Controller Medications

The current recommendation is to use controller medications long-term to control or manage your asthma. Controller medications are often steroids. Your healthcare provider may instruct you to take this medication daily to control your asthma and prevent any changes to your condition or symptoms.

Steroids

Steroids are one type of controller medication. They reduce inflammation in the body. However, that is not all they do. Steroids block reactions to allergens and limit airway responsiveness. Most people use inhaled steroids. Steroids are a staple asthma therapy. But, they can cause adverse reactions.

• They weaken your immune system. Steroids make it easier for you to get infections
• Increase your insulin resistance

Two conditions can result from steroid use. One is Cushing’s syndrome, which happens when there is too much cortisol in your body. Another condition is adrenal suppression, which happens when there is not enough cortisol in your body. Cushing’s syndrome results from long-term use of steroids, while adrenal suppression happens when there is sudden discontinuation. 

Corticosteroids

Corticosteroids ¹ are a kind of steroid used as a preventative medication. They have different roles, such as limiting airway inflammation and reducing airway responsiveness, sensitivity, and airway narrowing. 

Are Corticosteroids Safe?

Corticosteroids can help prevent asthma attacks. But, they can cause harmful side effects for some people. People in two groups tend to experience those side effects. The first group is people on high-doses of corticosteroids. The second group is people on corticosteroids for long periods. Do not abruptly discontinue your corticosteroids because your asthma symptoms can increase, and you will be at risk for complications.

• Irreversible damage to many of your organ systems
• Increased bone density in children making them susceptible to bone disorders, like osteoporosis
• Eye problems, like cataracts and pressure in the eyes
• Muscle weakness
• Skin conditions

Glucocorticoids

Glucocorticoids are another type of controller medication. As their name suggests, they’re a kind of corticosteroid. Their role is similar to steroids. So, this medication reduces inflammation in the body. However, that is not their only role. They also limit your immune responses.

Are Glucocorticoids Safe?

Glucocorticoids are fast-acting. That means you see results quickly, but only when used in high doses. However, high doses of glucocorticoids have serious side effects and risks of reactions.

• Children can develop glucocorticoid-induced diabetes
• Risk for gastrointestinal problems, such as ulcers, inflammation, and abdominal swelling
• Risk of heart attack, heart disease, and heart failure 

Chromones

Chromones ² are a controller medication often an alternative treatment for mild allergy-induced asthma. Remember that your body makes histamines in response to allergens, and histamines trigger your asthma symptoms. Chromones’ job is to prevent the production of histamines.

Are Chromones Effective?

Compared to steroids, chromones may seem like the better option. That is because chromones are associated with fewer side effects or risks. However, chromones have limitations.

• Healthcare providers don’t prescribe them often 
• They are not as effective
• You have to take them multiple times a day (e.g., 2-4 times) 
• Nebulized cromolyn is the only chromone used in the U.S.