Why There Are Different Types of Inhalers
If you've been prescribed more than one inhaler, you're not alone in feeling confused about which to use and when. The different types serve distinct purposes: some work to prevent inflammation from building up over time, while others provide rapid relief during an acute episode. Understanding the difference is key to using them correctly — and getting the most benefit from your treatment.
Reliever Inhalers (Short-Acting Bronchodilators)
Reliever inhalers are the ones you reach for when symptoms strike. They work within minutes by relaxing the muscles around the airways, widening the passage so air can flow more freely.
- Common names: Salbutamol (Ventolin), Terbutaline (Bricanyl)
- Colour convention (UK): Usually blue
- Class: Short-Acting Beta-2 Agonists (SABAs)
- When to use: At the first sign of symptoms, or before exercise if exercise-induced
- How quickly they work: Typically within 5–15 minutes
- Duration: Effects last around 4–6 hours
Important note: If you're reaching for your reliever more than twice a week (outside of exercise), it's a signal your asthma is not well controlled — speak to your doctor about adjusting your treatment plan.
Preventer Inhalers (Inhaled Corticosteroids)
Preventer inhalers are the cornerstone of long-term asthma management. They contain low doses of corticosteroids that work by reducing the underlying inflammation in your airways. They do not provide immediate relief — their benefit builds up over days and weeks of regular use.
- Common names: Beclometasone (Clenil, QVAR), Budesonide (Pulmicort), Fluticasone (Flixotide)
- Colour convention (UK): Usually brown, red, or orange
- Class: Inhaled Corticosteroids (ICS)
- When to use: Every day, as prescribed — even when you feel well
- Key tip: Always rinse your mouth with water after use to prevent oral thrush
Many people make the mistake of stopping their preventer when they feel symptom-free. It's precisely because the preventer is working that you feel well — stopping it allows inflammation to rebuild.
Long-Acting Reliever Inhalers (LABAs)
Long-Acting Beta-2 Agonists (LABAs) are similar to short-acting relievers but their effects last around 12 hours. They are never used alone in asthma — always in combination with an inhaled corticosteroid.
- Common names: Salmeterol (Serevent), Formoterol (Oxis)
- Purpose: Add-on therapy for people whose asthma isn't fully controlled by a preventer alone
Combination Inhalers
Combination inhalers package an ICS and a LABA into a single device, simplifying the treatment regimen. They are used twice daily for ongoing control.
| Brand Name | ICS Component | LABA Component |
|---|---|---|
| Seretide / Advair | Fluticasone | Salmeterol |
| Symbicort | Budesonide | Formoterol |
| Fostair | Beclometasone | Formoterol |
| Relvar Ellipta | Fluticasone furoate | Vilanterol |
Inhaler Devices: MDIs vs. DPIs
Beyond the medication inside, inhalers also come in different device types:
- Metered-Dose Inhalers (MDIs): The classic pressurised "puffer." Requires coordination between pressing and inhaling. A spacer device can make them much more effective.
- Dry Powder Inhalers (DPIs): Breath-actuated — the drug is inhaled by breathing in firmly. No need for coordination, but requires a strong enough inspiratory effort.
- Soft Mist Inhalers: Deliver a slow, fine mist — useful for people who struggle with both types above.
Using Your Inhaler Correctly
Studies consistently show that a large proportion of people use their inhalers incorrectly, significantly reducing the amount of medication that actually reaches the lungs. Ask your pharmacist or asthma nurse to check your technique at least once a year. Small adjustments to how you hold, press, or breathe with your inhaler can make a surprisingly large difference to how well your asthma is controlled.