This information sheet provides concise information for primary care health professionals, based on the National Asthma Council’s updated Australian Asthma Handbook.
Triple therapy refers to maintenance treatment with an inhaled corticosteroid (ICS), a long-acting beta2 agonist (LABA), and long-acting muscarinic antagonist (LAMA).
Triple therapy is a targeted treatment for severe asthma in some individuals, not a routine step-up from ICS-LABA treatment. The National Asthma Council's Australian Asthma Handbook recommendations for managing difficult-to treat asthma have changed.
If asthma is not adequately controlled by maintenance treatment with a medium* dose of inhaled corticosteroid in combination with a long-acting beta2 agonist:
1. Assess adherence, inhaler technique and other common causes before confirming severe asthma.
2. Complete initial investigations including spirometry, fractional exhaled nitric oxide (FeNO) test, and blood eosinophil count.
3. Offer specialist referral.
4. Consider a short treatment trial of add-on long-acting muscarinic antagonist or high-dose ICS-LABA.
* Medium-dose ICS in patients aged 12+ years: total daily dose beclometasone 250–400 microg, budesonide 500–800 microg, fluticasone propionate 250–500 microg, or equivalent (see Australian Asthma Handbook Medicines Guide).
View the information sheet by accessing the download button above.
Disclaimer
Although all care has been taken, this information is a general guide only, which is not a substitute for assessment of appropriate courses of treatment on a case-by-case basis. The National Asthma Council Australia expressly disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained herein.
Acknowledgements
Developed by the National Asthma Council Australia in collaboration with:
Clinical Associate Professor Debbie Rigby, Advanced practice pharmacist
Professor Christine McDonald, Respiratory physician
Dr Brett Montgomery, General practitioner
Professor Peter Wark, Respiratory physician
This information was developed independently by the National Asthma Council Australia with support from GlaxoSmithKline (GSK Australia).
© National Asthma Council Australia 2026
An essential guide to selecting and adjusting asthma medication for adults and adolescents available in Australia, updated December 2025.
Four monoclonal antibody therapies (benralizumab, mepolizumab, dupilumab and omalizumab) are available in Australia for the treatment of severe asthma in patients whose asthma is uncontrolled despite optimised standard treatment.
