Long-term control medicines

Long-term control medicines usually are taken daily to prevent asthma symptoms. You also might hear them called maintenance medicines. Types of long-term control medicines include the following:

• Inhaled corticosteroids. These medicines are breathed in to treat the airway inflammation that leads to asthma symptoms. They're the most effective and important type of long-term control medicine for children. Inhaled corticosteroids for infants and preschool children include budesonide (Pulmicort Flexhaler, Pulmicort Respules), fluticasone (Flovent HFA) and beclomethasone (Qvar Redihaler).

• Leukotriene modifiers. These medicines taken by mouth block the effects of immune system chemicals that lead to asthma symptoms. A leukotriene modifier may be added to a treatment plan if an inhaled corticosteroid alone does not control asthma well enough. The medicine montelukast (Singulair) is approved in a chewable tablet form for children ages 2 to 6. It's approved in a granular form that can be added to pureed food for children as young as 1.

  Rarely, montelukast has been linked to mental reactions. These include agitation, aggression, hallucinations, depression and suicidal thinking. Get medical help right away if your child has any unusual reactions.

• Long-acting beta agonist. This type of medicine is breathed in to relax muscles in the airways that carry air to the lungs. A long-acting beta agonist is not used by itself due to a risk of serious asthma attacks. Instead, it can be added to an inhaled corticosteroid treatment if the steroid alone doesn't help enough. A common long-acting beta agonist approved for children 4 years and older is salmeterol (Serevent).
• Long-acting beta agonist and an inhaled corticosteroid. These two medicines can be combined to treat small children with serious, persistent asthma. For example, salmeterol plus fluticasone (Advair Diskus) is approved for children 4 years and older.
• Cromolyn. This medicine is breathed in to ease inflammation in the lungs. It can be used by itself or as an add-on treatment with inhaled corticosteroids. There is not as much research as to how well it works compared with the other long-term control medicines for young children.
• Oral corticosteroids. These medicines taken by mouth help ease lung inflammation. They're used only when asthma can't be controlled with other treatments.