 Preventers control the swelling and inflammation in the airways, stopping
them from being so sensitive and reducing the risk of severe attacks.
Not everyone with asthma will be prescribed preventer medicine.
The protective effect builds up over a period of time so they need to
be taken every day (usually morning and evening) even when you are feeling
well.
Preventers do not give immediate or quick relief when you are breathless
but instead they reduce long-term inflammation. Preventer inhalers usually
contain a low dose of steroid medicine.
There are several kinds of preventers, but they all work in the same
way. You will be started on an appropriate level of treatment to get your
symptoms under control; once this has been achieved the treatment will
be reduced to the lowest possible dose.
Preventers are usually brown, red or orange inhalers.
When are preventers prescribed?
You should be prescribed a preventer if you:
- are breathless, cough or have a tight chest during everyday activities
three or more times a week
- need to use your reliever inhaler three times a week or more
- have sleep disturbed by cough or chest tightness each week
- have bad attacks of breathlessness when you have a chest infection
or are in a smoky atmosphere.
What will my preventer do for me?
As the protective effect of the steroid builds up, you will be less likely
to have asthma attacks. You will be less likely to be breathless during
the day and night and you will not need to use your reliever inhaler as
often.
Do I really need to take my preventer every day?
Yes. To work properly, preventers need to be taken every day, usually
morning and evening, even if you are feeling well. The protective effect
of the preventer medicine builds up gradually.
Once this protection is working, occasionally forgetting to take your
inhaler will usually not have bad effects. But forgetting or stopping
for several days at a time will mean your protection begins to disappear.
If you stop using your preventer, chest infections are more likely to
bring on an asthma attack.
Will my preventer medicines change?
Yes. It is likely that you will have to change your medicines from time
to time.
If your asthma gets really bad, you may need to increase the dose you
take. Or you may need a short course of steroid tablets as well as your
regular preventer.
When you begin taking preventer medicine, your doctor or asthma nurse
may want you to take a higher dose each day. This will get your asthma
under control quickly. As your symptoms improve, you may be able to take
fewer daily puffs or move to a lower strength inhaler
Side effects of preventer medicines
The possibility of side effects from taking your inhaled preventer medicine
is very low. Because the inhaled medicine goes straight down to the airways
where it is needed, very little is absorbed into the rest of the body.
If you use preventer medicine there is a small risk of having a sore
tongue, sore throat, hoarseness of the voice and a mouth infection called
thrush. To help prevent these side effects, rinse your mouth out and brush
your teeth after using your preventer inhaler. Using a spacer will also
help reduce the possibility of thrush.
Children should be monitored closely if they are taking preventer medicines
- especially for growth.
It is possible that long-term and high-dose use of preventer medicines
(inhaled steroids) may cause some other side effects (See 'Side effects
of long-term use of steroid tablets', below). That is why your doctor
and asthma nurse will try to keep you on the lowest dose to control your
symptoms.
Several studies have suggested the possibility of a very slight increased
risk of the development of cataracts in elderly people who have used inhaled
steroids. As with use of all medicines, careful attention needs to be
paid to the risk versus benefit argument and it's as likely that any risk
can be reduced by always using the lowest possible dose of medication
to control the condition.
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