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HealthInfo Canterbury

Inhalers

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People with lung problems like asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis are usually given inhalers as part of their treatment plan.

How to use an inhaler

These videos from the National Asthma Council of Australia show the right way to use several types of inhalers.

You can use many types of inhaler on their own or with a spacer that makes breathing in the medicine easier. Newer inhalers are often designed to be easy to use without a spacer.

A spacer is a plastic device that you use with an inhaler. Spacers help to deliver significantly more medication into your lungs than using an inhaler alone. Everyone can benefit from using a spacer, not just children.

Children who are too young to use a mouthpiece use a small volume spacer with a mask.

See Using a spacer for instructions.

Types of inhalers

Thumbnail image of inhalers posterThere are many different types of inhalers used with lung conditions such as asthma and COPD.

As well as containing different medicines, different inhalers have different ways of delivering the medicine to your lungs.

The best inhaler for you will depend on the type and severity of your lung condition and which sort of inhaler you find easiest to use.

Click the image to the right to see a larger version of a poster showing the inhalers that are available in New Zealand.

For information about your inhaler, follow the links in the following section or look up the medication in Medication factsheets.

Single inhaler therapy or anti-inflammatory reliever therapy (AIR) for asthma

There has been a recent change in the best treatment for asthma. People used to have a reliever (blue) inhaler to use when they felt wheezy or short of breath. We now know that a combination inhaler containing a steroid preventer and a long-acting reliever is a better way of treating asthma.

The steroid part of the inhaler works by reducing the inflammation in your airways, so they don’t react to triggers.

The reliever part works quickly to relax the small muscles in your airways, opening them up.

You can use this inhaler every day, both as a preventer and when you need quick relief if you feel wheezy or short of breath.

Symbicort, Vannair and Duoresp Spiromax are the only combination inhalers in New Zealand that can be used in this way. Other combination inhalers such as Seretide, Breo and Rexair shouldn't be used as single inhaler therapy.

Short-acting relievers

A reliever inhaler contains a medication called a bronchodilator, which relaxes the muscles in your airways. This opens them up to allow more air to flow. You usually use them when you feel wheezy or short of breath. You can also use a reliever inhaler before exercising to prevent wheezing. Examples of short-acting relievers include salbutamol (Ventolin), ipratropium bromide (Atrovent), and terbutaline (Bricanyl).

If you need to use your reliever inhaler often (most days or several times a day once or twice a week) it's important that you see your doctor to look at other treatments. You should always have your reliever inhaler with you in case of an asthma attack or COPD flare-up.

Inhaled steroid preventers

Inhaled steroid preventers reduce the inflammation in your airways and make an asthma attack less likely to happen. They're also sometimes used with COPD.

You usually take inhaled steroids preventers once or twice every day. Examples of inhaled steroid preventers include beclometasone (Beclazone or Qvar) and fluticasone (Flixotide).

Combination preventer inhalers

Combination inhalers contain both a long-acting reliever and an inhaled steroid preventer. You need to use this inhaler every day. Examples of these medications include formoterol plus budesonide (Symbicort or Vannair), salmeterol plus fluticasone (Seretide or Rexair), and vilanterol plus fluticasone (Breo).

Some of these inhalers can be used for asthma as both a reliever and preventer (AIR or single inhaler therapy).

Long-acting relievers

Long-acting relievers help to keep your airways in a relaxed open state.

There are two main types of long-acting relievers:

There are also some inhalers that combine these two types. These are known as LAMA/LABA inhalers.

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Written by HealthInfo clinical advisers. Endorsed by community respiratory physician, Canterbury DHB. Last reviewed June 2021.

Page reference: 317751

Review key: HIASA-39947