Long Acting Beta Agonist (LABA) Can Control Symptoms

A long-acting beta-agonist (LABA) is a type of bronchodilator that has effects lasting for 12 hours or longer. Two examples are Serevent and Foradil. In general, LABAs are used as adjunctive treatments for asthma and chronic obstructive pulmonary disease (COPD).

Symptoms that can often be prevented with LABAs include:

• Wheezing
• Chest tightness
• Shortness of breath
• Cough

This treatment can have benefits when added to the treatment regimen for people whose symptoms are not adequately controlled with an inhaled corticosteroid.

Benefits include:

• Improved lung function
• Decreased asthma symptoms
• Increased number of symptom-free days
• Reduction in the number of asthma attacks
• Decreased rescue inhaler use

Additionally, a LABA may be used for the prevention of exercise-induced asthma.

A LABA bronchodilator should not be used for treating an acute asthma attack.

How Does a LABA Work?

A LABA relaxes the smooth muscle lining the airways of the lungs and causes the airways to open up. For some people, this reduces symptoms of asthma or COPD.

The effects of a LABA can last 5 to 12 hours or longer.

And LABA medications do not decrease any of the underlying inflammation associated with asthma. This is why, if you have asthma, you can only use a LABA if you are also taking an inhaled steroid.

Side Effects

Many people do not experience any side effects from using albuterol and other LABAs. If you experience minor side effects, your healthcare provider may change your prescription to a different LABA.

Common side effects include:

• Indigestion
• Dry mouth
• Tremors
• Headaches
• Nervousness

If you experience any serious side effects, make sure to contact your healthcare provider promptly.

Serious side effects can include:

• A rapid heart rate, chest pain
• Wheezing, skin rash, trouble breathing

There has been some concern regarding whether LABA treatment increases the severity of asthma exacerbations and possibly increases the risk of fatal asthma. Even though a LABA may decrease the frequency of asthma episodes and severity of symptoms, a LABA may make asthma episodes more severe when they occur.

You need to discuss these risks with your asthma provider to figure out the best plan for you.

The LABA clenbuterol, similar in profile to albuterol, is not approved for use in the U.S. because there are similar drugs available that have the same desired effects on the breathing passageways but are less likely to cause dangerous side effects. Clenbuterol is not approved in many countries due to its potential to become toxic at even very low doses. Harmful side effects may include tachycardia, heart palpitations, tremors, seizures, increased blood sugar, cardiac arrest, and even death. Clenbuterol has been used illegally by athletes as a performance enhancer similar to anabolic steroids.

Examples of LABA Medications

The different LABA medications have different approved indications, and some are approved for children, others only for adults.

LABA medications and their indications:

• Serevent® (salmeterol): Prevention of asthma symptoms and exercise-induced asthma for children and adults age 4 and older
• Foradil® (formoterol): Long term control of COPD
• VoSpireER (albuterol sulfate): For relief of bronchospasm
• Borvana (arformoterol tartrate): Long term control of COPD
• Striverdi Respimat (olodaterol): Long term control of COPD

There are also combinations of LABAs and inhaled corticosteroids (ICS) such as Advair, Symbicort, and Dulera indicated for the maintenance treatment of asthma. The National Institute for Health and Clinical Excellence (NICE) in their review of ICS concludes “if a combination device is chosen then the least costly device that is suitable for the individual is recommended."

Summary

LABAs can be an important part of your asthma action plan when your symptoms are not adequately controlled on an inhaled steroid. It is important to monitor your symptoms to ensure that you do not need additional therapy. Additionally, it is important that you understand the potential side effects and what to do if they occur.