Hi there! Thank you for your question. Before I address your problem, allow me to explain briefly about asthma management. Asthma management can be done through Patient and family education about asthma, avoidance of identified cause and drug therapy with the lower possible dose and work our way up to reduce side effects.

As for drug therapy, it is given in a step like fashion. You are started with a short acting beta-agonist (SABA). This is a short acting reliever and they act by dilating the airway during an asthma attack. They are very effective to relive symptoms but do were little for the underlying asthma.

Examples of these are salbutamol (blue in inhaler). Then the next step is to add a low dose inhaled corticosteroid (ICS). These are more long term drug and are take daily. ICS has a lot of side effect, which it is started at the lowest possible dose to minimize the side effects. Examples of these are beclometasone (brown inhaler) and budesonide. The next step is to add a long acting beta agonist (LABA).

This also is a long term drug and it’s given for the underlying asthma itself. Example of this drug is salmeterol. LABA and ICS are usually combined in one inhaler for convenience. The nest 2 steps involves increasing the dose of ICS. Then oral steroid are added if control is still bad.

Oral steroids have too many side effects, so it is important to give a dose as low as possible for as short as possible. The usual steroid given is prednisolone which has to be taken daily until proper control is available. Last step there is omalizumab, a monoclonal antibody. This is an expensive drug reserved only for very severe asthma that requires many hospital admission.

So see your doctor to decide whether to step up (poor control) or step down (good control) your treatment depending on which step you are in and your medical record. Since currently you are having poor control, the doctor will carry out necessary test and increase the dose or add a new drug.

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