MART (Maintenance and Reliever Therapy)
MART stands for Maintenance and Reliever Therapy. It’s a newer approach to asthma treatment that uses just one combination inhaler both every day (to prevent symptoms) and as needed (to relieve symptoms when they occur).
MART can be an effective and convenient way to manage asthma in children and young people – reducing the risk of flare-ups and the need for emergency care.
What is MART?
In MART, your child uses a single inhaler that contains two medicines:
- An inhaled corticosteroid (ICS) – to reduce inflammation and prevent asthma attacks
- Formoterol (a fast-acting bronchodilator) – to quickly open the airways and relieve symptoms
Because formoterol works quickly, this combination can be safely used as both a preventer and a reliever. This means your child doesn’t need a separate blue “reliever” inhaler.
When is MART used?
MART is usually recommended for children and young people who:
- Have frequent asthma symptoms
- Need their reliever inhaler three or more times a week
- Have had an asthma attack in the last year
- Are struggling with poor asthma control on a regular preventer inhaler
Avoiding known triggers and reviewing symptom patterns regularly can help optimise asthma control.
How is MART taken?
Your child’s MART inhaler will be used in two ways:
- Regular daily doses – to maintain asthma control
- Extra doses when needed – at the first sign of asthma symptoms such as cough, wheeze or breathlessness
Your doctor will provide a personalised MART asthma action plan explaining how many puffs to take each day and how many extra puffs can be taken safely when symptoms occur.
Example MART Schedule
| Age Group | Inhaler Type | Regular Dose | Max Daily Dose (incl. reliever) |
|---|---|---|---|
| 12+ years | Fostair 100/6 or Symbicort 200/6 | 1 puff twice daily | Up to 8 puffs per day (Fostair) or 12 puffs (Symbicort) |
The number of puffs and the inhaler prescribed will vary depending on your child’s needs. Always follow your written asthma action plan.
Benefits of MART
- Reduces the risk of severe asthma attacks
- Helps maintain better overall asthma control
- Uses fewer inhalers, which can simplify treatment
- Fewer missed doses and less confusion over which inhaler to use
- Treats inflammation as soon as symptoms start
Things to Remember
- Don’t stop the regular daily dose, even if your child feels well
- Don’t exceed the maximum number of puffs per day
- Keep track of how often your child is using the inhaler for symptoms – frequent use may mean their asthma is not well controlled and needs review
- Always use the inhaler with a spacer, if advised by your doctor or nurse
MART Asthma Action Plan
You’ll be given a tailored MART action plan for your child. This outlines:
- How many puffs to take every day
- What to do when symptoms flare up
- When to seek medical help
When to Seek Help
- If your child is using their MART inhaler every day for symptoms, despite the regular doses
- If they have night-time symptoms
- If their asthma is interfering with daily life or school
- If they need urgent care or oral steroids for asthma flare-ups
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