If you have asthma, then you know how scary it can be when you have an attack and have trouble breathing for anywhere from a few minutes to a few days, depending on its severity.

So you’re probably careful to keep your rescue inhaler with you at all times—in case of an emergency.

But what happens if an attack starts and you discover that your inhaler is empty or you don’t actually have it??

How can you lessen the severity of an asthma attack and/or stop it altogether without your trusty inhaler?

To find out, I called Richard Firshein, DO, director and founder of The Firshein Center for Integrative Medicine in New York City and author of Reversing Asthma: Breathe Easier with This Revolutionary New Program. And he had some very interesting advice…


First off, quickly determine whether you’re in immediate danger, said Dr. Firshein. If you have a peak-flow meter—a device that measures how much air you can expel from your lungs and that many asthmatics keep around the house—use it. If you’re less than 25% off your normal mark, go on to the following steps, but if your number is off by more, get to an emergency room, he said, because this indicates that there is a serious problem—one that could be life-threatening, he said. If you don’t have a peak-flow meter, then think about your symptoms. For example, if your lips or fingernails turn blue…if you can’t stop coughing…if you feel soreness or tightness around the ribs…if you feel like you’re having a panic attack…or if you’re so exhausted from the effort of breathing that you can’t finish a short sentence or stand up, then you need help fast—get to an ER.


If you’re not in immediate danger, try these tricks, below, from Dr. Firshein. Some of these techniques may help within minutes, while others may take a few hours to kick in, but since it’s possible for an attack to last for days, try all of them to play it safe. During a typical asthma attack, the airways are constricted, muscles all over your body become tense and your body produces extra mucus—all of those things make it harder to breathe. So Dr. Firshein’s advice addresses all of those problems. You know your body best, so if you try all of these tips but your attack still gets worse, go to a hospital.

Change your location. Asthma is typically triggered by an irritant—either an allergen or toxin—that inflames the airways. So remove yourself from the environment that contains the trigger (if you know what it is) as fast as you can. If you’re reacting to dust, pets, mold or smoke, for example, get away from it…or at the very least, breathe through a sleeve, a scarf or your jacket collar to reduce your exposure.

Tell someone. Talking to someone may reduce your anxiety, and that’s especially helpful, because anxiety can make your asthma attack worse. Also, if your asthma attack becomes more severe later on, you may need a ride to the hospital, so it’s always good to keep someone else in the loop.

Also consider taking an over-the-counter decongestant (such as pseudoephedrine/Sudafed) and/or an expectorant (such as guaifenesin/Mucinex) or a drug that’s a combination of the two (ephedrine+guaifenesin/Primatene Asthma), because these loosen mucus and make coughs more productive so you can rid your body of more phlegm.

Sip hot coffee or nonherbal tea. Have one or two cups right away (but no more than that in one sitting, or your heart rate might spike too high—this is true among all people, not just asthmatics). Caffeine is metabolized into theophylline, which is also a drug that’s used to prevent and treat asthma by relaxing the airways and decreasing the lungs’ response to irritants. Getting caffeine from any source (a soda, an energy drink, a supplement, etc.) will likely help, but tea and coffee have other compounds that act similarly to caffeine (plus, liquids—especially hot liquids—help loosen mucus), so getting your caffeine in this form is best.

Practice breathing exercises. Many people panic when they have an asthma attack and start breathing quickly, but that only restricts the amount of oxygen that the lungs get—in other words, it makes the attack worse. So breathe in through your nose to the count of four and then out to the count of six. Pursing your lips as you exhale will help slow the exhalation and keep the airways open longer. Continue breathing this way for as long as you need.

Press on some acupressure points. The front parts of your inner shoulders (just above the armpits) and the outer edges of the creases of your elbows (when your elbows are bent) are “lung points.” Pressing on one area at a time for a few consecutive minutes may relax muscles that have tightened up.

Steam things up. Take a hot shower or stay in the bathroom with the hot water running from the showerhead or tub or sink faucet. Steam or warm moisture is better than cold moisture because it loosens mucus, so using a cool-air humidifier, although helpful, is not ideal.

Ask your doctor about taking magnesium and vitamin C. Taking 500 milligrams (mg) of magnesium and 1,000 mg of vitamin C during an asthma attack may help if you’re an adult. (Children ages 10 to 17 should take half the doses and children between the ages of five and nine should take one-third of the doses.) Magnesium is a bronchodilator that relaxes the breathing tubes, and vitamin C has a slight antihistamine effect.

Take medications. The prescription corticosteroid prednisone, available in pill form, is used only for acute problems, such as during an attack, because it helps reduce inflammation—so if your doctor has already prescribed it to you and you have it on hand, use it. “This medication will not work as quickly as an inhaler, but it may prevent the problem from getting out of hand if you’re having a lengthy attack,” said Dr. Firshein. Just call your doctor, and let him or her know that you’re taking it, so that he can supervise your dosing.