Tips to Remember:
More than 50 million people in the United
States suffer from asthma and allergies. Fortunately, today there are many
effective medications available to treat these conditions. The following
information is intended to help asthma and allergy sufferers better
understand the most commonly used types of medications.
Inflammation is an important part of allergic diseases and can affect the
skin as in eczema; the nose as in allergic rhinitis; the conjunctiva of the
eyes or the bronchial tubes as in asthma.
There are three classes of medications that are used as anti-inflammatory
agents to treat allergies and asthma:
1) Mast Cell Stabilizers: these are
non-steroidal medications that reduce inflammation by preventing the release
of inflammatory chemicals.
- They include cromolyn, nedocromil and lodoxamide and are available in
various forms to treat allergic disease.
2) Corticosteroids [also known as
"steroids"]: are effective anti-inflamammatory medications. These
medications are very different from the anabolic steroids that are misused
by some athletes to increase their performance.
- Corticosteroids are available in topical creams or ointments, nasal
sprays, inhalers, pills and by injection.
- Corticosteroid use needs to be supervised by a physician.
- Minor side effects from using corticosteroid inhalers can include
hoarseness and thrush (a fungal infection of the mouth and throat). Both
are less likely with rinsing, gargling and spitting with water after use.
- Long-term use of inhaled corticosteroids in children could potentially
result in reduced growth velocity; however in most situations the benefit
of having the asthma controlled is greater than the potential for a side
- Oral corticosteroids generally have more side effects than inhaled or
- Short-term use (up to several weeks) of oral corticosteroids is
usually not a problem for an otherwise healthy person.
- Side effects of short-term use include slight weight gain, increased
appetite, menstrual irregularities, cramps, heartburn or indigestion.
These side effects will go away shortly after stopping the
- Long-term use (months to years) of oral corticosteroids is associated
with ulcers, weight gain, cataracts, weakened bones and thinner skin, high
blood pressure, elevated blood sugar, easy bruising and decreased growth
- Corticosteroids, when taken properly, are a very effective method of
treatment for asthma and allergies.
- Oral corticosteroids are usually considered as short-term medications
for asthma flare-ups, marked nasal congestion, and at times for skin
conditions such as poison ivy.
- Inhaled corticosteroids are considered the most effective medications
for long-term control over persistent asthma.
- Please see the Tip brochure in this series for more information on the
use of inhaled medications for asthma.
- Many of the cells involved in causing airway inflammation are known to
produce potent chemicals within the body called leukotrienes (lu-ko-try-eens).
- Leukotrienes are responsible for increasing inflammation within the
body-causing contraction of the airway muscle and increasing leakage of
fluid from blood vessels in the airways.
- Currently we have several oral anti-leukotriene medications available
to help fight allergic inflammation.
- These drugs are primarily used to help gain control over persistent
- One is also approved to treat allergic rhinitis.
- These medications are available only in tablet form which some people
There are several classes of bronchodilators available to treat asthma.
Beta-agonist bronchodilators relax the muscle of the bronchial tubes.
- Short-acting beta-agonist bronchodilators are used as quick-relief
medications. These are available as inhalations, liquids, injectables and
pills. (Albuterol is the classic example.)
- Long-acting beta-agonists bronchodilators are used for long-term
control of asthma. (Salmeterol and formoterol are two examples.)
- Side effects of this class include nervousness, increased heart rate,
restlessness, insomnia and, rarely, headaches.
Theophylline has been used for over 30
years to treat asthma.
- These are available as tablets, capsules or intravenously.
- Their blood levels need to be monitored.
- Side effects can include headaches, elevated heart rate and stomach
Anticholinergics are available in
- These can be used alone or combined with the beta-agonist
- Ipratropium is used for asthma treatment as a quick-relief medication.
- Cough and headache can be side effects.
Omalizumab was approved in 2003 as a new class of therapy, known as anti-IgE,
for patients with moderate to severe persistent allergic asthma. IgE is an
antibody that we all have and it is responsible for causing allergic
problems in some people. It may reduce allergic reactions by causing free
IgE to disappear from the body so that the IgE cannot attach to pollen (and
other substances that are present).
Its use should be limited to those patients
with moderate to severe persistent allergic asthma who: 1) are inadequately
controlled with appropriate combination therapy; 2) have complications due
to inhaled or oral steroid use; 3) have increased urgent care, emergency
department or inpatient service needs due to asthma exacerbations; 4) have
significant problems with activities of daily living; or 5) have problems
taking regular medication prescribed to treat asthma. Omalizumab should be
administered every two to four weeks by injection based on body weight and
total serum IgE levels.
To treat your allergy and asthma symptoms,
your allergist/immunologist will prescribe the medications that are best for
you and your specific symptoms. If you have side effects from any
medications, be sure to contact your doctor.
Your allergist/immunologist can provide
you with more information on asthma and allergy medications.
Tips to Remember are created by the
Public Education Committee of the American Academy of Allergy, Asthma and
Immunology. This brochure was updated in 2003.
The content of this brochure is for
informational purposes only. It is not intended to replace evaluation by a
physician. If you have questions or medical concerns, please contact your
American Academy of Allergy,
Asthma and Immunology
555 East Wells Street
Milwaukee, WI 53202-3823
Physician Referral and
AAAAI Web site