Long acting Beta Agonists - LABAS

I have read worrying reports about the dangers (including deaths) connected to the use of LABAS and am concerned seeing as they are in both my asthma sprays.

Here is the view of a doctor at the Mayo Clinic, but I'd be interested in hearing your opinions:


LABAs for asthma — Should I stop taking them?

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


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 an inhaled corticosteroid along with a LABA is appropriate treatment for many people who have asthma. Don't stop any of your asthma medications before checking with your doctor first.

LABAs are used on a regular schedule to open up 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)

Formoterol (Foradil, Perforomist)

Arformoterol (Brovana)

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

Fluticasone (Flonase, Flovent HFA)

Budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort)

Mometasone (Asmanex)

Flunisolide (Aerobid, Aerospan)

Beclomethasone (Qvar, Qnasl)

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

Salmeterol and fluticasone (Advair)

Formoterol and budesonide (Symbicort)

Formoterol and mometasone (Dulera)

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. To be safe:

Confirm with your doctor that you know how to take your medications. If you don't take LABAs or other asthma medications exactly as prescribed, you may be increasing your risk of an asthma attack. Always talk to your doctor before making medication changes or stopping a medication.

Keep a quick-relief (rescue) inhaler on hand. LABAs don't treat sudden (acute) asthma symptoms. An albuterol inhaler or other quick-relief inhaler can prevent an asthma flare-up from becoming a severe asthma attack.

Meet with your doctor on a regular basis. Asthma symptoms change over time, so the medications you need may change as well. If your asthma can be controlled without a LABA, your doctor may recommend that you stop using one.

Talk to your doctor if your asthma isn't under control. The frequent need to use a quick-relief inhaler is a common sign of poorly controlled asthma. Talk to your doctor about other signs that your asthma may not be under control — and what to do if it isn't.

LABAs are sometimes used to treat chronic obstructive pulmonary disease (COPD). When used for COPD, LABAs don't have the same risks that are associated with asthma, so these warnings and recommendations don't apply.

10 Replies

  • Very interesting article Koala thanks for posting .My son has asthma, only shows up during the hayfever season though this is apparently quite common xxx Julie

  • Hi Julie xxx

    That is interesting a out your son. My llung doc says hayfever and asthma are closely connected at certain times and that the birch tree group is particularly bad.

    I wonder if your son would benefit from desensitisation to birch pollen? Has he had tests to see exactly what he reacts to?


  • "a out" should have read "about"

  • No he has not had any tests to see what he reacts too I will mention it to him he always says that he thinks that trees effect him more than flowers too. He will not give up his allotment or garden though hes very stubborn but I think he gets that from me. xxx

  • Well it could be worth checking birch pollen! xxx

  • He said his chest is very tight this morning, and he has been coughing a lot these past few days but still has just trotted of to the allotment clutching his inhaler but it is surrounded by trees will pass on info when he returns thanks. How are you doing now? as I know things have been difficult for you xxxxxxxxxxx

  • Thanks, yes, it has been a horrendous year. I feel so sad for my husband, losing both parents and his childhood house all suddenly and within 5 months. He is exhausted but distracting himself by doing work in the garden. Luckily we've got a large garden, 1,200 square metres.

    I need time to relax but although I thought I'd have that by now, things keep cropping up. This forum keeps me distracted too, and fortunately my asthma is so much better now it's rained so much and I'm on the strongest inhaler.

    My docs have all asked if we are going on holiday and when. I think they also think we desperately need time away. relaxing. We are going to my cousin's wedding in Spain, it should be really enjoyable once we've survived the long drive down!

    Big hugs for you Julie xxxxx (((((((hug))))))))

  • Thanks for the info on the long lasting inhalers, people seem to react in different ways to certain drugs. I tried Seravent and did not have a good reaction.

  • Yes, people really do react differently.

    I think that future medicine will be far more aware of our genetic make up and fine tune accordingly. As for now, it's trial and error.

    What reaction did you have to Seravent?

  • What a good blog, giving good information. Thanks for sharing :)

    Sandra x x x

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