What are the key parts of asthma care

For most people with asthma, treatment is made up of 2 parts:

1. an inhaled corticosteroid preventer to avoid redness and swelling in the airways, prevent flare-ups and for maintenance of asthma control
2. a reliever to open and relax the airways when symptoms occur

For a long time, this meant using two separate inhalers; a reliever (often a blue/grey puffer) and a preventer (which comes in many shapes and sizes).

Maintenance and Reliever Therapy (MART) offers a different option.

What is MART: Maintenance and Reliever Therapy?

In MART, the same inhaler is used as both the reliever and preventer. It still gets used morning and night every day the way you might use a preventer, but you also keep it with you to use as a reliever when symptoms occur. It is also sometimes called SMART (single-inhaler maintenance and reliever therapy).

Using the same inhaler for both reliever and preventer is possible because MART inhalers contain both types of medicine. A fast-acting reliever (formoterol) to quickly relax the airways and a low-strength inhaled steroid preventer for maintenance to keep airway inflammation at bay.

This means that when you start using your MART more often for relief at the start of a flare-up, you are automatically getting more of the inhaled steroid you need to calm inflammation in your lungs when they need it most.

Clinical trials show that for some people MART treatment may reduce the risk of flare-ups that need treatment with oral steroids.

Who can use MART: Maintenance and Reliever Therapy

Maintenance and Reliever Therapy requires a prescription from your doctor and is only available for people aged 12 and over.

Your doctor may prescribe a MART plan if you have frequent daytime symptoms (e.g. most days, or waking due to asthma once a week or more).

You might find MART a good option if you would prefer just to have one inhaler.

Not all medicine options are right for all people. Talk to your doctor about which asthma treatment is best for you.

Only the following inhalers are registered in Australia for MART use:

List of inhalers currently approved for MART: Maintenance and Reliever Therapy

(November 2024)

PLEASE NOTE: If your preventer is on this list, but you are not prescribed it as your reliever, do not attempt to use it as your reliever without checking with your doctor first.

How is MART: Maintenance and Reliever Therapy different from an anti-inflammatory reliever?
Many MART inhalers are also approved to be used as a ‘reliever only.’ This is called an ‘anti-inflammatory reliever’. You might have also heard it called by its acronym AIR, or referred to as ‘dual purpose reliever’.

AIR is different to MART because an anti-inflammatory reliever is used as-needed only, and is only suitable for people who get very few asthma symptoms. An anti-inflammatory reliever may be prescribed for people who have symptoms less than twice per month and are at low risk for a flare-up.

Read more about anti-inflammatory relievers here

Always talk to your doctor about which asthma treatment is best for you.

If you have asthma symptoms
Some people with asthma don’t know what they should do when they have a flare-up (also known as an asthma attack). If you have been prescribed AIR or MART, make sure you check with your doctor how many doses you should take during a flare-up. It will be different to the day-to-day maintenance instructions your doctor has given you. It also may differ from what you may be familiar with if you have used a blue/grey reliever during an asthma flare-up.

Having an up-to-date Asthma Action Plan means you know what to do if you have asthma symptoms or an asthma flare-up or attack.

In the event you don’t have instructions for if/when you have an asthma attack, or your symptoms are getting worse despite your reliever use, or you are performing first aid for someone else with asthma (and they don’t have their Asthma Action Plan with them) follow the steps for Asthma First Aid.

Click each picture below for Asthma First Aid instructions for each asthma medicine approved for MART:

Information about medicines and devices to support people with asthma are developed independently by Asthma Australia, made possible by grant funding under the ‘Know Your Options’ Program from AstraZeneca, Chiesi Australia, Sanofi who are not involved in content development.

Last updated: 28th November 2024