2025 Asthma Treatment Options & Costs: What to Do When Your Inhaler Stops Working

When your asthma inhaler no longer provides relief, it's essential to explore alternative treatments that can help control symptoms and prevent attacks. Beyond inhalers, options include oral medications, biologic therapies, and even surgical interventions tailored to your needs.

Inhalers remain the cornerstone of asthma management, designed to deliver medication directly to your lungs. There are three main types:

• Rescue inhalers: Contain short-acting beta-agonists (SABA) to quickly open airways during an asthma attack.
• Prevention inhalers: Use corticosteroids to reduce airway inflammation and prevent symptoms.
• Combination inhalers: Combine corticosteroids with long-acting beta-agonists (LABA) for both symptom relief and prevention.

Asthma symptoms and responses to treatment can evolve, meaning your current inhaler might become less effective over time. Recognizing when to seek new treatment strategies is crucial for maintaining control.

Emergency Response

If you or someone you know experiences severe asthma symptoms, call 911 immediately or head to the nearest emergency room.

Identifying When Your Treatment Is Failing

Monitor your symptoms closely. Consult your healthcare provider if you notice:

• Increased frequency or severity of symptoms
• Using your rescue inhaler three or more times weekly
• Nighttime awakenings due to asthma
• Limitations in daily activities caused by symptoms
• Declining lung function test results
• Persistent fatigue, stress, anxiety, or depression
• Development of pneumonia or other lung conditions

Document potential triggers, symptom changes, and peak flow meter readings to assist your doctor in adjusting your treatment plan.

Exploring Alternative Treatments

If inhalers are insufficient, your doctor may recommend:

Oral Medications

• Leukotriene receptor antagonists (LTRAs): Medications like montelukast help reduce inflammation but are not for immediate relief.
• Theophylline: A bronchodilator that opens airways but isn't used during acute attacks.
• Corticosteroids: Used short-term during attacks or long-term for difficult-to-control asthma.

Discuss potential side effects and interactions with your healthcare professional before starting these medications.

Biologic Therapies

Biologics target specific immune cells causing inflammation and are administered via injection or intravenous infusion every 2 to 8 weeks. FDA-approved options include:

• Reslizumab (Cinqaero)
• Mepolizumab (Nucala)
• Omalizumab (Xolair)
• Benralizumab (Fasenra)
• Tezepelumab (Tezspire)
• Dupilumab (Dupixent)

Surgical Options

Bronchial thermoplasty is a procedure that reduces airway muscle thickness to improve breathing in severe asthma cases. It involves inserting a heated catheter through the airways to reduce muscle mass.

Trigger Avoidance

Preventing asthma attacks also involves minimizing exposure to triggers such as:

• Allergens like pollen, dust mites, pet dander, and mold
• Environmental irritants including smoke, pollution, and chemicals
• Respiratory infections
• Extreme weather conditions
• Stress and vigorous exercise

Partnering With Your Doctor

Regular consultations are vital to monitor your condition and adjust treatments. Share any concerns about inhaler effectiveness or side effects, and undergo lung function tests like spirometry to assess airway health.

Managing a New Treatment Plan

When transitioning to new therapies, discuss medication management, cost considerations, and emergency preparedness with your doctor. Keep detailed notes on your regimen and never hesitate to seek clarification.

Remember, asthma management is dynamic. Staying informed and proactive ensures you maintain the best quality of life possible.

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