Pediatric asthma meds: what every parent should know
Asthma attacks can start fast. Having the right pediatric asthma meds and knowing how to use them changes outcomes. This page breaks down the common medicines, how they’re given, basic side effects, and simple steps to keep your child safer.
Rescue vs controller medicines
Think of meds in two groups: rescue (quick relief) and controller (daily prevention). Rescue inhalers like albuterol — and sometimes levalbuterol — act within minutes to open airways during an attack. They’re what you grab for coughing, wheezing, or shortness of breath. Controller drugs reduce inflammation over time and lower attack risk. The most common controllers are inhaled corticosteroids (fluticasone, budesonide) and sometimes leukotriene modifiers (montelukast).
Rescue meds work fast but wear off quickly. Controllers need regular use to work. That difference guides how and when your child should take each one.
How kids actually take these meds
Delivery matters. For young children, a metered-dose inhaler (MDI) with a spacer and mask or a nebulizer is common. Older kids may use an MDI with a spacer and mouthpiece or a dry powder inhaler. Key tips: shake MDIs, attach the spacer, have the child exhale first, press the canister once, then breathe in slowly and hold breath for a few seconds. For inhaled steroids, rinse and spit after use to cut the risk of thrush.
Know the dose, the number of puffs, and wait times between puffs. If you’re unsure, ask the pharmacist or pediatrician to show you technique during a visit.
Montelukast is a pill or chewable for daily use in kids who have allergies or exercise-related symptoms. It can help some children but watch for mood or sleep changes; report those to your doctor right away.
Combination inhalers (steroid + long-acting bronchodilator) are used in older children when controllers alone aren’t enough. Long-acting bronchodilators should never be used alone in kids — they need to be paired with a steroid.
Side effects are usually mild: tremor or fast heartbeat from albuterol, sore throat or thrush from steroids, and rare mood changes with montelukast. Growth checks are part of routine care if a child is on daily inhaled steroids.
When to get emergency help: if your child can’t speak in full sentences, has fast breathing, lips or face turning blue, or doesn’t improve after rescue doses. If in doubt, treat it as urgent.
Practical habits: keep an up-to-date written asthma action plan, check med expiration dates, store inhalers where kids can’t reach them, keep spare rescue inhalers at school, and review inhaler technique at every visit. Talk with your pediatrician about vaccines, trigger control, and when to step up or step down medicines.
Got questions about a specific drug or your child’s plan? Bring the medication and notes to your next appointment — a quick demo can save a lot of stress later.
