The focus on improving access to anti-inflammatory inhalers underscores an important gap in asthma care, extending beyond treatment availability to its understanding and appropriate use. While inhalation therapy is the cornerstone of asthma management, it continues to be underutilized in routine practice.¹ Misconceptions, social stigma, and a tendency to rely only on quick-relief medication mean that long-term controller treatments are not used as consistently as they should be. Studies in India show that fewer than 10% of diagnosed patients receive inhaled treatment required for controlling the underlying condition.¹ Understanding the difference between reliever and controller medications is therefore key to improving how asthma is managed in everyday life.

Q1. What is The Difference Between Reliever and Controller Medications in Asthma?

Inhalation therapy is the cornerstone of asthma management, as it delivers medication directly to the lungs, where it is needed most.¹ The right treatment depends on several factors, including a person’s age, symptoms, triggers, and what works best to keep asthma under control. However, since symptoms, triggers and the disease itself can change over time, treatment may need to be adjusted and an updated asthma action plan must always be in place in in consultation with a doctor.³

Asthma treatment usually includes two types of medicines - relievers and controllers, each with a different role.¹

• Reliever medications work quickly to open the airways and provide short-term relief from symptoms like breathlessness, coughing, or wheezing.
• Controller medications, on the other hand, are taken regularly to manage asthma over time. They help reduce inflammation in the airways, prevent symptoms, and lower the risk of future attacks. 

Q2. Why is It Not Enough to Rely Only on Quick-Relief Medication?

Quick-relief medicines act fast to ease symptoms, but they do not address the underlying inflammation in the airways. Over-reliance on these medicines, along with not following your doctor’s instructions on controller treatment, can increase the risk of frequent attacks, hospitalisation, and poorer overall health outcomes. Effective asthma care requires managing both symptoms and the underlying condition.^2,3

Q3. What Role Do Controller Medications Play in Asthma Care?

Controller medications are essential for long-term asthma management as they treat the underlying inflammation in the airways. Taken daily (as prescribed by your doctor), they help reduce swelling, mucus, and airway tightening, which prevents symptoms and flare-ups. With consistent use, patients can reduce emergency visits, and avoid frequent use of oral steroids. Unlike quick-relief medicines, controllers address the root cause of asthma and need to be used as prescribed by a doctor and as part of an individualised asthma management plan, in order to be effective.¹

Q4. What Are Some Common Mistakes Patients Make When Using Asthma Medication?

A common mistake is relying too much on quick-relief inhalers while not using controller medication regularly. Many patients also stop treatment when symptoms improve or do not follow proper inhaler technique. Poor adherence to an asthma action plan and irregular follow-ups can further affect control. Since asthma requires ongoing management, these gaps can lead to frequent flare-ups. It is important to use medications consistently, exactly as prescribed by a doctor, and follow an individualised asthma management plan.^1,2,3

Q5. What is The Key Message Patients Should Take Away?

Asthma care is not just about relieving symptoms when they occur, it’s about controlling the disease over time. Managing asthma effectively involves using controller medication as advised, keeping reliever medication available for emergencies, and attending regular check-ups. Understanding personal triggers and following a treatment plan can also help maintain better control. Using the right treatment in the right way can help people live active, unrestricted lives.

References:

[1] Scichilone N. Asthma control: the right inhaler for the right patient. Adv Ther. 2015 Apr;32(4):285-92. doi: 10.1007/s12325-015-0201-9. Epub 2015 Apr 7. PMID: 25845769; PMCID: PMC4415938.

2 Salvi, Sundeep1,2,; Madas, Sapna1; Ghorpade, Deesha1; Gadhave, Swapnil1; Barne, Monica1. Is underuse of Inhaled Corticosteroids for Asthma in India contributing to 42% of global asthma deaths?. Lung India 39(4):p 331-336, Jul–Aug 2022. | DOI: 10.4103/lungindia.lungindia_600_21

3 https://www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660

4 https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557

5 https://www.ncbi.nlm.nih.gov/books/NBK279519/

6 Zhang X, Ding R, Zhang Z, Chen M, Yin Y, Quint JK. Medication Adherence in People with Asthma: A Qualitative Systematic Review of Patient and Health Professional Perspectives. J Asthma Allergy. 2023 May 9;16:515-527. doi: 10.2147/JAA.S407552. PMID: 37193110; PMCID: PMC10182790.

7 https://www.lung.org/blog/asthma-control-medication#:~:text=Asthma%20is%20a%20chronic%20inflammatory,without%20symptoms%2C%20to%20be%20effective.

Disclaimer: This information is only for general awareness and is neither intended nor expected to promote, use, or endorse any product or encourage use of medicines or treatment in any way nor implied to be a substitute for professional medical advice nor for diagnosis or treatment/cure of any medical condition. The views expressed are independent opinion based on studies from validated qualified sources. Your discretion must be exercised before using the information for consulting doctor. Please consult your doctor/Registered Medical Practitioner before starting any treatment/medicine/ inhaler. This is being used only as a reference to create awareness and is NOT an advertisement