Reliever Inhalers for Asthma

Asthma inhalers are small handheld devices that are used to treat respiratory conditions, like asthma and chronic obstructive pulmonary disease (COPD). There are 3 main types of asthma inhaler:

1. Preventer inhalers – Often referred to as brown inhalers, preventer inhalers contain steroids that reduce swelling in the airways. These inhalers are usually used every day to prevent asthma symptoms from occurring.
2. Reliever inhalers – Sometimes known as blue inhalers, reliever inhalers are used when asthma symptoms happen. They contain short-acting bronchodilators, like salbutamol, to relax the airway muscles enabling you to breathe easier.
3. Combination inhalers – These inhalers contain a combination of long-acting bronchodilators and steroids. They can be used every day to prevent asthma symptoms, and as and when they are needed to relieve symptoms.

No matter which type of inhalers you use to manage your asthma, you need a prescription from a doctor to obtain them.

Here, we’ll discuss what reliever inhalers like salbutamol and Ventolin are, how they work, and where you can get them.

A reliever inhaler is an inhaler that relieves asthma symptoms when they happen. They contain a short-acting bronchodilator, like salbutamol, that relaxes the airway muscles leading to the lungs. This action helps to open up the airways, making it easier to breathe.

Reliever inhalers work quickly to ease asthma symptoms such as:

• breathing difficulties
• wheezing
• coughing

Reliever inhalers are usually blue, to help you distinguish between preventer inhalers which are normally brown. If you have asthma, you should carry your blue reliever inhaler with you at all times, just in case you experience asthma symptoms.

There are 3 types of asthma reliever inhaler available:

1. Pressurised metered dose inhaler (pMDI) - these types of inhaler release a measured dose of the medication when you press the top of the canister, to make sure it reaches your lungs and can take effect.
2. Breath actuated inhaler (BAI) - BAIs release a spray of medication when you breathe in through the inhaler's mouthpiece.
3. Dry powder inhaler (DPI) - DPIs release the medication in dry powder form when you inhale through the inhaler’s mouthpiece.

A reliever inhaler should only be used occasionally when you experience:

• asthma symptoms
• an asthma attack

When you are diagnosed with asthma, your doctor or asthma nurse will provide you with an asthma action plan that will tell you when to use your reliever inhaler and how you need to use it if you have an asthma attack.

Salbutamol, the active ingredient in most reliever inhalers, usually works within 5 minutes to relieve asthma symptoms and remains active for 4 to 6 hours.

The most common type of reliever inhaler is the pressurised metered dose inhaler.

Using a reliever pMDI:

1. Before you use your inhaler it is important to try to breathe as slowly as possible.
2. Try to sit or stand upright when you use your inhaler.
3. Remove the mouthpiece cover and make sure it is clean and clear of any obstructions.
4. Give the inhaler 4 or 5 shakes to mix the contents.
5. Hold the inhaler in your hand with your index finger on the canister and your thumb on the base.
6. Breathe out as far as you can and do not breathe back in yet.
7. Place the inhaler mouthpiece between your teeth and close your lips around it but do not bite.
8. Start to breathe in through your mouth. As you start to breathe in, press down on top of the canister to release a puff of the medication. Keep breathing in steadily and deeply.
9. Whilst holding your breath, remove the inhaler from your mouth.
10. Continue to hold your breath for as long as is comfortable.
11. If your doctor has advised you to take 2 puffs, wait 30 seconds then repeat steps 4 to 10.
12. When finished, replace the mouthpiece cover to keep it free from dust and foreign objects.

If you find it difficult to breathe while using your inhaler, speak to your doctor about using a ‘spacer’ to help you inhale the medication more easily.

When should I use a reliever inhaler?

A reliever inhaler is for occasional use and should be used if you get:

• asthma symptoms
• an asthma attack
• asthma symptoms during exercise – then it can be used before to prevent them

Dosage

Your doctor will advise how many puffs you should take of your reliever inhaler when you need to use it. It’s usually 1 or 2 puffs to relieve asthma symptoms. The maximum dose is usually 8 puffs in 24 hours.

Should I use a preventer or reliever inhaler first?

If you experience asthma symptoms or are having an asthma attack, you should only use your reliever inhaler.

You should take your preventer every day, as your doctor has prescribed, to help stop asthma symptoms from occurring.

How often should you use a reliever inhaler?

You should only use your reliever inhaler when you have asthma symptoms or you’re having an asthma attack.

If you need to use your reliever inhaler 3 or more times a week, then you should speak to your GP as this may be a sign your asthma is getting worse.

What should I do if I take too much?

If you take more reliever medication than prescribed to you, contact your doctor as soon as possible.

You may experience the following effects, but they should go away after a few hours:

• faster heartbeat than usual
• feeling shaky
• hyperactivity

Using a spacer with your inhaler

If you find it difficult to breathe using your reliever inhaler, you may need to use a spacer. This is a device that helps more of the medication reach your lungs. Most people will use a spacer with a mouthpiece, but if you are unable to form a tight seal around the mouthpiece, you will be given a mask.

When you use a spacer, you’ll need to use a technique called ‘tidal breathing’ to help the medication get into your lungs, unless your doctor has advised you otherwise.

1. Holding your inhaler upright, remove the cap.
2. Check the inhaler mouthpiece is clear and free of debris.
3. Shake the inhaler well.
4. If your spacer has a valve, make sure it is facing upwards.
5. Insert the inhaler mouthpiece into the hole at the back of the spacer.
6. If your spacer has a cap over the mouthpiece, remove it.
7. While sitting or standing up straight, slightly tilt your chin up.
8. Put your lips around the mouthpiece of the spacer to form a tight seal.
9. Press the canister on the top of the inhaler to release the medication and breathe in and out slowly and steadily into the spacer 5 times.
10. Remove the spacer from your mouth.
11. If you’ve been prescribed a second puff, wait a minute before shaking the inhaler again. Then repeat the steps.
12. When you’ve finished, take the spacer out of your mouth and replace the caps on both the spacer and inhaler.

Looking after your inhaler properly will ensure it works effectively when you need to use it. You should aim to clean your inhaler every week to:

• remove blockages which can affect how well the medication is taken into your lungs
• remove dirt, dust and debris that can build up and run the risk of getting an infection

To clean your reliever inhaler you should:

1. Take the metal canister from the casing and remove the mouthpiece.
2. Do not put the metal canister in water.
3. Hold the plastic casing under the tap and run warm water through it.
4. Make sure the casing is completely dry before putting the metal canister and mouthpiece on again.
5. Shake the inhaler and spray it into the air once to make sure it works.

You should ensure your inhaler is stored in a cool, dry place and avoid exposing it to moisture as this can cause the inhaler to malfunction or affect the medication.

Reliever inhalers are a safe and effective asthma treatment, but like all medications, they can cause side effects.

What are the common side effects?

Common side effects, affecting up to 1 in 10 people are:

• feeling shaky
• headache

Uncommon side effects affecting up to 1 in 100 people include:

• mouth and throat irritation
• muscle cramps

Rare side effects affecting up to 1 in 1000 people are:

• low blood potassium levels
• increased blood flow to the extremities

What are the serious side effects?

If you experience any of the following side effects, you should contact your doctor as soon as possible:

• a faster or stronger than usual heartbeat (palpitations)
• an uneven heartbeat

If you experience any of the following allergic reaction side effects, you should call 999 or go to A&E straight away:

• swollen face, lips, mouth, tongue, or throat
• difficulty swallowing or breathing
• itchy rash
• feeling faint
• lightheadedness
• collapse

What can you do to minimise side effects?

If you experience side effects when using your reliever inhaler, you can try the following to minimise them:

• make sure you are using your inhaler properly
• use a spacer device
• rinse your mouth with water after using your inhaler
• talk to your doctor about lowering your dose

Most of the common side effects, such as headaches and shakiness will go away quickly on their own, but you can manage them by:

• seeing if your symptoms improve with 1 puff rather than 2 (only if your doctor has approved this)
• only using the prescribed dose
• drinking plenty of water and getting rest
• avoid drinking too much alcohol

How to report side effects

If you experience any side effects while using your reliever inhaler, you should report them to your doctor or asthma nurse. You can also report side effects via the Yellow Card Scheme.

Most people with asthma can use a reliever inhaler, but it may not be suitable for everyone.

Do not use a reliever inhaler if you:

• are allergic to any of the ingredients it contains
• unexpectedly go into early labour

Before using a reliever inhaler, you should tell your doctor if you:

• have active asthma
• have high blood pressure
• have a history of heart problems
• are taking xanthine derivatives or steroids
• are taking water tablets
• are taking any other prescribed, over-the-counter, or herbal medications

Reliever inhalers and pregnancy

If you are pregnant or are planning to become pregnant, you should let your doctor know.

Reliever inhalers are usually safe to use during pregnancy because the active medication is inhaled into the lungs, so very little will enter your blood, and even less will reach your baby. Even if the active ingredient, like salbutamol, does reach your baby, it will not cause them any harm.

Reliever inhalers and breastfeeding

If you are breastfeeding, it should be okay to use your reliever inhaler, but you should speak to your doctor to make sure. A small amount of the active ingredient in your inhaler may pass into your breast milk, but it is unlikely to cause harm.

Asthma reliever inhalers are prescription-only medications which means you’ll need a doctor’s approval to obtain one.

Can you buy reliever inhalers over the counter?

No, asthma inhalers, including blue reliever inhalers, require a prescription from a doctor, so you will not be able to buy one over the counter.

Can you get reliever inhalers on the NHS?

Yes, reliever inhalers may be available from the NHS, but you will need to make an appointment to see your GP to get a prescription, and an asthma diagnosis if you do not already have one.

Can you buy reliever inhalers online?

Yes, reliever inhalers may be available from reputable online doctor services.

You can request reliever inhalers such as Ventolin and salbutamol from Superdrug Online Doctor as a repeat prescription, if you’ve already been diagnosed with asthma and have been using a reliever inhaler, simply:.

1. Complete a short online questionnaire about your health and lifestyle.
2. Order your preferred treatment and make payment.
3. One of our doctors will review your answers to the questionnaire and your order to see if it is suitable for you.
4. If approved, your order will be delivered to your address in plain packaging or to a Superdrug Pharmacy for collection, based on what you choose during the order process.
5. If our doctors do not feel your chosen medication is right for you, they will contact you via your account with other suitable treatment options.