Asthma controller therapy explained

Many controllers are inhaled medicines. They work in the background and may not produce the immediate sensation of relief associated with a reliever inhaler, so their benefit depends on consistent use as prescribed.

A controller targets the airway process that makes symptoms and flare-ups more likely. A reliever is used according to the treatment plan to ease tightening of the airway muscles when symptoms occur. Some prescribed inhalers combine medicines and have specific instructions for both regular and symptom-led use.

The correct choice depends on the person’s symptom pattern, flare history, age, other health conditions and ability to use a device. The label and written action plan should make the role of each inhaler clear.

Use the controller at the times written on the prescription, even during symptom-free periods. Have technique observed regularly because device preparation, breathing speed, breath timing and spacer use differ between inhaler types.

Follow device-specific advice about mouth care after an inhaled corticosteroid. Keep track of missed doses and remaining medicine, and request a review if the routine is difficult, side effects are troublesome or the instructions are unclear. Do not share inhalers.

Contact the treating clinic if cough, wheeze, tightness, nighttime symptoms or activity limits persist despite regular treatment. Before changing therapy, the clinician may check adherence, technique, trigger exposure and whether another condition is contributing.

Get emergency help for struggling to breathe, difficulty completing sentences, blue or grey colour around the lips, confusion, severe exhaustion, or worsening symptoms that fail to respond to the urgent steps in the written asthma plan.

Ask what each inhaler does, which one to use during symptoms, how missed doses should be handled, what side effects to watch for, and what signs would prompt a treatment adjustment. Request a demonstration using your own device.