Asthma is a common inflammatory condition that can affect the lungs and airways in both children and adults. Medications such as LABAs can help with symptoms.

According to the American Lung Association, over 25 million people in the United States have breathing difficulties because of asthma. Symptoms can vary from mild to severe.

LABAs are long-acting beta-agonists, a form of medication that doctors use to relieve asthma symptoms. They work by relaxing and opening the airways.

There has been some debate over links between these medications and severe asthma attacks. This article looks at LABAs and the latest evidence on whether they can cause asthma attacks. It also looks at other risks, how people may use these medications, and the alternatives.

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Long-acting beta-agonists (LABAs) are inhaled medications that doctors use to treat asthma and chronic obstructive pulmonary disease (COPD). People use an inhaler or nebulizer device to deliver LABAs directly into the lungs.

LABAs improve breathing and lessen asthma symptoms by acting as a relaxer for the airway muscles. With improved airflow comes a lessening or prevention of symptoms such as coughing, wheezing, shortness of breath, and chest tightness. Doctors primarily use LABAs to treat asthma exacerbations.

LABAs may increase the chances of someone having a severe asthma attack. Because of this, the United States Food and Drug Administration (FDA) strongly recommends combining this medication with inhaled steroids.

Asthma exacerbations are progressive increases in someone’s asthma symptoms that are significant enough that they need to change their treatment. Even with the best possible care and management around 10% of people with asthma experience a severe exacerbation, meaning they need oral corticosteroids, a visit to the emergency department, or hospitalization once a year.

Because asthma exacerbations can lead to a progressive decline in lung function, if a person reaches this point doctors may add a LABA to their treatment plan.

The best way to prevent asthma from worsening is to have an effective asthma action plan that details all the medication someone needs, how much they should take, and when. The most common medicines that doctors use to treat exacerbations are inhaled corticosteroids (ICS). Combining ICS and LABAs is an effective form of treatment.

In 2010 the FDA noted that some people who take LABAs alone have an increased risk of severe asthma exacerbations in comparison to those who do not use them. Because of this, they required LABA manufacturers to have risk management programs.

However, in 2017 the FDA completed a review of four large clinical safety trials. After reviewing the trials, the FDA concluded that they found no significant increase in the risk of severe asthma outcomes in people using a combination of ICS and LABAs.

The risk of using LABAs on their own remains. People should always use both LABAs and ICS together to avoid an increased risk of severe and potentially life-threatening asthma attacks.

If people have any concerns about their asthma treatment, they should discuss their options with a health professional.

Studies suggest that African Americans are at higher risk for experiencing fatal asthma attacks when taking LABAs.

LABAs are one treatment than can reduce asthma exacerbations. Doctors recommend them for short-term use, as using a LABA by itself is dangerous. Combining LABAs with an ICS is the safest way to use LABAs.

The purpose of an ICS is to decrease inflammation in the lungs. If doctors do not treat inflammation it can lead to breathing problems. LABAs promote muscle relaxation in the muscles surrounding the airways in the lungs and make symptoms such as wheezing, chest tightness, coughing, and shortness of breath less likely to occur.

The FDA does not recommend using LABAs by themselves due to the increased risk of asthma-related death. People should use LABAs in combination with an ICS for symptom relief, maintenance, and to reduce exacerbations.

There are a few alternatives to LABAs. The most popular are inhaled corticosteroids (ICS). ICS help reduce asthma exacerbations and improve asthma control.

Some other options include leukotriene antagonists and tiotropium.

Leukotriene antagonists reduce asthma exacerbations in both adults and children, but they are not as effective as ICS.

Tiotropium minimizes the frequency of asthma exacerbations in people 6 years of age or older who cannot control their asthma with ICS.

Other alternative approaches are non-medical and involve environmental control to remove allergens, such as dust or pet hair, or other triggers like tobacco smoke. However, these methods are best for those with a severe allergy to a single allergen. It is difficult to remove all traces of more than one allergen altogether.

Long-acting beta-agonists (LABAs) are a type of asthma medicine. When a person uses them in conjunction with inhaled corticosteroids (ICS) they can safely reduce asthma exacerbations. LABAs work by relaxing the muscles of the airways, making it easier to breathe. The FDA does not recommend the use of LABAs by themselves because this increases the risk of asthma-related death.

Individuals should only use LABAs for short-term treatment to gain control of their asthma. Once the person can manage their symptoms, they can switch to an asthma controller medication such as ICS. These inhaled corticosteroids can manage asthma long-term.

Environmental changes also may help, but typically work best when a person has issues with a single allergen.

Using LABAs in conjunction with ICS is an effective way to treat asthma attacks. However, people must carefully follow usage recommendations.