What Is the Best Asthma Medication for an Active Lifestyle?

Quick-relief medications, long-term control medications, and habit changes may all be part of a treatment plan that supports asthma management when you’re physically active.

Asthma is a chronic condition that can cause your airways to swell and become narrow, affecting your ability to breathe. For some people, this condition can interfere with the ability to exercise or perform other daily activities.

According to a 2016 review, 60% to 75% of people with uncontrolled asthma report that the condition limits their physical activity, including exercise, sports, and activities of daily living.

But having asthma does not have to prevent you from being active. In fact, in addition to being good for your overall health, regular exercise can help improve your lung capacity and lung health.

If you feel like your asthma symptoms are preventing you from leading an active lifestyle, it may be time to talk with your doctor. Making adjustments to your treatment plan, such as adding a long-term controller medication, may help you manage your asthma symptoms so you can get moving.

Some people with asthma have symptoms only when they exercise, while others may have more persistent symptoms that affect their ability to complete everyday activities.

If you experience asthma symptoms only when you exercise or perform other strenuous activities, you might have exercise-induced bronchoconstriction (EIB). Research suggests that 40% to 90% of people with asthma have EIB.

EIB symptoms emerge during or after an increase in your activity level. The symptoms, which are the same as asthma symptoms in any other situation, include:

• wheezing
• coughing
• tightness in your chest
• shortness of breath
• chest pain (this is rare)

Physical activity naturally increases your breathing rate, causing dry air and airborne irritants to move into your lungs more rapidly and often without the benefit of filtration through your nose (mouth breathing). This can result in a loss of heat, water, or both from your airways, triggering EIB.

You don’t have to be doing a strenuous cardiovascular workout to experience EIB. Any physical effort that increases your breathing rate could trigger it. Factors such as your physical fitness level, environment, and overall health may play a role in determining when activity might cause an asthma attack.

Signs of EIB typically develop within 5 to 20 minutes after the start of exercise and may peak soon after you’ve stopped the activity.

In many cases, EIB resolves spontaneously within 90 minutes of onset. After that, you’re likely to experience a few hours during which you can exercise without asthma symptoms.

It’s possible to experience symptoms not just during exercise but also at other times. You may have frequent or daily symptoms that affect your ability to work, sleep, or perform other daily tasks.

You may receive a diagnosis of uncontrolled asthma if you meet at least three of the following criteria:

• experiencing daytime asthma symptoms more than twice per week
• waking up at night because of asthma symptoms more than twice per month
• using quick-relief medications more than twice per week
• limiting your activity because of asthma symptoms

If you currently have an asthma treatment plan but notice that your symptoms worsen with activity or prevent you from being as active as you’d like to be, it may be time to talk with your doctor about adjusting your treatment.

Your doctor is your ally on the journey to manage asthma. It’s never too soon to touch base if you think your current asthma management strategies might not be effective for an active lifestyle.

To help your appointment go smoothly and make the most of your time with your doctor, come as prepared as possible to discuss treatment plan adjustments. This could mean bringing a symptom diary that details what you’ve been experiencing and when, as well as a list of questions you have about your asthma management.

If you’re interested in new or emerging therapies, consider researching a few beforehand and writing down questions to discuss.

Your doctor is not the one experiencing your asthma symptoms. They base their recommendations for your treatment plan on the symptoms you describe, as well as supporting medical tests and your medical history.

If you’re experiencing significant distress, don’t brush it off or downplay it when your doctor asks. Being honest about what you’re feeling can help you and your doctor decide on the best course of treatment.

Be clear about the level of activity and exercise you want to reach while managing asthma. If you’re not certain what level of activity might be appropriate, consider talking with your doctor about any health goals you have, such as weight loss or better heart health. They can help you plan for exercise and asthma treatment strategies.

Your asthma treatment plan depends on your asthma symptoms, their severity and frequency, and other factors, such as your overall health.

If your asthma is primarily triggered by physical activity or if your symptoms are mild, quick-relief medications (also known as rescue medications) might be the only treatment you need. These products can include inhalers and oral medications. You should carry your quick-relief medications with you at all times and use them as soon as you start experiencing symptoms.

If you have EIB, your doctor may recommend that you take certain rescue medications 15 minutes before you know you’re going to exercise.

Quick-relief medications quickly reduce inflammation and open your airways to help stop an asthma attack. Common options include:

• Inhaled short-acting beta2-agonists: These are bronchodilators that work quickly to open your airways so you can breathe more easily.
• Oral corticosteroids: These reduce swelling in your airways. A doctor may prescribe them for asthma attacks that don’t respond to other asthma medications.
• Short-acting anticholinergics: These help prevent muscles from tightening around your airways, but they may be less effective than short-acting beta2-agonists.

If your asthma is not limited to physical activity or if your symptoms are moderate to severe, your doctor may prescribe long-term control medications that you take daily.

Long-term control medications help prevent asthma symptoms before they start by reducing swelling and inflammation in your airways.

Examples of long-term control medications include:

• Inhaled corticosteroids: These medications help reduce inflammation and mucus production in your airways.
• Long-acting bronchodilators: This category of medications, which includes long-acting beta2-agonists, long-acting anticholinergics, and theophylline, helps prevent your airways from narrowing. These medications are typically used only along with inhaled corticosteroids.
• Leukotriene modifiers: These oral medications help reduce swelling and keep your airways open. You might take them in combination with corticosteroids.
• Mast cell stabilizers: These inhaled medications help reduce swelling by blocking the release of histamine when you’re exposed to an allergen or another asthma trigger.
• Biologics: These targeted medications are typically prescribed for moderate to severe asthma that is not well controlled with other asthma medications. They are given as an infusion or injection.

In addition to medications, some evidence suggests that noninvasive positive pressure ventilation (NIPPV) combined with respiratory muscle training (RMT) exercises might reduce the reactivity of the respiratory tract in exercise-induced asthma for some people.

NIPPV involves breathing pressurized air into your lungs through a mask to help promote open airways. RMT exercises and techniques help improve the strength and conditioning of your respiratory muscles.

Quick-relief medications for asthma should start working within a few minutes, but it can take more time to find out whether long-term therapies you’ve added to your plan are effective.

In general, asthma is considered well controlled when you experience very few symptoms throughout the day or at night and you can perform typical activities without any wheezing, coughing, shortness of breath, or other symptoms.

When it comes to treatment effectiveness in an active lifestyle, you’ll know your new plan is working if you can maintain your baseline of well-controlled symptoms and experience an increase in the amount of physical activity you can comfortably perform.

Sticking to your asthma management plan is the gold standard for maintaining an active lifestyle with asthma, but the following tips may also help reduce your chances of having an asthma attack while being active:

• Take time to slowly warm up and ease into activity.
• Train regularly to build up your fitness level.
• If you’re exercising outdoors or in the cold, cover your mouth with a mask or scarf to help warm and humidify the air.
• Avoid exercising in low temperatures or when air pollutants and allergens are high.
• Consider reducing activity if you have a respiratory infection.
• Take up activities that are less demanding on your breathing, such as leisure cycling or walking.
• Engage in activities in environments with warm and moist air, such as indoor swimming.

Asthma can affect how well you breathe, but it does not have to stop you from living an active lifestyle. You can discuss your activity goals and current symptoms with your doctor, and they can help you create a comprehensive treatment plan that supports your exercise goals.

Depending on your symptoms and their severity, your asthma management plan may involve quick-relief and long-term controller medications as well as habit changes, such as exploring new asthma-friendly activities.