Asthma · Mild-to-moderate persistent

Asthma care that notices your rescue inhaler is climbing before you do.

Clara's AI watches your rescue-inhaler use and allergy triggers, then builds a plan that updates as your asthma shifts.

Using my rescue inhaler twice a day and waking up coughing at 3am. Last spring was bad too.

Clara

Three albuterol refills in 10 weeks plus nighttime symptoms meets GINA criteria for uncontrolled asthma. GINA track-1 is a low-dose ICS–formoterol inhaler (budesonide/formoterol) used as both controller and reliever. I'll draft it for our doctor to sign off.

How fast should I expect to feel better?

How it works

Guideline-aligned asthma care, tuned to your chart and your refill history.

Tell Clara how your asthma is going

Describe symptoms, rescue-inhaler use in the last month, nighttime coughing, exercise limits, and triggers. Clara auto-pulls your refill history, prior spirometry, allergy diagnoses, and current controller regimen from 150,000+ connected records.

AI applies GINA step-up / step-down logic

Clara grades your control (well-controlled, partly, uncontrolled) against GINA criteria¹, then recommends step-up, step-down, or switch-track adjustments. It cross-checks pregnancy, age, beta-blocker use, and cardiac history before any long-acting beta agonist.

Clinical sign-off or escalation

A licensed physician reviews the plan and signs prescriptions. If your asthma is severe, frequently exacerbating, or not responding to high-dose ICS–LABA, Clara refers you to pulmonology and keeps the plan coordinated.

Peak flow, rescue use, and your chart. Step-up decisions based on all three.

Get startedFree to connect your records and start the conversation.

Treatments

Controller + reliever, chosen against your pattern.

Rx · GINA track-1 preferred

Budesonide/formoterol (ICS–formoterol)

Low-dose inhaled corticosteroid plus fast-onset LABA, used as both maintenance and reliever (MART / AIR). GINA's preferred track 1 for adults and adolescents with mild-to-moderate asthma¹. Replaces “just an albuterol inhaler” for most patients with symptoms more than twice a month.

Track 1

GINA preferred controller–reliever¹

Rx · Controller

Inhaled corticosteroids (ICS)

Fluticasone propionate or budesonide alone for track-2 regimens or patients whose pattern favors a fixed daily controller plus separate albuterol reliever. Clara picks between track 1 and track 2 based on adherence patterns and prior response.

Daily

Track-2 fixed controller

Rx · Reliever

Albuterol (SABA) rescue inhaler

Short-acting bronchodilator for symptom relief in patients on a track-2 ICS regimen, or as backup. GINA and the FDA label both warn against SABA monotherapy for persistent asthma — if you're refilling albuterol more than once every 2–3 months, your controller plan needs attention². See the albuterol page for detail.

~$15–$32

Typical cash-pay with GoodRx³

Rx · Step-up

ICS–LABA step-up (e.g., fluticasone/salmeterol)

For patients on medium-dose ICS who remain uncontrolled, a twice-daily ICS–LABA combo is an evidence-based step-up. Clara checks your chart for prior trials and adjusts before adding a second controller.

Step 4

Medium-dose ICS–LABA

Rx · Adjunct / allergic phenotype

Montelukast (Singulair)

10 mg daily. Useful when asthma overlaps with allergic rhinitis, exercise-induced bronchoconstriction, or aspirin-exacerbated respiratory disease. Carries an FDA boxed warning for neuropsychiatric effects⁴; Clara discusses this before any prescription.

Caution

Boxed warning discussed before Rx

Supportive · In-person referral

When Clara sends you in

Severe exacerbation (can't speak in full sentences, RR >30, O₂ sat <92%, peak flow <50% of personal best), suspected pneumonia, a step-4/step-5 regimen not controlling symptoms, or biologic-eligible severe asthma all warrant in-person care or pulmonology. Clara coordinates the referral rather than prescribing through it.

Refer

Urgent care, ED, or pulmonology as appropriate

Why Clara

An asthma visit that knows your rescue-inhaler refill history before it starts.

	Clara	Teladoc	CVS MinuteClinic Virtual	GoodRx coupon only	Your doctor
AI response time	Instant, 24/7	Scheduled video	Clinic hours	Coupon — no provider	Days–weeks
Reads your refill history & rescue use		Intake only	Portions of records	✗	If your PCP
GINA-aligned step-up / step-down logic	AI-applied	Provider-dependent	Provider-dependent	✗	Provider-dependent
Coordinates asthma ↔ allergy plans	One AI, one plan	Different visit	Different visit	✗	If your PCP
Cost of care	Free to start; $25/mo membership for Rx & labs	Variable, often via employer	$107–$164 out of pocket per visit	No visit — Rx only	$150+ copay
Prescription may be covered by your insurance	Sent to your pharmacy			Cash coupon only
Spots a worsening pattern before the next ED visit		✗	✗	✗	Maybe at annual visit

GINA step-up, step-down, or switch-track. Run on your actual data, every time.

Get startedCoordinates with your allergy plan so the two aren't treated in isolation.

The AI difference

Asthma is a pattern disease. It rewards the reader who actually looks at the pattern.

Your last three albuterol refills are a claim about how controlled your asthma is. GINA has been explicit since 2019 that SABA-only asthma is not the right answer. The gap isn't the guideline — it's that nobody is reading your whole chart every time.

Reads your refill history every time

Clara notices that you've refilled albuterol three times since January and your last ICS refill was 9 months ago. Your old doctor may see that once a year at a 15-minute visit; Clara sees it every message.

Applies GINA track 1 vs track 2 to your data

Is ICS–formoterol MART the right move, or are you an adherence-to-a-daily-controller patient better served by track 2? Clara reasons through your adherence pattern, trigger profile, and prior response, then hands off to our doctor.

Spots the escalation before the ED

Five albuterol refills in a quarter plus a pollen spike plus a respiratory virus is a predictable setup for an exacerbation. Clara flags the pattern early and steps therapy up rather than waiting for the urgent care visit.

See the trend coming. Step therapy up before the next ED visit.

Get startedHIPAA compliant. Records never sold or used to train public models.

Common questions

Asthma questions patients ask.

What does Clara cost?

It's free to connect your medical records and start chatting with Clara. If you want Clara to provide medical advice, prescribe medications, or order labs, plans start at $25/month. All plans are HSA/FSA eligible. The cost of medications and lab work is separate and may be covered by your insurance.

How is Clara different from Teladoc, CVS MinuteClinic, or my regular doctor?

Teladoc and CVS MinuteClinic can both write an asthma prescription, but they operate as per-visit encounters, with a different provider each time and portions of your records rather than your whole chart. Your regular doctor can hold your chart, but probably can't rewrite your plan the week your rescue refills jumped. Clara is the AI that reads your entire chart every time you message (your refill cadence, your prior spirometry, your allergy history) and applies GINA step-up logic before handing off to our doctor for sign-off.

Isn't albuterol alone enough for mild asthma?

No. GINA has explicitly recommended against short-acting beta-agonist (SABA) monotherapy for asthma since 2019¹. Patients on SABA-only regimens are at higher risk of exacerbations and death. Even for very mild asthma, the preferred track-1 approach is a low-dose ICS–formoterol inhaler used both as controller and as reliever. Clara will help you transition safely if you're currently on albuterol alone.

What counts as "uncontrolled" asthma?

GINA defines partly or uncontrolled asthma by any of: daytime symptoms more than twice a week, night-time waking from asthma, reliever needed more than twice a week, or any activity limitation from asthma, over the prior 4 weeks¹. Clara applies these criteria to your chart and chat input, then recommends whether to step up your regimen.

Can Clara treat a current asthma attack?

No. Acute asthma exacerbations need in-person emergency care, especially if you can't speak in full sentences, if your peak flow is below 50% of your personal best, if your oxygen saturation drops below 92%, or if you're not responding to albuterol. Clara will tell you exactly that and help coordinate follow-up once you're stable.

Are my allergies making my asthma worse?

Often yes, and they usually move in lockstep. If your albuterol refills spike during your local pollen season, it's allergic asthma until proven otherwise. Clara coordinates your allergy plan with your asthma plan in the same chart so the two aren't treated in isolation.

Does Clara order spirometry?

Clara can order spirometry through a local partner lab or clinic when it will change management — for example, to confirm a new asthma diagnosis, to rule out COPD in an older adult with new wheezing, or to assess response after a 3-month controller trial. Clara will not reflexively order a PFT when the history is clear and the patient is responding to therapy.

Is Clara a real medical practice?

Yes. Clara is licensed in all 50 states. Every prescription, lab order, and diagnosis is reviewed and signed off by a licensed physician. Clara's AI handles intake, clinical reasoning, triage, and follow-up; our clinicians provide the medical oversight required by state law.

Can I use Clara for other health issues too?

Yes. Clara is full-service AI-first primary care. One membership covers asthma alongside allergies, albuterol refills, respiratory infections, chronic conditions, labs, preventive care, and everything else.

An AI asthma plan that reads your refill history first.

Connect your records for free. See what an asthma visit looks like when the AI already knows how many rescue refills you've had this quarter and when your allergy season starts.

Get started

Clara manages mild-to-moderate persistent asthma. Severe or life-threatening exacerbations, severe persistent asthma requiring biologics, and pediatric asthma require in-person evaluation and, when appropriate, pulmonology referral. Montelukast (Singulair) carries an FDA boxed warning for serious mental health side effects. Albuterol and other SABAs should not be used as monotherapy for persistent asthma per GINA. Ventolin, ProAir, Proventil, Symbicort, Advair, Flovent, and Singulair are registered trademarks of their respective owners.

For important safety information about the medications discussed on this page, see the FDA prescribing information: budesonide/formoterol (Symbicort), fluticasone propionate (Flovent), fluticasone/salmeterol (Advair), albuterol (Ventolin, ProAir), montelukast (Singulair).

¹Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2024 update. GINA Track 1 (ICS–formoterol as both controller and reliever) is the preferred treatment pathway for adults and adolescents with mild-to-moderate asthma; SABA-only treatment is no longer recommended for persistent asthma. View the GINA report.

²U.S. Food & Drug Administration. Prescribing information for albuterol sulfate inhalation aerosol (Ventolin HFA, ProAir HFA, Proventil HFA). DailyMed: albuterol prescribing information.

³GoodRx. Asthma inhalers savings list. Accessed 2026-04-21: “Generic Proventil HFA (6.7g): As low as $19.00–$19.45. Generic ProAir HFA (8.5g): As low as $23.00–$23.76. Generic Ventolin HFA (18g): As low as $32.10.” View on GoodRx.

⁴U.S. Food & Drug Administration. FDA requires Boxed Warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair). March 2020. Read the FDA safety communication.