Inhalers

Inhalers Overview

Inhalers are the main treatment for asthma, including asthma triggered by allergies. About 8.4% of people in the U.S., roughly 27.8 million, had current asthma in 2023 (CDC). If pollen season brings on wheezing, coughing, chest tightness or shortness of breath, allergies may be triggering your asthma.

Seasonal allergies and asthma are closely linked, and controlling allergies can help keep asthma in check (FDA). Below we explain the main types of inhalers and how they work. See also seasonal allergies vs. asthma.

What is Allergic Asthma?

Allergic asthma happens when allergens such as pollen or mold spores, the same triggers that cause sneezing and watery eyes in some people, set off asthma symptoms in others. It is a common form of asthma. Year-round allergens can trigger it too.

These allergens commonly include: cockroaches, their body parts, saliva, and feces. Dust mites, pet dander, or mold.

Once these allergens get into your body, it overreacts your immune system and tightens the muscle around your airways. The air passage is swollen up and gets clogged with thick mucus. The symptoms and treatment of allergic asthma or non-allergic asthma are usually the same.

Inhaler Options for the Treatment of Allergic Asthma

With the right treatment plan, most people with allergic asthma can live active lives. Inhalers deliver medicine directly to the lungs. Here is a rundown of the main types.

What is an Inhaler?

An inhaler is a device that delivers medicine directly into the lungs. Quick-relief inhalers work by relaxing and opening the airways; controller inhalers reduce airway inflammation over time. There are many inhaler styles, so ask your doctor or pharmacist to show you the right technique.

Quick-Relief (Rescue) Inhalers

Quick-relief medicines work fast when you are coughing, wheezing, having trouble breathing or having an asthma attack. Most are bronchodilators, which relax and open the airway muscles. Short-acting beta-agonists can also be used before exercise to prevent exercise-induced symptoms (MedlinePlus).

Common quick-relief medicines include (MedlinePlus):

• Albuterol (also called salbutamol) and levalbuterol
• Terbutaline

Different brands and devices may contain the same medicine, so always read the label. Tell your doctor if you need your quick-relief inhaler twice a week or more; your asthma may not be under control and your daily controller medicine may need adjusting (MedlinePlus).

Controller (Preventive) Inhalers: Inhaled Steroids

It is taken regularly to avoid the development of symptoms. The most popular form of the drug in prevention pumps is a steroid. Steroids act by reducing airway inflammation. When the inflammation is over, the airways are possibly less narrowed, hence preventing the signs of wheezing. Inhalers with steroids are usually taken twice a day. You could be recommended to use the preventive inhaler more frequently if you have an exacerbation of your asthma symptoms.

Controller inhalers don’t give instant relief like rescue inhalers. They work gradually, so keep using them every day as prescribed even when you feel well, and follow up with your doctor to see how well they’re working.

The primary steroid preventer inhaler medicine is:

• Beclometasone
• Budesonide
• Fluticasone
• Ciclesonide
• Mometasone

Long-acting Inhalers for Bronchodilators

The medications in these inhalers work like relievers yet work for up to 12 hours after each dosage. They include:

• Salmeterol
• Formoterol

In addition to a steroid inhaler, a long-acting bronchodilator can be recommended if the effects are not managed completely by the steroid inhaler on their own. Some inhaler brands include a steroid and a long-lasting bronchodilator for those who need their symptoms to be managed.

Side Effects of Inhalers

Inhaled medicines use much smaller doses than pills or liquids, so they generally cause fewer side effects. Read the leaflet that comes with your inhaler for a full list.

Usage of some steroid inhalers causes thrush, sore throat, or hoarse voice in some patients. Rinsing your mouth with fresh water subsequently would help to reduce these side effects.

Long-term use of high-dose inhaled steroids may affect bone density. Quick-relief inhalers can cause anxiety, a fast or irregular heartbeat, headache, restlessness or tremor; contact your provider right away about a fast or irregular heartbeat (MedlinePlus).

Benefits of Using Inhalers

Inhaled steroids have a much greater advantage for asthma control than risks related to asthma that include:

• Lower rates of asthma attacks
• Reduced allergic asthma attacks
• Decrease use of reliever inhalers and quick-relief inhalers
• Improvements in lung functioning
• Reduced trips to hospitals and asthma emergency

Conclusion

Inhalers deliver medicine straight to the airways: quick-relief inhalers ease symptoms fast, while controllers prevent attacks over time. Work with your doctor on an asthma action plan, especially before your allergy season starts. Learn about related treatments in corticosteroids and respiratory irritation.

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Written by: Madiha Ather Hashmi (September 28, 2020)

This article is for general education and is not medical advice. Talk with your doctor or pharmacist about your symptoms and before starting, stopping, or combining any medicine.

Inhaler FAQs

What is the difference between a rescue and a controller inhaler?

Rescue inhalers relax the airways quickly during symptoms; controllers reduce inflammation over time to prevent attacks (MedlinePlus).

How often is too often to use a rescue inhaler?

Tell your provider if you use it twice a week or more; your asthma may not be well controlled (MedlinePlus).

How common is asthma?

About 8.4% of people in the U.S. had current asthma in 2023 (CDC).

Why rinse my mouth after a steroid inhaler?

Rinsing with water after use helps reduce the risk of thrush, sore throat and hoarseness.

Sources

Looking to learn more about allergy lifestyles? Find a full list of living with allergies resources here.