February 6, 2023

Breath Easy: A Comprehensive Guide to Asthma Inhalers

Asthma is a chronic respiratory disease that affects millions of individuals worldwide. While there is no cure for asthma, it can be managed effectively with the help of inhalers. Inhalers are portable and easy-to-use devices that deliver medication directly to the lungs, relieving asthma symptoms and preventing exacerbations. In this comprehensive guide, we will walk you through everything you need to know about asthma inhalers, from different types to usage tips and best practices.

Types of Asthma Inhalers

There are two main types of asthma inhalers, each serving a different purpose.

1. Controller Inhalers

Controller inhalers are long-term medications designed to prevent asthma symptoms from occurring. They contain corticosteroids, which reduce inflammation and swelling in the airways. Controller inhalers are to be used daily, even when the individual is feeling well, to keep asthma symptoms under control. Common examples of controller inhalers include Flovent, Pulmicort, and Qvar.

2. Rescue Inhalers

Rescue inhalers, also known as quick-relief inhalers, are designed to provide immediate relief from asthma symptoms. They contain short-acting bronchodilators, which open up the airways and improve breathing. Rescue inhalers are to be used when the individual experiences symptoms such as coughing, shortness of breath, or wheezing. Common examples of rescue inhalers include albuterol (ProAir, Ventolin) and levalbuterol (Xopenex).

How Inhalers Work

Inhalers work by delivering medication directly into the lungs. The medication is inhaled as a fine mist or powder, which is then absorbed into the bloodstream. Different types of inhalers work in slightly different ways.

1. Metered-Dose Inhalers (MDIs)

Metered-dose inhalers are the most common type of inhaler. They contain a pressurized canister filled with medication and are designed to deliver a specific dose with each puff. To use an MDI, the individual must press down on the canister while inhaling deeply.

2. Dry Powder Inhalers (DPIs)

Dry powder inhalers deliver medication in the form of a dry powder. Unlike MDIs, DPIs don’t require a propellant to deliver the medication. Instead, the individual must inhale forcefully to activate the device and release the medication.

Usage Tips

Using an inhaler correctly is crucial to ensure that the medication reaches the lungs and is effective in relieving asthma symptoms. Here are some tips for using inhalers properly:

– Shake the inhaler before use
– Exhale fully before inhaling the medication
– Hold the inhaler one or two inches away from the mouth
– Inhale slowly and deeply while pressing down on the canister (or activating the DPI)
– Hold your breath for 5-10 seconds after inhaling the medication
– Rinse your mouth with water after using a corticosteroid inhaler (to prevent oral thrush)

Common Mistakes to Avoid

Making mistakes while using an inhaler can reduce its effectiveness and worsen asthma symptoms. Here are some common mistakes to avoid:

– Not shaking the inhaler before use
– Exhaling into the inhaler instead of exhaling fully before using it
– Holding the inhaler too close or too far away from the mouth
– Inhaling too quickly or not inhaling deeply enough
– Not holding the breath after inhaling the medication
– Not rinsing the mouth after using a corticosteroid inhaler

When to Replace an Inhaler

Inhalers have a limited lifespan and need to be replaced periodically. The number of doses an inhaler can deliver depends on the specific type and brand. Generally, inhalers should be replaced after about 120 doses or when the dose counter (if present) reaches zero. If an inhaler’s spray appears to be weaker than usual or doesn’t deliver medication properly, it may also be time to replace it.

Best Practices

In addition to using inhalers correctly and replacing them when necessary, there are some best practices that individuals with asthma can follow to manage their symptoms. Here are a few tips:

– Work with a healthcare provider to create an asthma action plan
– Avoid triggers that worsen asthma symptoms, such as smoke or pollen
– Take controller inhalers as prescribed, even when feeling well
– Keep rescue inhalers on hand and use them as needed
– Stay up to date on immunizations, particularly the flu vaccine
– Monitor asthma symptoms regularly and report any changes to a healthcare provider

Cost and Insurance Coverage

The cost of inhalers can vary widely depending on the type, brand, and insurance coverage. While some inhalers may be inexpensive, others can cost hundreds of dollars per month. Insurance plans may cover some or all of the cost of inhalers, depending on the specific plan and medication. Individuals without insurance coverage may be eligible for assistance programs through the manufacturer or nonprofit organizations.

Alternative Treatments

In addition to inhalers, there are several alternative treatments that individuals with asthma may find helpful. These include:

– Breathing exercises, such as pursed-lip breathing and diaphragmatic breathing
– Yoga and other forms of gentle exercise
– Acupuncture
– Herbal remedies, such as ginger and turmeric
– Dietary changes, such as avoiding trigger foods or increasing intake of anti-inflammatory foods

While these alternative treatments may provide some relief from asthma symptoms, they should not be used as a substitute for medication prescribed by a healthcare provider.

Possible Side Effects

Like all medications, inhalers can cause side effects. The most common side effects of controller inhalers are oral thrush (a fungal infection in the mouth) and hoarseness. These side effects can be minimized by rinsing the mouth after using a corticosteroid inhaler. The most common side effects of rescue inhalers are trembling, nausea, and a rapid heartbeat. Long-term use of high-dose controller inhalers may increase the risk of osteoporosis, cataracts, and other conditions.

Age Considerations

While inhalers can be used by individuals of all ages, some age groups may require special considerations. For example, young children may need a spacer device to help deliver medication, and older adults may need a lower dose due to changes in lung function.

Stigma and Misconceptions

Asthma is often stigmatized and misunderstood, leading to misconceptions about inhalers and their use. Some common misconceptions include:

– Inhalers are addictive
– Inhalers are only for severe asthma
– Inhalers should only be used during an asthma attack
– Inhalers are dangerous and can cause heart problems

In reality, inhalers are safe and effective for managing asthma symptoms, regardless of the severity of the condition. They can be used daily as prescribed, even if the individual is feeling well.

Frequently Asked Questions

1. Can inhalers be used by pregnant women?

Yes, most inhalers are safe for use during pregnancy. However, it’s important to work with a healthcare provider to determine which inhalers are safest and most effective for individual circumstances.

2. Do inhalers have an expiration date?

Yes, inhalers have a limited lifespan and should be replaced periodically. The specific lifespan varies depending on the type and brand of inhaler.

3. Can inhalers be used by individuals with other respiratory conditions?

Inhalers are designed specifically for asthma and may not be effective for other respiratory conditions. Individuals with other conditions should work with their healthcare provider to determine the most appropriate treatment options.

4. Can inhalers interact with other medications?

Yes, some inhalers may interact with other medications. It’s important to inform healthcare providers of all medications and supplements being taken to avoid potential interactions.

5. Can inhalers be used by individuals with food allergies?

Most individuals with food allergies can safely use inhalers. However, it’s important to check the specific ingredients of the inhaler to ensure that it doesn’t contain any allergens. If in doubt, consult with a healthcare provider.


Inhalers are a safe and effective way to manage asthma symptoms and prevent exacerbations. Understanding the different types of inhalers, how they work, and usage tips, including best practices, is crucial for individuals with asthma. By following a healthcare provider’s guidance and staying up to date on medication use, individuals with asthma can live a full and active life.

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