoterol/fluticasone, and budesonide/formoterol 4, 5, 6.
- Generic versions of these combinations, such as Wixela Inhub, have been approved and may provide an alternative option for patients 4.
- The choice of ICS/LABA combination should be based on individual patient needs, treatment response, and guidelines for asthma management 3, 5, 6.