An Overview of Asthma Inhalers

Asthma inhalers are prescription medications that you breathe directly into your lungs to relieve or prevent your asthma symptoms. You might be prescribed a short-acting (rescue) inhaler that you use as needed for asthma attacks and/or a long-acting inhaler that you use regularly for overall asthma control.

Pediatrician explaining inhaler to patient and mother
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Inhalers may contain steroid medication that reduces airway inflammation or a bronchodilator medication that opens the airways. Some asthma inhalers contain a combination of both.

Of course, asthma inhalers are but one type of asthma treatment, and you may require more than one to manage your condition.

Long-Acting Inhalers

These medications are used to prevent asthma symptoms on an ongoing basis. They don't work fast enough to relieve sudden shortness of breath in an emergency situation, so they should not be used to treat asthma attacks.

Rather, long-acting inhaler medications work by counteracting the underlying causes of asthma. These medications are often described as controllers (although not all controllers are inhalers).

There are two types of long-acting asthma inhalers: long-acting bronchodilators and steroid. Your doctor may prescribe one or both—or an all-in-one combination inhaler—to help you breathe comfortably and prevent asthma attacks.

If you are given a prescription for a long-acting inhaler, you will need to take it on a regular schedule, even when you don't have symptoms. Long-acting inhalers take hours or days before they begin to work, and their effects last for several days before wearing off.

Steroid Inhalers

Many long-acting inhalers contain corticosteroids, which reduce inflammation.

Inflammation contributes to asthma symptoms by narrowing the airways. And asthma attacks often occur when inhaled particles or an infection trigger excessive inflammation and spasm of the bronchi (airways).

Taking a steroid on a regular schedule can help prevent acute inflammation. Steroid inhalers commonly used for asthma include:

Bronchodilator Inhalers

Some asthma controller inhalers contain a long-acting bronchodilator, which widens the airways to help you breathe.

Many long-acting bronchodilators are long-acting beta-agonists (LABAs), which act directly on beta receptors on the airway muscles to control the size of the airway opening. Others are anticholinergics, which also relax the airway muscles, resulting in bronchodilation.

Bronchodilator asthma controllers include:

  • Atrovent (ipratropium), an anticholinergic bronchodilator, relaxes the muscles of the airways to widen them. It is used several times per day because it is not as long-acting as many controllers (though it still cannot be used in an emergency situation).
  • Spiriva (tiotropium), an anticholinergic bronchodilator, is more commonly used for chronic obstructive pulmonary disease (COPD) than for asthma, but it is considered an option for asthma treatment—especially when the goal is to reduce the steroid dose.
  • Slo-Bid (theophylline) is in a class of drugs called methylxanthines. This asthma drug is a muscle relaxant that opens up constricted airways and may have mild anti-inflammatory properties. With the advent of newer asthma medicines, theophylline is not used as often today as it was in the past, but it is available and it is an option that works for some people.

Combination Inhalers

You may be prescribed a steroid and a bronchodilator combination inhaler for control of your asthma symptoms.

Experts suggest that using a single combination inhaler instead of multiple inhalers may reduce hospitalizations for asthma attacks, and this may be due to the ease of using just one device instead of multiple devices.

Combination inhalers used for asthma include:

  • Advair is a controller asthma medicine that combines two drugs into one inhaler: fluticasone propionate (an inhaled steroid) and salmeterol (a LABA).
  • Symbicort is a combination of budesonide (a steroid) and formoterol (a LABA).

Short-Acting Inhalers

Short-acting inhalers are often bronchodilators, which contain short-acting beta-agonists (SABAs). As they counteract the sudden bronchoconstriction (narrowing of the airways) that causes acute shortness of breath, your doctor might prescribe one of these inhalers for you to use if you have sudden asthma symptoms.

Sudden asthma symptoms may be the sign of an impending asthma attack, and it is important that you learn to recognize asthma symptoms that require immediate treatment with an inhaler.

Short-acting inhalers used for the treatment of acute asthma symptoms include:

  • Ventolin (albuterol), a bronchodilator, is a quick-relief rescue inhaler that relieves acute asthma symptoms.
  • Xopenex (levalbuterol) is a rescue inhaler used to relieve acute asthma symptoms. It is similar to albuterol.

Both of these short-acting inhalers can cause side effects that include jitteriness and palpitations.

If you use a rescue inhaler often—for instance, more than twice per week and without an obvious trigger—this could be a sign that you need a change in your long-acting asthma medication (or to start on such a drug, if you haven't already).

A Word From Verywell

Keep in mind that skipping your long-acting asthma medication because you have a "backup" (in a rescue inhaler) in case of an emergency is not safe. An asthma attack can be life-threatening, and recurrent asthma attacks (even if they are mild) can worsen your overall lung health by causing stiffness and scarring of your lungs.

It's important that you understand the intended use of each inhaler you use. In addition, avoiding your triggers (e.g., dust, pollen, certain foods) may have even more of a beneficial effect than medication.

Asthma Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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