PREVENTER TREATMENT FOR PEOPLE WITH MODERATE TO SEVERE ASTHMA
People with moderate to severe asthma usually need to use a regular daily or twice daily inhaled medication to keep their symptoms under control, maintain their quality of life and reduce their risk of having an asthma flare-up.
The Australian Pharmaceutical Benefits Scheme (PBS) has recently listed a new combination preventer inhaler for use by people with moderate to severe asthma. It’s called Atectura Breezhaler and contains indacaterol and mometasone in a fixed-dose combination in one inhaler device.
Asthma Australia would like to update you on this so you’re informed and empowered to know your options and make the best choices for you and your family.
WHAT IS ASTHMA?
Asthma is a long-term condition of the airways (the passage that transports air into our lungs). At the moment there is no cure, but for many people, it can be managed with the right treatment. Asthma is recognised by the following:
- Tightening of the airways
- Swelling and inflammation in the airways
- Mucus production inside the airways
These lead to asthma symptoms which are commonly experienced as breathlessness, cough, chest tightness, and wheeze. Flare-ups happen when symptoms persist, don’t improve with reliever use, or become severe.
HOW IS ASTHMA TREATED?
The main goal of treatment in asthma is to obtain control and prevent ‘asthma attacks’ or ‘flare-ups’. The most important treatment, therefore, is medicine which prevents these from occurring. Preventers are used to reduce the inflammation and sensitivity in the airways, which in turn prevents symptoms and reduces the risk of flare-ups. This is effective for most people with asthma. Preventers are inhaled, so they work inside the airways, where they need to.
The other part of medical treatment in asthma involves the use of a bronchodilator (to open and relax the breathing tubes), which aims to relax the muscles in the airways. Commonly known as relievers or dual-purpose relievers, these medicines are also inhaled and provide quick relief of symptoms. Relievers are usually used alongside preventers to treat symptoms that breakthrough despite tailored preventer treatment.
Dual purpose relievers
Dual purpose reliever (budesonide/formoterol as-needed): relieves symptoms and reduces the risk of serious flare-ups by treating inflamed airways. The combination of budesonide/formoterol in the dual purpose reliever, when used as-needed, relieves symptoms and reduces the risk of experiencing serious asthma flare-ups. It does this by relaxing tight airway muscles and treating inflammation in the airways.
Some inhaled preventers come in combination form, and they are called combination preventer inhalers. They contain both the preventer and reliever types of medications and they work by both reducing the inflammation in the airways and relaxing the tight airway muscles. Combination preventers are prescribed for daily or twice daily inhalation and must be used in this way to be effective. Atectura is a combination preventer medicine.
WHAT IS ATECTURA BREEZHALER (mometasone/indacaterol)?
Atectura Breezhaler (mometasone/indacaterol) is a combination preventer inhaler available by prescription only for adults and adolescents 12 years and over with moderate to severe asthma. Atectura Breezhaler may be prescribed to people who have poor control of their symptoms despite correct and regular use of:
- Inhaled low dose preventer medicines plus as-needed reliever, or
- Inhaled low-dose combination preventer medicine plus as-needed reliever.
Atectura works in two ways due to the action of its two ingredients:
- Indacaterol: relaxes the tight muscles around your airways which help airflow in and out of your lungs, helping your small airways to stay open.
- Mometasone: acts to reduce inflammation in the airways, making them less swollen, less irritated, and less likely to produce mucus which reduces the narrowing and aims to prevent troublesome asthma symptoms. It also reduces your risk of having asthma flare-ups.
Atectura will be prescribed for once daily use and needs to be taken regularly, as prescribed, to be effective – even when you feel well. It should not be used to relieve a sudden episode of breathlessness or wheezing.
WHAT HAS CHANGED?
The Atectura Breezhaler is a new addition to the list of combination preventer medicines.
- It is a single daily dose regime due to the long lasting effects of the two medicines it contains: mometasone and indacaterol
- It is delivered by the Breezhaler device which may be a new device for people with asthma. See below for device use instructions
- The Breezhaler device requires the preparation of a capsule inside the device, which may be new for people with asthma
- The capsule is to be used with the device and not swallowed.
Atectura Breezhaler comes in three different dose strengths and your doctor will prescribe the dose strength which is the right one for you.
HOW WILL THIS CHANGE IMPACT ME?
For people with asthma and their health care providers, it provides another option to be considered as medical treatment is tailored to your individual needs.
As with everything in asthma, not every medicine and device will work for everybody and it is important that you can use your preventer medicine device correctly, you take it regularly and you have an Asthma Action Plan in place. If you find that you’re not managing with any of these important things, go and have a chat with your doctor soon, there is likely to be a solution available for you.
If you haven’t spoken to your doctor recently about your asthma control, this might be a good time to do so. Together, you should be aiming for symptoms twice per week or less, no limitations to your activity and lifestyle goals, and no asthma flare-ups.
HOW TO USE ATECTURA BREEZHALER
Your doctor or pharmacist will advise you on how to use your inhaler. Usually, you will be advised to inhale the contents of one capsule each day, every day. It is important to use your Breezhaler device correctly in order to get the most benefit from the medicine. Watch this and be sure to speak with your pharmacist about a device technique demonstration.
HOW TO USE YOUR ATECTURA BREEZHALER
- Open device
- Remove cap
- Flip mouthpiece to open
- Load capsule
- Remove capsule from blister and place in chamber
- Close mouthpiece until it clicks
- Press side buttons in once and release
- Inhale single dose
- Breathe out gently away from the inhaler
- Put the mouthpiece between teeth without biting and close leaps to form a good seal
- Breathe in quickly and steadily, so the capsule vibrates. Continue to breathe in until comfortable
- Hold breath for about 5 seconds or as long as is comfortable
- Remove the inhaler from your mouth while holding your breath
- Breathe out gently away from the inhaler
- Close device
- Open mouthpiece and remove the capsule
- Close mouthpiece and cap
- Rinse your mouth out with water after use
Other important points:
- Only use the capsules provided in the pack with the inhaler
- Keep capsules in the blister until you need them
- Peel the blister back to retrieve the capsule, don’t push the capsule through the blister
- Take your medicine at the same time each day
- Mild side effects are common in up to 1 in 10 people and include changed voice, sore mouth, sore throat, and muscle pain
- Report all side effects to your doctor. Make an urgent appointment with your doctor if you feel like your asthma is deteriorating.
- Atectura Breezhaler (indacaterol and mometasone) is a new medicine available in Australia for people with asthma, available by prescription only for people aged 12 years and over
- Atectura is a combination preventer medicine, which means it contains more than one medicine in one device and is prescribed for regular use to prevent symptoms and flare-ups
- The list of asthma medicines available in Australia is growing which might provide you and your treating health professional with more options to tailor your treatment to your individual needs
- Together you should be aiming for good asthma control (symptoms on no more than two days in one week), no flare-ups, and no interruption to your lifestyle and well-being goals
- Ensure you use your preventer inhaler regularly as prescribed to get maximum benefit from it. Ensure you use the device correctly and you have an updated asthma action plan which clearly describes your medical treatment plan and what to do in case of deterioration
- If symptoms are still not controlled whilst using Atectura Breezhaler it is important to review your asthma urgently.
Want to know more? For more information about Atectura Breezhaler or to speak with an Asthma Educator about your asthma, call 1800 ASTHMA (276 462).
Content updated 13/07/21