Controller medications (previously known as ‘preventer’ medications) reduce inflammation of the airways over time and lower the risk of a severe attack occurring. They do not provide any instant relief of symptoms but build up protection and reduce symptoms over a longer period. With proper use of their controller inhaler, many people will be totally symptom free and will only need to use their reliever inhaler very rarely.
It can take up to two weeks for the effects of controller medication to kick in, or up to two months in children. Because of this, it’s important to continue using your controller inhaler as prescribed, even if you feel no immediate improvement. Gradually your symptoms should become less, and you will notice that you don’t need to use your reliever inhaler as frequently.
Normally, you will be started on a dose high enough to get your symptoms under control. Once this has been achieved, the treatment is steadily reduced to the lowest possible dose that maintains your asthma without symptoms. Controller medication usually comes in a brown inhaler.
You may be prescribed a controller inhaler if you have regular symptoms and/or use your reliever more than twice a week.
Symptoms that suggest you might need a preventer inhaler
- Breathlessness
- Coughing
- Tight chest during daily activities more than twice a week
- Disturbed sleep from the same
- Bad attacks of breathlessness when you are ill or in a smoky atmosphere
Controller medication must be taken every day as prescribed, even when you’re feeling well. It is an essential part of keeping asthma symptoms under control.
Examples of controller medication
- Beclomethasone (e.g. Becotide)
- Budesonide (e.g. Pulmicort)
- Fluticasone (e.g. Flixotide)
Do I really need to take my controller inhaler every day?
Yes – very definitely. To work properly, controller inhalers need to be taken every day, usually morning and evening, even if you are feeling well. The protective effect of the controller medicine builds up gradually.
Once this protection is working, occasionally forgetting to take your inhaler will usually not have any major effects. But forgetting or stopping for several days at a time will mean you lose your protection.
Possible side effects of controller inhalers
Controller medication may sometimes cause hoarseness, a sore throat or oral thrush. These side effects can be reduced by making sure you use your inhaler correctly, use a spacer device, rinse your mouth and wipe your face after taking medication.
It is important to note that the steroids found in controller medication are identical to those produced naturally in the body and should not be confused with anabolic steroids which are sometimes used illegally by athletes.
Steroids
- Many people are anxious about the side effects of steroids used in preventer treatment. Here are some key points to remember:
- The steroids used to treat asthma are called corticosteroids.
- Corticosteroids are identical to those produced naturally in the body.
- They are completely different to the anabolic steroids used by body builders and athletes. Most people with asthma use low dose inhaled steroids, which go straight down to the airways, so very little is absorbed into the rest of the body.
- You doctor will prescribe the lowest possible dose to get your asthma under control.
- There is a small risk of a mouth infection called thrush, and hoarseness of the voice. You can avoid this by using your inhaler before brushing your teeth, and by rinsing out your mouth well afterwards. Using a spacer device also helps reduce the possibility of thrush. Top tip: Leave your preventer inhaler beside your toothbrush to remind you to take it morning and evening before you brush your teeth.