4 Preventive Asthma Controller Medicines

Asthma controller medicines help prevent asthma symptoms when taken regularly—typically every day—as prescribed. There are four types of controller asthma medications, each of which works in a unique way to ward off wheezing, coughing, shortness of breath, and other common symptoms of an impending or in-progress asthma attack.

These drugs affect the pathophysiology of asthma in different ways; some are more appropriate than others for certain levels of asthma severity.

Surprisingly, many patients with asthma do not take their medications regularly. If you do not take your controller medication as prescribed, you may be frustrated as they cannot work for you to prevent asthma symptoms. While there are many things you can do to help you remember and be more adherent, the bottom line is that controller medications need to be taken regularly to improve your asthma control.

Each of these medicines has a time and place that will depend on your particular asthma situation. If you think that you might benefit from a particular treatment or notice that you are experiencing side effects from a treatment you are currently taking, make sure that you talk with your healthcare provider and tell them why you think a particular medicine might be good for you.


Inhaled Corticosteroids (ICS)

Woman using inhaler

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Inhaled corticosteroids (ICS), sometimes also referred to as inhaled steroids, are a mainstay of treatment for persistent asthma in children and adults. They are safe, effective, and when used as prescribed can greatly enhance quality of life with asthma.

These medications can be prescribed alone or may also be prescribed as a combination product with a long-acting beta-agonist (LABA), such as ​Advair, which combines fluticasone (ICS) with salmeterol (LABA).


Leukotriene Modifiers

Leukotriene modifiers (also called leukotriene receptor antagonists) are asthma controller medications that are sometimes used in combination with, or instead of, inhaled steroids for people whose asthma is moderate to severe.


Long-Acting Beta Agonists

Long-acting beta-agonists are asthma medicines that control or prevent asthma symptoms and asthma attacks. These are bronchodilators whose effects last for 12 hours or more. Their recommended use is in combination with inhaled steroids. Generally, your healthcare provider will only prescribe this as an add-on treatment and not as the sole treatment for your asthma.



Immunomodulators such as Xolair are used as add-on therapy in people who have severe persistent asthma with allergies that have not responded adequately to inhaled steroids. Immunomodulators are a type of antibody. This is a significantly more expensive asthma treatment and your insurance company may want you to see a specialist before starting this treatment.

Bottom Line

Ultimately asthma controller medications are about getting your asthma symptoms under control. Make sure you have the information you need to control your asthma.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Heart, Lung, and Blood Institute. 2020 Focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group.

  2. Brennan V, Mulvey C, Costello RW. The clinical impact of adherence to therapy in airways disease. Breathe. 2021;17(2):210039. doi:10.1183/20734735.0039-2021

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.