Exercise-induced bronchoconstriction
Transient airway narrowing triggered by exercise. Occurs in 40–90% of asthmatics and 5–20% of individuals without a prior asthma diagnosis. Prophylaxis is taken 15–30 minutes before exercise.
ICD-10 J45.93 drugs
Also known as: EIB, Exercise-induced asthma
Drugs used for this condition
- ASalbutamol (Albuterol)First line · Short-acting beta-2 adrenergic agonists (SABA)Per ATS 2013 and GINA 2024, salbutamol 200 mcg taken 15 minutes before exercise is first-line prophylaxis for exercise-induced bronchoconstriction in patients without underlying asthma. In asthma patients, daily prophylactic SABA is not needed – optimize controller ICS therapy. Frequent pre-exercise SABA use leads to tachyphylaxis.
- BMontelukastSecond line · Leukotriene receptor antagonistsFor exercise-induced bronchoconstriction the first-line is a short-acting bronchodilator (SABA) inhaled 5–20 minutes before exercise (ATS 2013, GINA, GEMA). Montelukast is an add-on option for those with persistent symptoms and for patients whose asthma is mainly exercise-driven; its once-daily dosing protects for up to 24 hours. It acts more slowly and less strongly than a SABA, so it does not replace the inhaler right before exercise.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit