Long-acting beta2-agonists for long-term control of asthma
Examples
Long-acting beta2-agonists:
Generic Name formoterol (Foradil Dry Powder Capsules for Inhalation, Oxeze) salmeterol xinafoate (Serevent) Long-acting beta2-agonist and inhaled corticosteroid combinations:
Generic Name budesonide and formoterol (Symbicort Turbuhaler) fluticasone propionate and salmeterol (Advair Diskus or MDI) These medications are used in a metered-dose or dry powder inhaler. Inhalers may be used differently, depending on the medication used. Always consult the directions to be sure you are using the inhaler correctly.
How It Works
Long-acting beta2-agonists (bronchodilators) relax the smooth muscles lining the airways that carry air to the lungs (bronchial tubes), allowing the tubes to remain open longer and making breathing easier.
Salmeterol takes about 30 minutes to start to work, reaches peak effectiveness after 3 to 4 hours, and lasts for more than 12 hours.
Formoterol starts to work within a few minutes and also lasts for more than 12 hours.
Why It Is Used
Long-acting inhaled beta2-agonists are used on a daily basis to control moderate and severe persistent asthma. They should be used only as an addition to inhaled corticosteroids.1 Long-acting inhaled beta2-agonists enhance the corticosteroids' anti-inflammatory action for controlling asthma and preventing asthma attacks. They should not be used as a substitute for inhaled corticosteroids.
Different types of medications are often used together in the treatment of asthma. For more information on how medications may be used together in asthma, see:
- Asthma medications for adults, teens, and children older than age 5.
- Asthma medications for children age 5 and younger.
How Well It Works
A review of research reports that in adults with persistent asthma who use inhaled corticosteroids but continue to have symptoms (poorly controlled asthma), adding long-acting beta2-agonists:2
- Improved symptoms and lung function compared with using a corticosteroid only.
- Improved symptoms and lung function and resulted in less use of quick-relief medication compared with increasing the dose of inhaled corticosteroids.
- Improved lung function compared with adding a leukotriene pathway modifier.
Side Effects
Side effects of long-acting beta2-agonists may include:
- Throat irritation and hoarseness (caused by inhaled corticosteroids in combination medications).
- Rapid heartbeat or palpitations.
- Headache and dizziness.
- Nausea, vomiting, and diarrhea.
- Anxiety.
- Nervousness or tremor (such as unsteady, shaky hands).
Health Canada and the U.S. Food and Drug Administration (FDA) have reported that these medicines may make an asthma episode worse and may increase the risk of death. If your wheezing gets worse after you take this medicine, call your health professional right away.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Long-acting inhaled beta2-agonists should not be used without being combined with an inhaled corticosteroid. Salmeterol may improve your symptoms at first. But if you stop taking an inhaled corticosteroid, the inflammation
in the bronchial tubes will return, and your symptoms may become worse because of decreasing lung function and increasing inflammation.
When salmeterol is used to prevent asthma symptoms during exercise, it needs to be given at least 30 to 60 minutes before exercise.
Complete the new medication information form (PDF)
(What is a PDF document?) to help you understand this medication.
| Author: | Maria G. Essig, MS, ELS | Last Updated: September 4, 2007 |
| Medical Review: | Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology Caroline S. Rhoads, MD - Internal Medicine Harold S. Nelson, MD - Allergy and Immunology Anne C. Poinier, MD - Internal Medicine | |
 | ||
| |
| Topic Contents | |
| Examples | |
| How It Works | |
| Why It Is Used | |
| How Well It Works | |
| Side Effects | |
| What To Think About | |
| References | |