How Asthma Controller Medicines Compare
The first step in managing your asthma is to prevent the inflammation in the lungs that leads to coughing, wheezing, and shortness of breath. Medicines that do this are called asthma controllers. The newest drugs to join the asthma controller lineup are called leukotriene modifiers. Here's a look at what they do and how they compare with inhaled corticosteroids, the most commonly prescribed controller medicine.
Just as their name implies, leukotriene modifiers work by blocking the action of leukotrienes, chemicals released by cells in the lungs during an asthma flare-up. In the airways, leukotrienes cause swelling, which produces mucus and leads to difficulty breathing. Three leukotriene modifiers are available: montelukast (Singulair), zileuton (Zyflo), and zafirlukast (Accolate). No major side effects have been reported with these medications, and they are considered safe. In June 2009, the U.S. Food and Drug Administration requested that manufacturers add a precaution in the drug-prescribing information regarding neuropsychiatric events--behavior and mood changes--reported by some patients taking these medications.
Swallowed, not inhaled
Unlike corticosteroids, leukotriene modifiers are not inhaled, but are sold as tablets to be swallowed. For patients who have difficulty using an inhaler--especially younger children--this can be an advantage. Montelukast also comes in the form of chewable tablets and granules that can be mixed into soft foods. Montelukast is taken just once a day and is suitable for adults and children 12 months and older. Zafirlukast is taken from two to four times daily and is suitable for asthma patients ages 5 and older.
Combo adds protection
According to guidelines from two professional asthma organizations, leukotriene modifiers are an acceptable alternative to other controller medicines for people with mild asthma. For people with moderate persistent asthma, these drugs can be taken in addition to inhaled corticosteroids for added protection against asthma attacks. Experts say that, with time, researchers will better understand the role of leukotriene modifiers in asthma management. For now, corticosteroids remain the most effective anti-inflammatory drug.
No matter what type of controller medicine you use, be sure to take it every day, even if you have no symptoms. Many cases of asthma can be improved simply by taking controller medicines exactly as the provider recommends.