Some people with asthma need to use multiple inhaled medicines to keep their symptoms under control. Some inhaled medicines can be used on a regular basis to manage symptoms. Other inhaled medicines, also known as “rescue inhalers,” can be used when you are having a hard time breathing (such as an asthma attack) and need to relieve your symptoms right away. The approval of combination inhalers, that contain more than one medicine, is changing the way that asthma is treated.
Previous rescue inhalers only contained one medicine. Airsupra (ayr-soo-prah) was approved in 2023 and is the first and only combination rescue inhaler that is used to treat and prevent asthma symptoms and help prevent future asthma attacks in adults. Airsupra contains two medicines: albuterol and budesonide.
How Does Airsupra Work for Asthma?
Asthma is a long-term chronic condition that causes the muscles of the airways to become narrow from swelling (inflammation) and can cause your lungs to make mucus, which can make it hard to breathe. An asthma attack happens when the muscles around your airways suddenly tighten (bronchospasm), which can cause a sudden and severe breathing problem. A person having an asthma attack may have the following symptoms: coughing, wheezing, chest pressure, chest tightness, fast breathing, or a hard time with talking. Certain people may have an asthma attack when exposed to triggers. Some examples of triggers are:
- Pet dander
- Dust
- Mold
- Smoke
- Pollen
- Infection
- Exercise
Airsupra contains two medicines that work to relax your airways and prevent them from tightening:
- Albuterol is a medicine that widens your airways, which allows you to breathe better. It is a short-acting beta-2 agonist (SABA).
- Budesonide is a medicine that reduces inflammation in the lungs. It is an inhaled corticosteroid (ICS).
Will I Still Need to Use Any Other Inhalers?
Airsupra is a rescue inhaler that should be used, as needed, when you are having a hard time breathing. A rescue inhaler is used in an emergency to provide quick relief of symptoms. A maintenance inhaler is used on a daily basis to prevent asthma symptoms and can be used even when you don’t have asthma symptoms.
Airsupra cannot be used as a maintenance inhaler and should only be used as a rescue inhaler. Depending on how severe your asthma is, your doctor may also prescribe you a maintenance inhaler to have alongside your rescue inhaler.
How Do I Use Airsupra?
Airsupra is inhaled into the lungs. Inhale two puffs when you are having sudden trouble breathing or having an asthma attack. It is important not to take more than 12 puffs (six doses) in a 24-hour period. Shake the inhaler before each use.
After inhaling your dose, rinse your mouth with water and spit the water out into the sink. Doing this can help lower your chances of getting a yeast infection in your mouth called thrush.
Airsupra comes in one dose: 90 micrograms/80 micrograms (albuterol/budesonide) per puff. It is important that you use your inhaler correctly so that you get the full dose. Your prescription should come with “Instructions for Use,” which explains how to prepare your dose, inhale the medicine, and when to refill your inhaler. Ask your health care provider or pharmacist if you are unsure how to use your inhaler.
How Was It Studied for Asthma?
Two clinical studies were done to test Airsupra. The first clinical study looked at how safe and effective it was for treating people with moderate to severe asthma, specifically, the rate at which asthma exacerbations (worsening of asthma symptoms) occurred. This study included people who had at least one asthma attack in the last year and still had asthma symptoms.
People in this study were receiving inhaled glucocorticoids, also known as inhaled corticosteroids (ICSs) (beclomethasone, budesonide, ciclesonide, fluticasone, mometasone) or inhaled glucocorticoids with a long-acting beta-2 agonist (LABA) (Advair, AirDuo, Breo, Dulera, Symbicort) with or without other medicines including leukotriene-receptor antagonists (montelukast, zafirlukast), leukotriene synthesis inhibitors (zileuton), long-acting muscarinic antagonists (Incruse Ellipta, Spiriva, Tudorza Pressair, Yupelri) and/or xanthine.
Adults in this study were 18 to 84 years old, with the average age being 52 years old. The study included people who were White Americans, African Americans, Asian Americans, Alaska Natives, and Native Americans, including those who identified as Hispanic or Latino.
The second study looked at the effect of Airsupra on lung function in people with mild to moderate asthma. Specifically, the study looked at lung function through change in FEV1 from baseline to 12 weeks, which showed how well a person could force more air out of their lungs with each breath.
People in the study were receiving a short-acting beta-2 agonist (SABA) (albuterol or levalbuterol) as needed or low-dose inhaled corticosteroid (ICS) (beclomethasone, budesonide, ciclesonide, fluticasone, mometasone) plus SABA medicine as needed.
Adults in this study were 18 to 84 years old, with the average age being 50 years old. The study included people who were White Americans, African Americans, Asian Americans, Alaska Natives, and Native Americans.
What Were the Benefits?
Airsupra is for people 18 years of age or older. The clinical study results in this section look at the data in adults.
Asthma attacks. Adults 18 or older who used Airsupra had 24% fewer asthma exacerbations on a yearly basis, as compared with people using albuterol. This means people who used Airsupra had more controlled asthma symptoms and fewer events of their asthma symptoms worsening.
Lung function. Adults 18 or older who used Airsupra saw their breathing problems improve quicker and were able to breathe better for a longer time, as compared to albuterol.
How Can I Tell if Airsupra Is Working, and How Fast Does It Start to Work?
You can tell if Airsupra is working if you have less trouble breathing within a few minutes of using it, with the effects lasting for a few hours. If you feel like your breathing is getting worse, contact your health care provider or get help right away. Do not take more than 12 puffs (six doses) in a 24-hour period.
Tell your health care provider if you feel that Airsupra is not helping you breathe better. Your health care provider may ask you to show them how you are using the inhaler, to make sure that you are using it properly. Your health care provider may add on other medicines for your asthma or change you to another medicine for asthma.
Read the “Instructions for Use” that comes with Airsupra on how to prime your inhaler. Priming your inhaler helps to make sure that you are getting the full dose every time you use it. It is important to prime your inhaler before you first use it, when you have not used it in more than 7 days, if it has been dropped on the floor, and after cleaning the inhaler.
What Are the Possible Side Effects, and How Can I Prevent or Manage Them?
The most common side effects are a headache, a yeast infection in the mouth (thrush), coughing, and hoarseness.
Talk to your health care provider if you are having headaches that are not going away, happening often, or causing you a lot of pain. Your health care provider may recommend over-the-counter medicines that you can take to help.
Airsupra can cause a yeast infection in your mouth called oral thrush. To help prevent this, rinse your mouth with water after each dose and spit the water out in the sink.
Talk to your health care provider if you are coughing or are hoarse after using Airsupra and it is not going away. Your health care provider may have you review how you are using your inhaler, to make sure you are using it correctly. Rinsing your mouth with water and spitting out the water in the sink after every dose can help with this. Your health care provider may give you a spacer to use with your inhaler. A spacer is a tube that you can attach to your inhaler to help get the medicine into your lungs and reduce the chances of getting it on your tongue or mouth.
What Do We Know About the Long-Term Safety of Airsupra?
Using Airsupra for a long time may increase your chances of having more side effects, especially if you have certain health conditions. Long-term use has shown to weaken your bones, which can make your bones more prone to fracturing or breaking. If you have a family history of osteoporosis, have not moved around for long periods of time, are experiencing or have experienced menopause, use tobacco, are older in age, have poor nutrition, or take certain medicines, you may be at an increased risk of having problems with your bones while using Airsupra. Talk to your health care provider about all your health conditions, all the medicines that you take, and your family history.
Long-term use could also increase your chances of developing higher in pressure in your eye, glaucoma, or cataracts. Keep regular appointments to get your vision checked.
The risk of having changes to your hormone levels (cortisol) may increase if you use too much Airsupra and use it for a long time. This can lead to different conditions. Your health care provider may monitor your hormone levels while you are using Airsupra.
What Type of Drug Interactions Can Happen?
There are a few medicines that can affect the level of Airsupra in the blood, which may increase the risk of side effects. Tell your health care provider if you are taking any medicines for HIV or AIDS, antibiotics including clarithromycin or telithromycin, any medicines for fungal infections, including ketoconazole or itraconazole, or a medicine used for depression called nefazodone.
Many other inhalers contain similar or the same medicine as Airsupra. Using these inhalers with Airsupra may cause too much medicine to be in your blood and can increase your risk of side effects. Talk to your health care provider about all the inhalers you are using and how often you are using them.
There are also medicines called beta-blockers that are used for blood pressure, certain heart conditions, and migraines. Taking beta-blockers with Airsupra may cause Airsupra to not work as well as it should and may tighten the muscles in your lungs, making it harder to breathe.
Taking medicines for swelling, blood pressure, or heart failure known as loop or thiazide diuretics (also known as water pills) can lower potassium levels in the body. Your health care provider may monitor your blood levels while you are using Airsupra.
Taking a medicine called digoxin for your heart along with Airsupra can increase the level of digoxin in your blood. Tell your health care provider if you are taking digoxin. Your health care provider may monitor the digoxin levels in your blood while you are using Airsupra.
Taking certain medicines for your depression called monoamine oxidase inhibitors or tricyclic antidepressants with Airsupra or within 2 weeks of stopping these medicines can increase the effects on your heart, and cause it to work harder. Tell your health care provider if you are taking any medicines for depression or have recently stopped taking any medicines for depression. Your health care provider may monitor your blood pressure and heart rate while you are using Airsupra
This is not a complete list of medicines that may interact with Airsupra. Tell your pharmacist or health care provider about all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them determine if there are any interactions with Airsupra or if you need a dosage adjustment.
Is There a Cost Savings Program?
There is a savings card available from the drugmaker that may allow you to pay $0 for a prescription. Whether you are eligible depends on the type of insurance you have and whether or not your insurance covers the full cost of your prescription. You can find out more at https://www.airsupra.com/savings-card or by calling 866-480-0030 to ask for help with the savings card.
If you do not meet the requirements for the savings card or you cannot afford your Airsupra prescription, you may be eligible for a program offered by the drugmaker called the AZ&Me Prescription Saving Program. You can find out more at https://azandmeapp.com/.
For questions about cost, insurance coverage, or any other questions related to Airsupra, visit https://www.airsupra.com/.
