The Two Types Every Asthma Patient Needs to Know
Asthma medications fall into two broad categories: relievers (bronchodilators) that open the airways quickly during symptoms, and preventers (inhaled corticosteroids) that reduce inflammation over time. Most patients understand the reliever but underuse the preventer — and that is why their asthma is not controlled.
Reliever Inhalers — For Immediate Relief
Relievers contain a short-acting beta-agonist (SABA) — most commonly salbutamol (Ventolin). They work within 5–10 minutes by relaxing the muscles around the airways, opening them up quickly. They are blue in most markets.
When to use: When symptoms start — wheeze, chest tightness, cough, shortness of breath. Also before exercise if exercise triggers your asthma.
Important: A reliever treats symptoms but does not treat the underlying inflammation. If you are using your reliever more than twice a week, your asthma is not adequately controlled — and you need to review your preventer dose with your doctor.
Preventer Inhalers — For Long-Term Control
Preventers contain an inhaled corticosteroid (ICS) — beclomethasone, budesonide, or fluticasone. They reduce airway inflammation over weeks of regular use, making the airways less reactive to triggers. They are typically brown, orange, or red.
When to use: Every day, morning and evening — regardless of whether you have symptoms. It takes 4–6 weeks of consistent use to see the full benefit.
Common mistake: Stopping the preventer when symptoms improve. This allows inflammation to rebuild, leading to another flare. The preventer only works when used consistently.
Combination Inhalers
Many patients are prescribed a combination inhaler containing both an ICS and a long-acting bronchodilator (LABA) — for example, Seretide (fluticasone + salmeterol) or Symbicort (budesonide + formoterol). These provide both daily control and sustained bronchodilation. Some combination inhalers can also be used as a reliever (MART therapy).
Inhaler Technique Matters More Than the Device
Studies show that 70–80% of patients use their inhaler incorrectly. Poor technique means the medication does not reach the lungs effectively. Common mistakes include not breathing out fully before inhaling, inhaling too fast (for MDI devices), or not holding the breath for 10 seconds after inhaling. Ask your doctor or nurse to check your technique at every review.
Spacer Devices
A spacer is a chamber that attaches to an MDI inhaler. It slows the aerosol and allows you to breathe it in at your own pace — making delivery more effective and reducing the amount deposited in the mouth and throat (which causes thrush with steroid inhalers). All children should use a spacer. Adults with coordination difficulties benefit significantly from one.
When to Review Your Inhaler
If you are using your reliever more than twice a week, waking at night with symptoms, or having asthma flares that affect your daily life — book a review. Stepping up your preventer dose or switching device type can make a significant difference.