Table of ContentsView AllTable of ContentsLong-Acting InhalersShort-Acting InhalersTypes of InhalersPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Long-Acting Inhalers
Short-Acting Inhalers
Types of Inhalers
Prevention
Frequently Asked Questions
Asthma inhalers contain prescription medications that are breathed directly into the lungs to relieve or prevent asthma symptoms. They may contain a steroid medication that reduces airway inflammation or a bronchodilator medication that opens the airways. Some inhalers contain both.
If you have asthma, your providers may prescribe controllers or preventative medications- this may include ICS (inhale corticosteroids) and long-acting bronchodilators to use regularly for overall asthma control.
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This article explains what types of preventative and short-acting asthma inhalers are available, including when and why they are used. It also explainshow the different types of inhalers work.
How Asthma Is Treated
The medications in preventatives are used to prevent asthma symptoms on an ongoing basis. They are often described ascontrollersand work to reduce inflammation, the underlyingcauses of asthma.
If you are prescribed a controller, you need to use it every day, even when you don’t have symptoms. These are not used to treat asthma attacks but rather to help prevent them. If you do not use them regularly, asthma symptoms are more likely to occur.
Do I Need an Inhaler Every Day?According to updated guidelines, controllers are recommended for people with moderate to severe asthma. People with mild asthma only need to use short-acting bronchodilators or rescue inhalers as needed.If you use an inhaler daily, ask your healthcare provider if the new guidelines might affect your treatment.
Do I Need an Inhaler Every Day?
According to updated guidelines, controllers are recommended for people with moderate to severe asthma. People with mild asthma only need to use short-acting bronchodilators or rescue inhalers as needed.If you use an inhaler daily, ask your healthcare provider if the new guidelines might affect your treatment.
There are three types of controllers commonly used for people with asthma:
Steroid Inhalers
Asthma attacksoften occur when inhaled particles or an infection triggers excessive inflammation and spasms in the larger airways (called thebronchi). Inhaling 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-actingbronchodilator. This is a type of drug that widens the airways for around 12 hours to help you breathe.
Many long-acting bronchodilators arelong-acting beta-agonists (LABAs)that act directly on receptors in the lungs that control the constriction (narrowing) of the airways.Others areanticholinergicsthat block chemical messages that cause airway constriction.
Bronchodilator asthma controllers include tiotropium (Spiriva),an anticholinergic bronchodilator, is more commonly used forchronic obstructive pulmonary disease (COPD)than for asthma. It is considered an option for asthma treatment, especially when the goal is to reduce the steroid dose.
Prevention and Control of Asthma Attacks
Combination Inhalers
Combination inhalers are those that contain both a steroid and a bronchodilator. Studies suggest that using a single combination inhaler instead of multiple inhalers may reduce hospitalizations for asthma attacks.
Combination inhalers used for asthma include:
Short-acting inhalers, also known as rescue inhalers, are a type of bronchodilator that contains drugs known asshort-acting beta-agonists (SABAs).Because SABAs rapidly counteract the constriction of the airways, they are used when a person experiences an asthma attack.
Short-acting inhalers used for acute asthma symptoms include:
While effective, both can cause jitteriness and heart palpitations.
Do I Need to Adjust Treatment?If you use a rescue inhaler often—for instance, more than twice weekly without an obvious trigger—this could be a sign that you need a change in your controller.
Do I Need to Adjust Treatment?
If you use a rescue inhaler often—for instance, more than twice weekly without an obvious trigger—this could be a sign that you need a change in your controller.
Recognizing an Asthma Attack
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Different types of inhaled asthma medications are delivered in different forms. Some are delivered in powdered form, while others are inhaled as a spray or mist.
Learning how to use the different inhalers is important as it ensures that you are getting the right amount of medication with each dose.
There are four types of inhalers commonly used for the treatment of asthma.
Metered-Dose Inhalers (MDIs)
Metered-dose inhalers (MDIs) are canisters with a mouthpiece that deliver the drug to the lungs under pressure. The drug is dissolved in a chemical known as hydrofluoroalkane (HFA) that acts as a propellant.
Each dose contains a measured dose of medication. MDIs require a high degree of hand-breath coordination for effective treatment, which is the major disadvantage of these devices.
Ventolin and Xopenex are both MDIs.
How to Use a Metered-Dose Inhaler
Dry Powder Inhalers (DPIs)
Dry powder inhalers (DPIs) were developed to overcome the problems of hand-breath coordination. The device delivers a measured dose of powdered medication that you need to inhale from a preloaded chamber.
People who lack inhaling strength, such as those with COPD, may find these devices difficult to use.
Advair, Asmanex, Pulmicort, Qvar, and Symbicort are all DPIs.
Soft Mist Inhalers (SMIs)
Soft mist inhalers (SMIs) are handheld devices that generate a soft mist that lasts longer and delivers more drug particles than an HFA propellant. It is ideal for people with limited inhaling strength, although the device still requires a bit of hand-breath coordination.
Soft mist inhalers can be used with a mouthpiece or a face mask for children.
Spiriva is an SMI.
Nebulizers
A nebulizer is a small machine that turns liquid medicine into a mist. The medicine goes into your lungs as you take slow, deep breaths for 10 to 15 minutes. The device is ideal for younger children or older adults who lack hand-breath coordination or inhaling strength.
Many different asthma drugs can be nebulized, including LABAs, SABAs, and anticholinergics.
Prevention of Asthma Flare-Ups
As effective as asthma inhalers are, they are not the only components of an informed treatment plan. To reduce your need for inhalers, particularly rescue inhalers, it is important to identify and avoid asthma triggers that can set off an attack.
These are just some of the common asthma triggers and ways you can avoid them:
Keeping an Asthma DiaryIf you do not know what your triggers are, keep an asthma diary. By making a note of when asthma symptoms occurred, where you were, and what you were doing at the time, you can usually pinpoint the likely causes of your attacks.
Keeping an Asthma Diary
If you do not know what your triggers are, keep an asthma diary. By making a note of when asthma symptoms occurred, where you were, and what you were doing at the time, you can usually pinpoint the likely causes of your attacks.
Summary
There are many different asthma inhalers that your healthcare provider may prescribe, some of which are used to treat attacks and others of which are used to prevent them.
These include controllers that contain drugs called corticosteroids (steroids), long-acting beta-agonists (LABAs), or anticholinergics, each of which works differently. Short-acting asthma inhalers, also known as rescue inhalers, contain drugs known as short-acting beta-agonists (SABAs).
These inhaled drugs are delivered in different ways. Some are inhaled with a pressurized propellant (metered-dose inhalers, or MDIs), while others are inhaled in powdered form (dry powder inhalers, or DPIs). Others like soft mist inhalers (SMIs) and nebulizers deliver the drugs in mist form.
Inhalers are part of an asthma treatment plan that also involves the avoidance of asthma triggers such as pollen, tobacco smoke, dust mites, and pollution.
A Word From Verywell
It’s important to understand the intended use of every inhaler you use. If you are not sure if a medication is working (or if you are using an inhaler correctly), speak with your healthcare provider.
You should rinse and gargle after using an inhaler to clear excess medications from your mouth, but do not swallow. This is especially true with steroid inhalers as doing so can get extra drug into your bloodstream. After you thoroughly rinse, you can take a sip of water if needed.
The cost of asthma inhalers can vary. Without insurance, inhalers can cost as little as $75 for Ventolin (salbutamol) to as much as $500 for Serevent (salmeterol). Other inhalers fall somewhere between in price.
There is currently no cure for asthma. However, the symptoms can be effectively managed with medications and lifestyle choices.If you are unable to control your asthma symptoms and have frequent attacks, discuss treatment options with a specialist known as anallergist or immunologist.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asthma and Allergy Foundation of America.Asthma treatment.Mccracken JL, Veeranki SP, Ameredes BT, et al.Diagnosis and management of asthma in adults: a review.JAMA.2017;318(3):279-290. doi:10.1001/jama.2017.8372Cloutier MM, Baptist AP, Blake KV, et al.2020 focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003Murdoch JR, Lloyd CM.Chronic inflammation and asthma.Mutat Res. 2010;690(1-2):24-39. doi:10.1016/j.mrfmmm.2009.09.005American Academy of Allergy, Asthma, and Immunology.Inhaled asthma medications.Cleveland Clinic.Bronchodilator.Cheng WC, Liao WC, Wu BR, et al.Clinical predictors of asthmatics in identifying subgroup requiring long-term tiotropium add-on therapy: a real-world study.J Thorac Dis. 2019;11(9):3785-3793. doi:10.21037/jtd.2019.09.22Ghossein N, Kang M, Lakhkar AD.Anticholinergic medications. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Hamelmann E.Corrigendum to “Managing severe asthma: A role for the long-acting muscarinic antagonist tiotropium”.Biomed Res Int. 2019;2019:8515804. doi:10.1155/2018/7473690Zhang S, King D, Rosen VM, Ismaila AS.Impact of single combination inhaler versus multiple inhalers to deliver the same medications for patients with asthma or COPD: a systematic literature review.Int J Chron Obstruct Pulmon Dis. 2020;15:417-438. doi:10.2147/COPD.S234823Shlomi D, Katz I, Segel MJ, et al.Determination of asthma control using administrative data regarding short-acting beta-agonist inhaler purchase.JAsthma. 2018;55(5):571-577. doi:10.1080/02770903.2017.1348513Usmani OS.Choosing the right inhaler for your asthma or COPD patient.Ther Clin Risk Manag.2019;15:461–72. doi:10.2147/TCRM.S160365Centers for Disease Control and Prevention.Controlling asthma.National Heart, Blood, and Lung Institute.Asthma.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Asthma and Allergy Foundation of America.Asthma treatment.Mccracken JL, Veeranki SP, Ameredes BT, et al.Diagnosis and management of asthma in adults: a review.JAMA.2017;318(3):279-290. doi:10.1001/jama.2017.8372Cloutier MM, Baptist AP, Blake KV, et al.2020 focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003Murdoch JR, Lloyd CM.Chronic inflammation and asthma.Mutat Res. 2010;690(1-2):24-39. doi:10.1016/j.mrfmmm.2009.09.005American Academy of Allergy, Asthma, and Immunology.Inhaled asthma medications.Cleveland Clinic.Bronchodilator.Cheng WC, Liao WC, Wu BR, et al.Clinical predictors of asthmatics in identifying subgroup requiring long-term tiotropium add-on therapy: a real-world study.J Thorac Dis. 2019;11(9):3785-3793. doi:10.21037/jtd.2019.09.22Ghossein N, Kang M, Lakhkar AD.Anticholinergic medications. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Hamelmann E.Corrigendum to “Managing severe asthma: A role for the long-acting muscarinic antagonist tiotropium”.Biomed Res Int. 2019;2019:8515804. doi:10.1155/2018/7473690Zhang S, King D, Rosen VM, Ismaila AS.Impact of single combination inhaler versus multiple inhalers to deliver the same medications for patients with asthma or COPD: a systematic literature review.Int J Chron Obstruct Pulmon Dis. 2020;15:417-438. doi:10.2147/COPD.S234823Shlomi D, Katz I, Segel MJ, et al.Determination of asthma control using administrative data regarding short-acting beta-agonist inhaler purchase.JAsthma. 2018;55(5):571-577. doi:10.1080/02770903.2017.1348513Usmani OS.Choosing the right inhaler for your asthma or COPD patient.Ther Clin Risk Manag.2019;15:461–72. doi:10.2147/TCRM.S160365Centers for Disease Control and Prevention.Controlling asthma.National Heart, Blood, and Lung Institute.Asthma.
Asthma and Allergy Foundation of America.Asthma treatment.
Mccracken JL, Veeranki SP, Ameredes BT, et al.Diagnosis and management of asthma in adults: a review.JAMA.2017;318(3):279-290. doi:10.1001/jama.2017.8372
Cloutier MM, Baptist AP, Blake KV, et al.2020 focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee expert panel working group.Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003
Murdoch JR, Lloyd CM.Chronic inflammation and asthma.Mutat Res. 2010;690(1-2):24-39. doi:10.1016/j.mrfmmm.2009.09.005
American Academy of Allergy, Asthma, and Immunology.Inhaled asthma medications.
Cleveland Clinic.Bronchodilator.
Cheng WC, Liao WC, Wu BR, et al.Clinical predictors of asthmatics in identifying subgroup requiring long-term tiotropium add-on therapy: a real-world study.J Thorac Dis. 2019;11(9):3785-3793. doi:10.21037/jtd.2019.09.22
Ghossein N, Kang M, Lakhkar AD.Anticholinergic medications. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Hamelmann E.Corrigendum to “Managing severe asthma: A role for the long-acting muscarinic antagonist tiotropium”.Biomed Res Int. 2019;2019:8515804. doi:10.1155/2018/7473690
Zhang S, King D, Rosen VM, Ismaila AS.Impact of single combination inhaler versus multiple inhalers to deliver the same medications for patients with asthma or COPD: a systematic literature review.Int J Chron Obstruct Pulmon Dis. 2020;15:417-438. doi:10.2147/COPD.S234823
Shlomi D, Katz I, Segel MJ, et al.Determination of asthma control using administrative data regarding short-acting beta-agonist inhaler purchase.JAsthma. 2018;55(5):571-577. doi:10.1080/02770903.2017.1348513
Usmani OS.Choosing the right inhaler for your asthma or COPD patient.Ther Clin Risk Manag.2019;15:461–72. doi:10.2147/TCRM.S160365
Centers for Disease Control and Prevention.Controlling asthma.
National Heart, Blood, and Lung Institute.Asthma.
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