Asthma Medication and Treatment in Australia: A Comprehensive Guide

Introduction

Asthma is a common, long-term and sometimes life threatening condition that affects breathing. Out of every 9 people you know, 1 of them may have asthma. It affects people of all ages. It can even start in older age.

An asthma attack can come on suddenly and when you don’t expect it, and in some cases need emergency medical treatment with a doctor. Symptoms of an asthma attack might be coughing a lot, feeling short of breath, tightness in the chest or having noisy breathing. This often leads to poor sleep, missing out on work or school, and emergency trips to the hospital.

Most of this is preventable if you take the right steps. This starts with a visit to your GP, who will make sure that your asthma is correctly diagnosed, you have an optimal asthma action plan and you are on the right medications.

Medication is necessary to safely control asthma. This guide will cover the medications used for asthma: relievers, preventers, and add-on medications to help you understand what they are, how they work and when to use them. You will also learn how non-medication treatments and lifestyle changes can complement this.

Understanding the types of Asthma Medication

Like a fire, an asthma attack can occur quickly and at any time, stopping your lungs from breathing properly.

The types of asthma medications are: relievers, preventers and add-on medications:

Reliever medications, like a big hose to a fire, can quickly settle down an asthma attack. All people with asthma should have a reliever with them at all times. Relievers are only used when you feel asthma symptoms.

Preventer medications are used every day, even if you don’t have symptoms. They settle down your lungs to stop the asthma symptoms from occurring in the first place. Many adults with asthma (especially if you have symptoms more than once a month) and some children should be taking a preventer. If you have been prescribed a preventer then it is important you take it everyday.

Add-on medications are needed for some people, if they still have breathing trouble from asthma despite correctly using their reliever and preventer.

Your GP will be able to advise the best medication for your situation.

What is an Asthma Reliever?

If you have asthma you must always have a reliever on you at all times. Usually, you only need to use a reliever if you feel asthma symptoms. However, some people need to take them before certain situations that might trigger asthma, such as exercise.

Your lungs have muscles built into them which help control how much air goes in and out. In an asthma attack, these muscles squeeze too tight, causing asthma symptoms. Asthma relievers provide quick relief by relaxing airway muscles, making breathing easier.

Everyone with a reliever medication should have an asthma action plan from their GP so you know when and how to use it confidently.

Types of Asthma Relievers

The main types of asthma relievers available in Australia include:

1. Salbutamol (brands include Ventolin, Asmol, Airomir, Zempreon)

2. Terbutaline (Bricanyl)

3. Combination inhaler (brands include Symbicort, Duoresp Spiromax)

If you need to use your reliever more frequently, consult your GP to ensure your asthma is properly controlled.

Side effects of using reliever medication

Reliever medications are generally safe but may cause mild side effects, such as:

• Fast heart rate

• Shakiness or muscle cramps

• Headaches

• Rarer side effects can occur with very high doses

These side effects are usually temporary but should be discussed with a healthcare provider if they persist or worsen. Make sure you have an asthma action plan from your GP so that you know when and how much reliever medication to use.

What is an Asthma Preventer?

Preventer medications are taken daily to make you less likely to have an asthma attack. Unlike relievers, they need to be taken everyday, even if you feel well.

In asthma, the lungs can continue to be inflamed and very sensitive, causing particularly bad or frequent asthma attacks. This might cause your asthma to prevent you from sleeping properly, going to school or work, or from effectively carrying out your day. In bad cases it leads to needing emergency treatment with a doctor or hospital.

Preventer medications reduce these effects on your life by making your lungs less inflamed.

Your GP can help you determine whether a preventer is required. Anyone who is prescribed a preventer should have an up to date asthma action plan.

Types of Asthma Preventers

Common preventers include:

• Inhaled corticosteroids (Budesonide, Fluticasone, Beclometasone, Mometasone)

• Combination inhalers (Symbicort, Duoresp Spiroma, Seretide, Fostair, Rilast, Flutiform)

• Leukotriene receptor antagonists (Montelukast)

Your GP or respiratory physician (lung doctor) can help determine which preventer is best for your situation.

Side effects of using preventer medication

Preventers are very effective, but may have some mild side effects, including:

• Oral thrush (a fungal infection)

• Hoarseness or a sore throat

• Coughing or throat irritation

• Bruising

• Rarer side effects can occur with prolonged and/or high doses

To minimise these effects, use a spacer and rinse your mouth after inhaling, and ensure you use the preventer as directed on your asthma action plan.

If side effects persist or you have any concerns, it’s important to discuss alternative treatments with your GP or respiratory physician.

Add-on Medicine

Your GP may prescribe “corticosteroid” or "steroid” tablets (or syrup) such as Prednisolone (or prednisone) to be used for a few days during severe flare-ups, though long-term use is generally avoided due to potential side effects.

If you have a prescription for steroid tablets or syrup, make sure you have an asthma action plan so you know when, how much and how long to take it.

For people living with severe asthma, standard medications may not be enough. In such cases, add-on therapies may be required. These include Montelukast, long-acting bronchodilators, and monoclonal antibody injections. You may need a referral from your GP to see a specialist lung doctor (respiratory physician) to know which add-on medicine is right for you.

How to take Asthma Medication

Inhalers & Spacers

Most asthma medications are inhaled so that they can go straight to your lungs and work quickly and effectively. Types of inhalers include pressured metered dose inhalers (pMDI) or dry powder inhalers (DPI).

Some people find it hard to use an inhaler, in which case a spacer can help. Spacers are especially useful for children or older adults, as it makes the medication easier to breathe in and reach the lungs more effectively.

Your GP can help you work out which inhaler is best for you.

Nebulisers

A nebuliser are a special medical device that is sometimes used when inhalers don’t work well, especially during a severe asthma attack. They turn liquid medicine into a mist that’s easier to breathe in. Nebulisers can deliver both preventer and reliever medications and are helpful when you need extra support with your asthma. Tap here to learn more about nebulisers.

How long will I need to take my asthma medication for?

Asthma is a long-term condition, and anyone with asthma should always have their medication with them at all times. Preventer medications should be taken daily, even when you feel well, to help reduce the impact of asthma on your life. Reliever medications are used when you have an asthma attack and can be lifesaving.

You should always continue to take your asthma medication, unless you have been advised by your doctor to stop.

Accessing Asthma Medications in Australia

Most asthma medications require a prescription from your GP or specialist. However, some relievers are available over the counter at pharmacies.

It’s a good idea to talk to your doctor or book an appointment with a Myhealth GP to get the right treatment and ensure your asthma is well managed.

The role of Australian Pharmaceutical Benefits Scheme (PBS)

The PBS provides subsidies for asthma medications, making them more affordable for Australians. Consult your GP to determine which medications are covered under the scheme.

Following your Asthma Action Plan

This is one of the best ways to manage your asthma effectively. An asthma action plan is a personalised strategy that outlines medication use and symptom management. It includes information on preventer medications, reliever medications, and how to adjust your treatment based on your symptoms or peak flow readings.

Your doctor plays a key role in creating and reviewing your plan, ensuring it suits your needs. For more information, tap here: Understanding the Asthma Action Plan: What It Is and How to Get One

Non-Medical treatments for Asthma

Life-style changes

All patients with asthma should have their asthma medication with them at all times. Lifestyle modifications can complement medications to reduce the impact of asthma on your life.

Key changes include:

• avoiding asthma triggers (like dust or smoke) – your GP can help you identify possible triggers for your asthma

• quitting smoking

• maintaining a healthy diet

• regular exercise

• maintaining a healthy weight.

Small adjustments can have a big impact on your asthma control.

Breathing Exercises and Techniques

While these cannot replace the role of medications in asthma, some people find breathing exercises are helpful for their lung health. Some examples include:

• Diaphragmatic breathing strengthens respiratory muscles

• Pursed-lip breathing

• Buteyko breathing techniques

Discuss with your GP whether breathing techniques are right for you.

Here are additional ways to help manage asthma:

• Keep up to date with your immunization to protect against infections such as influenza, COVID-19, RSV and pneumococcal bacteria, as these can trigger and worsen asthma attacks

• Maintain a Healthy Weight to reduce respiratory strain.

• Air Purifiers may minimise indoor allergens

• Manage Stress through mindfulness and relaxation strategies

• Monitor Air Quality and limit outdoor activity on high-pollen days