What to Expect With an Asthma Medication Injection

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A few puffs of an inhaler are not always enough to relieve asthma symptoms, so many asthma sufferers require additional medications to keep it under control. For some people, this may come in the form of an injection. A few different types of asthma injections are currently available, each working in a distinct way. If your doctor thinks an asthma injection is right for you, here some things you need to know.

The discovery of different subtypes of asthma has led to the development of new asthma medication.

Asthma is characterized by a narrowing of the airways and an increase in mucus production, leading to coughing, wheezing, and shortness of breath. Research shows asthma isn’t just one general condition. Instead, it can be broken into several subtypes, each with its own triggers and differences in what’s occurring within the body at the cellular level. Because of this discovery, researchers have learned how to tailor treatments to specific asthma subtypes, resulting in some of the new asthma medication injections.

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Allergy shots may improve asthma symptoms.

Though you may think of allergies and asthma as two separate issues, they are actually often related. If you have what is known as allergic asthma, the same things that may cause you to have an allergic reaction, such as dust, pollen, mold, or certain foods, may also trigger your asthma. Allergy shots, a type of treatment known as immunotherapy, help you build up a tolerance to the allergen. By doing so, the goal is to decrease your body’s allergic response and improve your asthma symptoms as a result.

First your doctor will do testing, usually on the skin, to determine exactly what you are allergic to. From there, a very small amount of that allergen will be given as a shot, often in your upper arm. You will initially get one to three shots a week, gradually building up the amount of allergen in each dose. This phase usually takes around four to six months, and you should begin to see an improvement in your symptoms. At this point, you will reach what is considered a “maintenance dose” and will continue to receive a shot once a month for the next three to five years. After that, your allergy shots will be stopped. If all goes as planned, you should be desensitized to the allergen for a long period of time, perhaps even permanently.

Allergy shots are always given in a doctor’s office so you can be monitored for any type of severe reaction. You are usually expected to wait about 30 minutes after receiving the injection.

Biologics are an exciting addition to the asthma medication arsenal.

Major advances have been made in the treatment of many diseases, including asthma, with the development of biologics.  Biologics are made from living cells and proteins, such as human DNA. For many asthma sufferers, these injections are providing relief that was not previously possible. By targeting specific cells, biologics can disrupt the inflammatory process that occurs during an asthma attack. Some examples include:

  • Omalizumab (Xolair): This may be used for allergic asthma that isn’t well controlled with other medications. An antibody, IgE, is released when your body has an allergic reaction and causes a chain reaction that leads to airway inflammation. Omalizumab blocks IgE, and thereby, decreases flare-ups of asthma. It is given as an injection once or twice a month in a doctor’s office.

  • Mepolizumab (Nucala) and reslizumab (Cinqair): These biologic medicines are used for eosinophilic asthma, a type of asthma characterized by high levels of white blood cells called eosinophils.  Mepolizumab and reslizumab help reduce the number of eosinophils in the blood and can lower the occurrence of severe asthma attacks.  They are given once a month in a doctor’s office - mepolizymab is administered by injection and reslizumab by intravenous infusion. Due to the increased risk of developing shingles during treatment with mepolizymab, it is also recommended that non-immunocompromised asthmatics also be immunized against herpes zoster varicella.

It’s important to remember that this type of asthma medicine is meant to be given as an “add-on” to your other medications. Don’t stop taking your normal asthma medication just because you begin receiving an injection. Additionally, these asthma injections can take several months to take effect. Be patient, but also understand that this treatment won’t work for everyone.

Another important consideration is that there is a slight risk of having a severe reaction to the injection, and you will be monitored in your doctor’s office after receiving it. But unlike allergy shots, the reaction can occur right away or may not happen until further down the line. Make sure to discuss with your doctor what symptoms you should watch for and know when you need to seek emergency help.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Sep 25

  1. Allergy Shots. American Academy of Allergy, Asthma, and Immunology. https://www.aaaai.org/conditions-and-treatments/library/at-a-glance/allergy-shots

  2. Biologics in Asthma- the Next Step Towards Personalized Treatment. The Journal of Allergy and Clinical Immunology: In Practice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774509/

  3. How is Asthma Treated and Controlled. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/asthma/treatment

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