Inhaled corticosteroids and long-acting bronchodilators in fixed dose 

Commonly called combination preventers, inhaled corticosteroids (ICS) plus long-acting bronchodilator or combination therapy inhalers. 

Includes medications such as Atectura, Breo, DuoResp, Enerzair, Fluticasone and Salmeterol Cipla, Flutiform, Fostair, Seretide, Symbicort. (See generic names here: Active Ingredients Guide for Asthma Medication) 

HOW DO COMBINATION PREVENTERS HELP ASTHMA?

Combination preventers contain two or three asthma medications in combination: a preventer (corticosteroid) and one or two long-acting relievers (bronchodilator). 

Corticosteroid preventer: 

  • The inhaled corticosteroid reduces inflammation, sensitivity, and excess mucus 
  • When taken regularly will reduce the risk of having asthma symptoms or flare-ups. 
  • They may take a few weeks of consistent use to show improvement. 

Long-acting reliever: 

  • The long-acting medicine might be either a long-acting beta2 agonist (LABA) or long-acting muscarinic antagonist (LAMA) or one of each. 
  • They relax tight airway muscles for up to 12 hours, some up to 24 hours. 
  • They are either fast or slow acting. Some combination preventers contain a long-acting reliever that works within minutes. Others take up to 30 minutes to start working 

HOW DO YOU USE YOUR COMBINATION PREVENTER?

Using your combination preventer properly is vital to get the medication to your lungs where it is needed. This is true no matter what type of inhaler you are using.  

To make sure you are using your preventer correctly see: https://asthma.org.au/about-asthma/medicines-and-devices/techniques/ 

Always use a spacer if your preventer is in a metered dose inhaler device (puffer). This will reduce the chance of side-effects.  

Rinse, gargle, and spit after use. This will reduce the risk of side effects in your mouth and throat.  

WHY MIGHT YOU NEED A COMBINATION PREVENTER? 

Combination preventers are considered a ‘step-up’ in asthma treatment. They may be prescribed for people who have asthma symptoms despite regular single preventer use. 

If you use a combination preventer regularly and correctly, and still experience asthma symptoms speak to your doctor. You might benefit from add-on medications. 

MAINTENANCE AND RELIEVER THERAPY 

Low dose DuoResp, Fostair and Symbicort can sometimes be used as a preventer and a reliever, under strict conditions. This is called ‘Maintenance and Reliever Therapy’, and means you use the same device to relieve symptoms if they occur. 

POSSIBLE SIDE EFFECTS OF COMBINATION PREVENTERS 

 Sore, yellowish, raised patches in the mouth (thrush) 

  • hoarse voice 
  • irritation of the tongue and mouth 
  • Coughing 
  • headache 
  • trembling or shakiness 
  • feeling anxious, nervous, restless, or upset 
  • fast or irregular heart rate or pounding heart  

You can reduce these by: 

  • Using a spacer with a puffer  
  • Always rinse, gargle and spit after using combination preventer medication or have a drink of water for young children 

Speak to your doctor if you have any concerns about side effects.