ICS asthma treatment: what you should know

Inhaled corticosteroids, often called ICS, act mainly in the airways to calm inflammation. They are controller medicines: they work when used regularly as prescribed and are not usually intended to provide immediate relief during sudden breathlessness. A separate reliever may be included in an asthma plan, depending on the inhaler and your clinician's advice.

The medicine may be delivered through a metered-dose inhaler, dry-powder inhaler, or another device. Incorrect technique can leave medicine in the mouth instead of reaching the lungs. Hoarse voice, throat irritation, or oral thrush can occur; rinsing the mouth after use and using a spacer when advised may reduce local effects.

Take the inhaler on the schedule prescribed, even on days when breathing feels well, unless your clinician changes the plan. Ask a pharmacist or nurse to watch your technique and check that the device suits your breathing and coordination. Keep an updated asthma action plan, monitor symptoms such as night waking or activity limitation, and arrange review if control is slipping.

Do not stop a regular controller suddenly without medical advice. Tell your clinician about recurrent mouth soreness, voice change, shakiness, palpitations, other medicines, pregnancy, or frequent need for a reliever. A review can check the diagnosis, inhaler technique, adherence, triggers, and whether the regimen should change.

Use your asthma action plan during worsening symptoms. Seek emergency help for severe breathlessness, blue or grey lips, exhaustion, confusion, collapse, or difficulty speaking in full sentences. Get prompt medical advice when wheezing, cough, or chest tightness is worsening, waking you, limiting activity, or not responding as expected to your reliever.

Which inhaler is my controller and which is my reliever? How should I use and clean my device? Should I use a spacer or rinse after each dose? What is my action plan for worsening symptoms? When should my treatment be reviewed or stepped down?