Updated March 18, 2015.
What Is a LABA?
A LABA is a type of bronchodilator whose effects last for 12 hours or more. LABA stands for long acting beta agonist and two brand names are Serevent and Foradil. It's used for adjunctive treatment for the prevention of symptoms such as:
While a LABA bronchodilator should not be used for acute asthma symptoms, a LABA is associated with the following benefits when added in patients who are inadequately controlled on an inhaled corticosteroid:
- Improved lung function
- Decreased asthma symptoms
- Increased number of symptom-free days
- Reduction in number of asthma attacks
- Decreased rescue inhaler use
Additionally, a LABA may be used for the prevention of exercise induced asthma.
How Does a LABA Work?
A LABA improves your asthma symptoms by increasing airflow through your lungs as demonstrated in this bronchodilator video. A LABA relaxes smooth muscle lining the airways of your lung and causes your airways to open up. As a result, you begin to experience less symptoms. The effects of a LABA can last 5 to 12 hours depending on how frequently you use this inhaler. Importantly, a LABA does not decrease any of the underlying inflammation associated with asthma.
LABA Side Effects
The physical side effects of LABAs are very similar to those described for SABAs. Many patients do not experience any side effects using albuterol and other LABAs. If you experience some of the minor side effects, some physicians may change you to a different LABA. If any of the other side effects occur, make sure to contact your healthcare provider promptly.
LABA Controversy
There has been some concern regarding whether LABA treatment increases severity of asthma exacerbations and possibly increases the risk of fatal asthma. These concerns have resulted in a black box warning from the FDA. Even though a LABA may decrease the frequency of asthma episodes and severity of symptoms, a LABA may make asthma episodes more severe when they occur. Despite this warning, if inhaled steroids do not adequately control your asthma symptoms, you can:
- Increase the dose of your inhaled steroid
- Add a LABA
However, you should not be taking a LABA if you are not also taking an inhaled steroid. You need to discuss these risks with your asthma provider to figure out what the best plan for you is.
Examples of LABA Medications
- Serevent® (salmeterol)
- Foradil® (formeterol)
There are also combinations of LABAs and ICS such as Advair, Symbicort, and Dulera. All are indicated for the maintenance treatment of asthma. The National Institute for Heath and Clinical Excellence (NICE) in their review of ICS concludes “if a combination device is chosen then the least costly device that is suitable for the individual is recommended/
Summary
LABAs can be an important part of your asthma action plan when your symptoms are not adequately controlled on an inhaled steroid. It is important to monitor your symptoms to ensure that you do not need additional therapy. Additionally, it is important that you understand potential side effects and what to do if they occur.
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Sources:
1. National Heart, Lung, and Blood Institute. Accessed: July 1, 2009. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Aslhma
2. National Institutes for Health and Clinical Excellence (NICE). Inhaled corticosteroids for the treatment of chronic asthma in adults and children aged 12 years and over. March 2008. Accessed January 31, 2015/
http://www.nice.org.uk/nicemedia/pdf/TA138Guidance.pdf