I've heard that long-acting beta agonists (LABAs) can cause severe asthma attacks. Should I stop taking them?

Answers from James T C Li, M.D., Ph.D.

In some studies, long-acting beta agonists (LABAs) have been linked to life-threatening asthma attacks. The risk appears to be greatest when a LABA is used without also using an inhaled corticosteroid. In contrast, taking a LABA with an inhaled corticosteroid is appropriate treatment for many people who have asthma. Don't stop any of your asthma medications before checking with your doctor.

LABAs are used on a regular schedule to open narrowed airways and prevent asthma attacks. But because they increase the risk of having a life-threatening asthma attack, the Food and Drug Administration warns that LABAs should never be used without an inhaled corticosteroid. So if you're taking a LABA without an inhaled corticosteroid, check with your doctor.

LABAs include:

  • Salmeterol (Serevent Diskus)
  • Formoterol (Perforomist)
  • Arformoterol (Brovana)

A LABA should be taken with an inhaled corticosteroid, such as:

  • Fluticasone (Flovent HFA, Flovent Diskus)
  • Budesonide (Pulmicort Flexhaler, Pulmicort Respules)
  • Mometasone (Asmanex HFA)
  • Flunisolide (Aerospan)
  • Beclomethasone (Qvar)

Another option is to take a medication that combines both a corticosteroid and a LABA. There are four of these medications on the market:

  • Fluticasone and salmeterol (Advair Diskus, Advair HFA)
  • Budesonide and formoterol (Symbicort)
  • Mometasone and formoterol (Dulera)
  • Fluticasone and vilanterol (Breo Ellipta)

Children who need both a LABA and a corticosteroid should take them only as a combination medication, and not as separate medications.

The benefits of LABAs to keep asthma under control generally outweigh the risks — if they're used as recommended. If you have any questions about your asthma medications, talk to your doctor.

Aug. 12, 2017