Corticosteroids can be used as maintenance medications to prevent asthma flare-ups or to treat severe asthma attacks. These drugs relieve inflammation in the airway and indirectly cause relaxation of the smooth muscles in the air passages. Inhaled corticosteroids can be taken by metered dose inhaler, by dry powder inhaler or by nebulizer. Because inhalation is thought to deliver the drug directly to the bronchioles, only small doses are required when taken in inhaled form. In severe attacks, an appropriate dose of a corticosteroid may be given by injection or in tablet or liquid form.
Prednisone and Prednisolone
Prednisone and prednisolone are two forms of an oral corticosteroid; they are always given with bronchodilators to treat either chronic, hard-to-control symptoms or acute asthma flare-ups. According to the American Academy of Allergy, Asthma, & Immunology, these medications take at least six to 12 hours to reach peak effectiveness. Prednisone or prednisolone is often initially given in high doses and then tapered to a lower maintenance dose that is taken daily or every other day for asthma control.
Budesonide
Generic budesonide, sold under the brand name Pulmicort, can be taken using a dry powder inhaler or by inhaled solution. The Pulmicort Turbuhaler is a dry power inhaler, and the Pulmicort Respules contain a liquid solution used in a small volume nebulizer. Budesonide can be mixed with bronchodilators such as albuterol, levalbuterol and ipratropium without affecting the strength or effectiveness of the corticosteroid. The Pulmicort Turbuhaler can be used by children over six years of age, and the Pulmicort Respules can be used for children from age one through eight in the 0.5 milligram total dose given once daily or twice daily in a divided dose.
Fluticasone Propionate
Generic fluticasone propionate/salmeterol, sold under the brand name Advair, is a combination of the corticosteroid fluticasone with the long-acting bronchodilator salmeterol added in. Advair is administered as a dry powder using a dry powder inhaler or by metered dose inhaler, and is available in three different strengths. According to the Cleveland Clinic, this combination of a corticosteroid and bronchodilator is often used with patients having moderate persistent asthma who need medications to adequately manage asthma symptoms. Advair Diskus and Advair HFA can be used by children 12 years and older.
Beclomethasone Dipropionate HFA
Generic beclomethasone dipropionate HFA, sold under the brand name "QVAR,", was known as Vanceril and Beclovent before the transition away from inhalers with CFC propellants. According to the American Academy of Allergy Asthma & Immunology, the new reformulated metered dose inhaler can be used by children ages five to 12 using a smaller dose inhaler than inhalers used by adults. Beclomethasone, with the brand name Beconase AQ, is a nasal spray that can be used for children ages six and older.
