Rather than taking the route of using higher-dose inhaled corticosteroids, your child's health care provider is likely to take the safer route and prescribe the longer-term symptom control medications on the market. These medications can assist in opening airways and lowering inflammation. Not all, though, are recommended for children under the age of twelve years.

Mast-Cell Stabilizers

Cromolyn sodium and nedocromil sodium, which are available as metered-dose inhalers, are long-term asthma controllers used to decrease inflammation and improve lung function. They are not corticosteroids.

They may be used to prevent asthma symptoms related to triggers such as allergens or exercise if the medication is used prior to an exposure. They do not, though, provide quick relief of asthma symptoms. These medicines block the action of mast cells in the body that release various chemicals that cause inflammation in your airways.

Both drugs, which have been on the market for years (cromolyn since the 1970s and nedocromil since the early 1990s), have less potency than many of their longer acting counterparts and usually must be used about three to four times a day if inhaled. (For cromolyn, it's three to four times a day from a metered-dose inhaler and with a nebulizer.) Generally, they might be only prescribed to patients with very mild asthma. Side effects are very minimal and possibly include coughing, skin rash, and headaches. These drugs have a long history of safety — even with children. Examples are Intal (cromolyn) and Tilade (nedocromil).

Inhaled Corticosteroids

Inhaled corticosteroids, given in low doses, are recommended for children (even those under age five) requiring long-term asthma treatment.

Like the older mast-cell stabilizers, inhaled corticosteroids work to control inflammation — making your child's airways less sensitive when asthma triggers appear. Unlike quick-relief medications, they may take two weeks to a month to see the full benefits from the medication and must be given twice daily to maintain their protective effect. Examples include Aerobid, Azmacort, Flovent HFA, Pulmicort, and QVAR.

Combination Medications

Combination medications are made from two types of asthma medicines that are joined together: Inhaled corticosteroids are usually paired with long-acting beta2-agonists. Generally, these medications are recommended for older children (ages four or up). Together they work in an inhalant form to open the airways and reduce inflammation. Brand names include Symbicort, Advair Diskus, or Advair HFA.

Combivent is a medication that combines two short-acting bronchodilators — albuterol and atrovent. It is used in adults more often than children and comes as a metered-dose inhaler.

Long-Acting Beta2-Agonists

These medicines are inhaled or oral bronchodilators (or muscle relaxers). They are not designed to treat the inflammation. These medications are strongly recommended to be used with inhaled corticosteroids to avoid asthma flare-ups.

However, long-acting types have been found to be better for prevention since they last twelve hours. Examples are Serevent Diskus and Foradil Aerolizer.

Leukotrine Modifiers

Leukotriene modifiers are oral, anti-inflammatory medicines that can be used alone in cases of mild asthma or combined with inhaled steroids for patients with moderate asthma or asthma with allergic rhinitis. One of the products has been approved for use when symptoms arise when exercising. This medicine works to block leukotrienes, a chemical in the body that contributes to the airway inflammation. It also helps prevent swelling inside the airways, stops mucus from forming, and decreases muscle tightening around the airways. Side effects include headaches, nausea, or diarrhea. Examples of leukotriene modifiers are Zyflo, Singulair, and Accolate.

Oral Bronchodilators

A member of this group is theophylline, the generic name of one of the oldest asthma drugs on the market. It can be taken as a tablet, liquid, capsule, or time-released tablet, and works to relax and open up airways.

Theophylline is often combined with a moderate dose of inhaled corticosteroids to provide better control. The medication, though, may have numerous side effects in children — even at low doses. These include nervousness, nausea, restlessness, and headache. Among children who are already diagnosed as hyperactive, it could cause additional stimulation.

Theophylline also can interact with other medications, such as antibiotics or antacids, and can stimulate gastroesophageal reflux, which in turn could trigger asthma.

With so many brands of theophylline on the market, check with your child's health care provider if a change is made as the amount of medicine that gets into the bloodstream can vary with each product. Examples are Aerolate III, Slo-bid, Theo-dur, Theolair, T-Phyl, and Uni-Dur.

Subcutaneous Injection of Anti-IgE

This medication, known as omalizumab, is injected under the skin every two to four weeks in a health care provider's office. It can be used in combination with other agents to treat allergic asthma or allergy symptoms. It is designed to bind to immunoglobulin E (IgE), an antibody that is an underlying cause of asthma and allergies. The drug is designed only for children ages twelve and over. Side effects may include trouble breathing, chest tightness, dizziness, fainting, itching and hives, and swelling of the mouth and throat. It is utilized predominantly in children with severe asthma.