Treatment Guidelines from The Medical Letter
Drugs for Asthma
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Revised 11/13/08: In the table on page 86, the last sentence of footnote 7 was incomplete. It now correctly reads: "Zileuton is taken within 1 hour after morning and evening meals."

No truly new drugs have been approved for treatment of asthma since omalizumab (Xolair) in 2003, but some randomized controlled trials of older drugs have been published, and new guidelines have become available.1


Inhalation is the preferred route of delivery for most asthma drugs. Chlorofluorocarbons (CFCs), which have ozone-depleting properties, are being phased out as propellants in metered-dose inhalers; albuterol inhalers with CFCs will not be available in the US after December 31, 2008. Non-chlorinated hydrofluoroalkane (HFA) propellants, which do not deplete the ozone layer, will replace them.2

Metered-dose inhalers (MDIs) require coordination of inhalation with hand-actuation of the device. Valved holding chambers (VHCs) or spacers can help young children or elderly patients use MDIs effectively. VHCs have one-way ... more      

The Medical Letter is a subscriber-funded nonprofit organization that publishes critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases.

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