What Are Beta 2 Agonists in Asthma?

beta 2 agonists
An albuterol inhaler is one type of beta 2 agonist. Photo: © ADAM


Beta 2 agonists are a type of bronchodilator used in the treatment of asthma. Beta 2 agonist medications stimulate beta cells, which relax the smooth muscles of your airways that tighten as part of the pathophysiology of asthma to cause symptoms such as:

Beta 2 agonist medications stimulate beta cells, resulting in dilation of the airways and relief of asthma symptoms.

Some beta 2 agonists are short-acting SABAs, while others are long-acting LABAs.

How Do Beta Agonists Fit Into My Asthma Treatment

It is important to understand how different medications fit into your asthma action plan. With beta agonists, the answer is it depends on the formulation. Some beta agonists are long acting and others are short acting.

The short-acting beta-agonists are used for the acute, short-term relief of symptoms. In your asthma action plan, this will be referred to as your rescue inhaler. When your peak flow drops below a certain number or you develop wheezing or shortness of breath, your action plan will instruct you on how to use your rescue inhaler. In fact, one of the tenants of poor asthma control is needing to use a short acting beta agonist more than twice per week.

Long-acting beta-agonists or LABAs, on the other hand, are taken daily when part of your prevention strategy.

However, LABAs are not usually used as a monotherapy in asthma. They are generally part of a combination asthma product such as Advair or Symbicort. These drugs combine an inhaled steroid and a LABA into one inhaler. When used in a combination product, the LABA will generally be used daily.

There are some physicians who are beginning to look at whether or not one of these combination inhalers could be used as the only inhaler for your asthma.

  A systematic review compared a standard therapy (inhaled steroids plus separate rescue inhaler) with a single  combination inhaler containing a inhaled steroid/ LABA combination both  twice daily as prevention and then as needed for worsening symptoms. The single inhaler treatment did not decrease asthma exacerbations requiring admission to the hospital, but there were fewer adult patients had asthma exacerbations requiring oral corticosteroids like Prednisone. While not significant enough to change standard practice, the results are very interesting and there is further ongoing research.

What About Side Effects?

Side effects of the various beta 2 agonists are similar, and include:

  • Appetite changes
  • Dizziness
  • Headache
  • Hyperactivity
  • Nausea or feeling sick to your stomach
  • Nervousness
  • Shakiness
  • Sinus pain
  • Sore throat
  • Tremor
  • Trouble sleeping
  • Vomiting

More serious side effects of beta 2 agonists include:

  • Allergic reactions such as rash, hives, difficulty breathing, swelling of the mouth, face, lips, or tongue
  • Chest pain
  • Ear pain
  • Fast or irregular heartbeat
  • Hoarseness
  • Pounding in the chest
  • Red, swollen, blistered, or peeling skin
  • A severe headache or dizziness
  • Trouble breathing

What Are Some of the Medications My Doctor Might Prescribe?

Examples of beta 2 agonists include:

  • Proventil HFA
  • Ventolin HFA
  • Proair HFA
  • Xopenex HFA
  • Alupent
  • Serevent (salmeterol)
  • Foradil (formoterol)

Need More Help or Want More Information?

If you found this article helpful or if you think others you know would find it helpful, please share it using one of the social media sharing buttons on this page. 

I would also like to hear from you. I cannot address your biggest asthma problems or challenges if I do not hear from you. Please take a few minutes describing your asthma challenges so I can develop better asthma content and we can develop a solution together.

Feel free to email me about any asthma questions or concerns. I am not your asthma doctor and cannot provide treatment advice to you directly, but I can help steer you towards information that may help you improve your asthma.

If you want to interact with a community concerned about asthma, ask questions or get advice from other patients or parents of asthmatics in a supportive environment, our private Facebook group allows you to do all of this. You can ask questions, interact, get useful information and realize that you are not alone on the asthma journey.

Continue Reading