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Asthma Controller Medicines - Leukotriene Modifiers  

The first step in managing your asthma is to prevent the inflammation in the lungs that leads to coughing, wheezing, and shortness of breath. Medicines that do this are called asthma controllers. The most commonly prescribed controller medication is an inhaled steroid. But leukotriene modifiers are another option.

Just as their name implies, leukotriene modifiers work by blocking the action of leukotrienes, chemicals released by cells in the lungs during an asthma flare-up. In the airways, leukotrienes cause swelling, which produces mucus and leads to difficulty breathing. Three leukotriene modifiers are available: montelukast (Singulair), zileuton (Zyflo), and zafirlukast (Accolate). Reported side effects are limited, but may include liver problems.

Swallowed, not inhaled

Unlike corticosteroids, leukotriene modifiers are not inhaled, but are sold as tablets to be swallowed. For patients who have difficulty using an inhaler, this can be an advantage. Some also come in the form of chewable tablets and granules that can be mixed into soft foods.         

Combo adds protection

According to guidelines from professional asthma organizations, leukotriene modifiers are an alternative, but not preferred to other controller medicines for people with mild asthma. For people with moderate persistent asthma, these drugs can be taken in addition to inhaled corticosteroids for added protection against asthma attacks. Experts say that, with time, researchers will better understand the role of leukotriene modifiers in asthma management. For now, corticosteroids remain the most effective anti-inflammatory drug.

No matter what type of controller medicine you use, be sure to take it every day, even if you have no symptoms. Many cases of asthma can be improved simply by taking controller medicines exactly as your health care provider recommends.


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