A Long-Acting Beta-Agonist (LABA) is a bronchodilator medication used for asthma. These inhaled medications help manage and control asthma symptoms over an extended period. LABAs are part of a long-term asthma management plan, preventing symptoms rather than providing immediate relief during an acute attack.
How LABAs Treat Asthma Symptoms
LABAs relax the smooth muscles surrounding the airways, keeping them open and making breathing easier. This allows air to flow more freely into and out of the lungs. The bronchodilating effect of LABAs lasts for 12 hours or longer, contributing to sustained symptom control.
Short-Acting Beta-Agonists (SABAs), or “rescue inhalers,” also relax airway muscles but provide quick, short-term relief, lasting around 4-6 hours. In contrast, LABAs are taken daily for ongoing prevention and maintenance, not for immediate symptom relief during an asthma flare-up. Their purpose is to reduce the frequency and severity of asthma symptoms like wheezing, chest tightness, coughing, and shortness of breath over time.
The Importance of Combination Therapy
While LABAs relax airway muscles, they do not address the underlying cause of asthma: chronic inflammation. Inhaled Corticosteroids (ICS) are the primary medications that control this inflammation, reducing swelling and mucus production. Relying solely on a LABA without an ICS (monotherapy) can mask worsening inflammation, potentially leading to severe asthma attacks.
Historically, the FDA issued a “black box warning” on single-ingredient LABA products due to an increased risk of asthma-related death when used without an ICS. However, recent large clinical safety trials showed that LABAs combined with ICS do not significantly increase the risk of serious asthma-related hospitalizations, intubations, or deaths compared to ICS alone. Consequently, the FDA removed the boxed warning from combination products in 2017. Current medical guidelines recommend that LABAs for asthma be used only in products that also contain an ICS to ensure symptom control and address underlying inflammation.
Potential Side Effects
While LABA medications are well-tolerated when used as prescribed, particularly in combination with inhaled corticosteroids, some individuals may experience side effects. Common side effects include tremors (shakiness, especially in the hands). Some people may also feel nervous or experience an increased heart rate, also known as tachycardia, or heart palpitations. Headaches are another reported side effect.
Muscle cramps are also possible. These side effects often lessen as the body adjusts to the medication over a few weeks. It is advisable to discuss any side effects experienced with a healthcare provider, who can offer guidance and adjust the treatment plan if necessary.
Examples of LABA Medications
Long-Acting Beta-Agonists are typically prescribed for asthma as part of a combination inhaler that also contains an Inhaled Corticosteroid (ICS). These combination products offer both bronchodilation and anti-inflammatory action in one device. Common examples include fluticasone and salmeterol, known as Advair Diskus or Advair HFA.
Another widely used combination is budesonide and formoterol, known as Symbicort. Mometasone and formoterol are combined in Dulera, while fluticasone and vilanterol are found in Breo Ellipta. These medications are designed for regular, daily use to manage persistent asthma symptoms and improve lung function.