Combinations of a long-acting beta2-agonist and inhaled corticosteroid:
|Generic Name||Brand Name|
|formoterol and budesonide||Symbicort|
|salmeterol and fluticasone||Advair|
|formoterol and mometasone||Zenhale|
Long-acting beta2-agonists are used only in combination with a corticosteroid to treat asthma. They are used in a metered-dose or dry powder inhaler. Inhalers may be used differently, depending on the medicine used. Always read the directions to be sure you are using the inhaler correctly.
Long-acting beta2-agonists (bronchodilators) relax the smooth muscles lining the airways that carry air to the lungs (bronchial tubes). This allows the tubes to stay open longer and makes 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.
Long-acting inhaled beta2-agonists are used on a daily basis to control moderate and severe persistent asthma. The Canadian Thoracic Society (CTS) and the U.S. National Asthma Education and Prevention Program (NAEPP) recommend using them only as an addition to inhaled corticosteroids.1, 2 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 medicines are often used together in the treatment of asthma. Medicine treatment for asthma depends on a person’s age, his or her type of asthma, and how well the treatment is controlling asthma symptoms.
Your doctor will work with you to help find the number and dose of medicines that work best.
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:3
A review of research reports that in children with persistent asthma who use inhaled corticosteroids but continue to have symptoms (poorly controlled asthma), adding long-acting beta2-agonists resulted in:4
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Common side effects of this medicine include:
The U.S. Food and Drug Administration (FDA) has 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 doctor right away.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
Long-acting inhaled beta2-agonists should not be used without being combined with an inhaled corticosteroid. If you don't take an inhaled corticosteroid, the inflammation in the bronchial tubes may not be controlled, and your symptoms could get worse because of decreasing lung function and increasing inflammation.
Long-acting inhaled beta2-agonists should never be used in place of a short-acting beta2-agonist to treat asthma attacks. A quick-relief medicine such as inhaled salbutamol should be used.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- Lougheed MD, et al. (2010). Canadian Thoracic Society asthma management continuum—2010 consensus summary for children six years of age and over, and adults: Canadian Respiratory Journal, 17(1): 15–24. Available online: http://www.respiratoryguidelines.ca/canadian-thoracic-society-asthma-management-continuum-%E2%80%93-2010-consensus-summary-for-children-six-year.
- National Institutes of Health (2007). National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (NIH Publication No. 08–5846). Available online: http://www.nhlbi.nih.gov/guidelines/asthma/index.htm.
- Dennis RJ, et al. (2010). Asthma in adults, search date June 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Keeley D, McKean M (2006). Asthma and other wheezing disorders in children, search date October 2005. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Last Revised: April 19, 2012
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.