Asthma can be controlled in many ways. If your current inhaler isn't enough or you worry about steroids, what other choices exist? This page lists practical alternatives you can discuss with your doctor, from lifestyle fixes to advanced treatments.
Check inhaler technique — most people use inhalers wrong. Using a spacer with a metered dose inhaler can boost drug delivery and cut throat and mouth side effects. Regularly clean devices and swap old inhalers. Track symptoms with a peak flow meter and write down triggers. Avoiding allergens like dust mites, pet dander, and smoke often cuts attacks without changing medicine.
Breathing and physical strategies help too. Slow, nasal breathing methods such as Buteyko or Papworth exercises reduce hyperventilation for some people and can lower rescue inhaler use. Pulmonary rehab and guided exercise improve fitness and reduce breathlessness. Weight loss and quitting smoking make a big difference in control and medication needs.
Non-steroid prescription options. Leukotriene receptor antagonists such as montelukast (Singulair) are pills that help allergic and exercise-induced asthma; they work well for some people and are easy to try. Long-acting muscarinic antagonists like tiotropium (Spiriva) may be added for adult patients who stay symptomatic despite inhaled steroids. Oral theophylline is an older option rarely used now but may still benefit some patients under careful monitoring.
Biologics and advanced care. For severe asthma that does not respond to standard inhalers, biologic drugs target specific immune pathways. Examples include anti-IgE therapy (omalizumab), anti-IL-5 agents (mepolizumab, benralizumab, reslizumab), and anti-IL-4/13 therapy (dupilumab). These require specialist assessment, blood tests, and often injections every few weeks, but they can dramatically reduce attacks in the right patients.
Allergy-focused approaches. Allergy testing followed by immunotherapy (allergy shots or sublingual tablets) can lower sensitivity to specific triggers and reduce asthma medication needs over time. For allergic asthma this approach can be a long-term game changer.
Procedural option: bronchial thermoplasty. Reserved for a tiny group with severe persistent asthma, bronchial thermoplasty uses controlled heat to reduce airway muscle and may cut exacerbations. It’s done by specialists and isn’t suitable for everyone.
Safety and next steps. Every alternative has pros and cons — pills have side effects, biologics need specialist follow-up, procedures carry risks. Ask your doctor about tests like spirometry, FeNO, and blood eosinophils to match the right option to your asthma type. If you want, bring this list to your next visit and ask which choices fit your situation.
Want a quick action plan? First, carry written asthma action plan that says when to use rescue inhaler and when to seek help. Second, consider allergy testing and a specialist referral if you have frequent attacks. Third, keep a symptom diary for two to four weeks so clinician can spot patterns. Finally, if cost or side effects worry you, ask about trials, patient assistance programs, or lower-dose strategies that might work.
Start small and change one thing at a time. Book a checkup soon.
A looming shortage of Ventolin nebules has been flagged by GlaxoSmithKline, expected to last from mid-next week until August 2024. This shortage, impacting the salbutamol 2.5 mg/2.5 mL inhalation solution, prompts medical professionals to turn towards alternative asthma and bronchodilation treatments like Metered Dose Inhalers (MDI) with spacers.
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