Types of Asthma Inhalers

There are 3 main types of asthma inhalers: reliever inhalers, preventer inhalers and combination inhalers. Each inhaler type has a different function to help you manage your asthma symptoms effectively – whether that’s everyday use (preventer and combination inhalers), or during severe flare-ups and attacks (reliever inhalers).

The colour of the inhaler usually indicates the specific function, helping you to quickly identify the right type of inhaler to use depending on the scenario. Though there are a few different inhaler device types, they are all categorised based on their use.

Reliever inhalers and preventer inhalers contain different medications and are used at different times. They are different colours so you can easily tell them apart.

Reliever inhalers (blue) are taken as you need them, when you get symptoms. They use fast-acting medication to ease symptoms quickly. This can stop symptoms from developing into an asthma attack.

Preventer inhalers (brown/red/pink) are used every day to prevent symptoms. They should not usually be used when experiencing symptoms or during an asthma attack.

There are many different types of inhaler devices used to treat asthma. The most common are metered dose inhalers (MDIs) and dry powder inhalers (DPIs), which require the user to take a deep breath and press down on a canister.

Others include:

• breath-actuated inhalers (BAIs) – deliver the medication when you breathe in
• soft mist inhalers (SMIs) – deliver medication to your lungs in a slow and gentle way
• nebulisers – devices with a mask or mouthpiece that deliver medication as a fine mist and are mainly used in a hospital or emergency setting

Your doctor will prescribe the best inhaler for you, and this could include one or more devices. Below, we explore and compare different asthma inhalers so you know what to expect from each device.

Metered-dose inhalers (MDIs)

MDIs are one of the most commonly prescribed types of inhalers for asthma. They are handheld devices that deliver a measured dose of medication as a fine mist when you press down on a canister while inhaling. MDIs are compact, portable, and can be paired with a spacer for easier use, particularly for those who struggle with timing the spray and inhalation.

Examples of MDIs include common types of reliever and preventer inhalers such as Ventolin, Clenil Modulite, and Soprobec. You may also see MDIs referred to as pMDIs, which just means ‘pressurised Metered Dose Inhalers’.

Dry powder inhalers (DPIs)

DPIs deliver medication as a dry powder, requiring a strong, deep breath to draw the medication into the lungs. They are fast-acting and effective for deep lung delivery, making them a good choice for those who may struggle with the coordination required by MDIs. However, because DPIs rely on the user's ability to take a strong breath, this type of inhaler may not always be suitable for young children or patients experiencing severe asthma symptoms.

Symbicort Turbohaler is a popular dry powder inhaler widely available in the UK.

Breath-actuated inhalers (BAIs)

BAIs automatically release medication when you inhale through the mouthpiece, removing the need to press a canister. This simplicity makes BAIs ideal for young children or elderly patients who may struggle with the coordination required for MDIs. However, they still require deep inhalation to activate, which may be difficult during severe asthma episodes or for patients with restricted airflow.

Soft mist inhalers (SMIs)

SMIs release a slow-moving mist, allowing for more time to inhale the medication which improves absorption in the airways. These devices are particularly beneficial for patients who struggle with coordination or have difficulty using traditional types of asthma inhalers. Despite being effective, SMIs are less commonly prescribed in the UK and are not always available for every medication type.

Nebulisers

Nebulisers convert liquid medication into a fine mist, inhaled through a mask or mouthpiece. They’re especially effective when you’re experiencing severe asthma symptoms or if you’re unable to use handheld inhalers. While nebulisers are highly effective and easy to use, particularly for children or elderly patients, they are bulkier than other devices and require a power source, making them less portable.

What is a spacer?

Spacers are plastic tubes that attach to the mouthpiece of an MDI at one end and have a mask or mouthpiece for you to use at the other end. They can help you get better results from your measured dose inhaler.

Benefits of using a spacer

1. Spacers are designed to make using an MDI easier and more effective, especially for people who find it challenging to press the inhaler and breathe in at the same time. By holding the medication in the spacer, it ensures you can inhale at your own pace, delivering a consistent dose to your lungs.
2. Using a spacer can also reduce the amount of medication wasted, making your inhaler last longer and potentially reducing the number of repeat prescriptions. Research has shown that using a spacer can deliver up to 70% more medication to your lungs when compared to using an MDI alone depending on use and other factors.
3. Spacers are especially beneficial if you get side effects from your inhaler, such as a sore throat, hoarseness, or coughing.

How to use a dry powder inhaler (DPI)

1. Prepare the device: for multi-dose inhalers, click to load the dose. For single-dose inhalers, place the capsule into the chamber.
2. Breathe out fully to ensure you’re ready to take a breath.
3. Place the mouthpiece in your mouth and take a fast, strong breath.
4. Hold your breath for 5 to 10 seconds, then exhale slowly.
5. Breathe out, and repeat if necessary.
6. Check the capsule (if applicable): For capsule devices, ensure the powder is fully inhaled. If any residue remains, inhale again until the capsule is empty. Discard the empty capsule.
7. Close and store: Close the inhaler and store it in a dry place. Clean the mouthpiece with a dry cloth; do not use water.

How to use a breath-activated inhaler (BAI)

1. Remove the cap and check the mouthpiece and vents for any blockages.
2. Shake the inhaler to mix the medicine.
3. Exhale fully, avoiding breathing into the inhaler.
4. Hold the inhaler upright with the mouthpiece pointed towards your mouth. Ensure the vents are not blocked.
5. Place the mouthpiece between your lips and inhale deeply. You’ll feel the mist and hear a click as the medicine is released – keep inhaling steadily.
6. Hold your breath for 5 seconds, then exhale slowly.
7. Rinse your mouth with water or saline, and spit it out. Do not swallow.

How to use a soft mist inhaler (SMI)

1. Prime the inhaler as directed before first use, or if it hasn’t been used for 3 or 21 days.
2. Exhale completely.
3. Place the mouthpiece in your mouth, and begin a slow inhalation while pressing the dose release button.
4. Continue breathing in slowly and deeply.
5. Remove the inhaler, hold your breath for 10 seconds, then exhale.
6. Close the cap to store the inhaler.

How to use a nebuliser

1. Wash your hands thoroughly to avoid contamination.
2. Add your prescribed asthma medication to the nebuliser cup.
3. Connect the cup to the mouthpiece or mask and attach it to the compressor.
4. Sit upright to maximise lung capacity. Place the mouthpiece in your mouth (or the mask over your face) and start the compressor.
5. Breathe in and out slowly and steadily through your mouth for 5 to 15 minutes, until the medication is fully used.
6. After use, clean the nebuliser following the manufacturer’s instructions to ensure it’s ready for next time.

Asthma inhalers are vital in managing asthma symptoms and preventing attacks. Whether you’re using a reliever inhaler for immediate symptom relief, a preventer inhaler to reduce airway inflammation over time, or a combination inhaler for stronger treatment, understanding how different types of inhalers work is key to keeping your symptoms under control.

When using the right asthma treatment, you can improve your quality of life, breathe more easily, stay active, and sleep better. If you're unsure about which type of inhaler you need or how to use it properly, speak to your GP or ZAVA online doctor for personalised advice.

What is the most common inhaler medication?

The most commonly prescribed inhaler medication in the UK is salbutamol, which is found in blue reliever inhalers like Ventolin and Salamol. Salbutamol is a short-acting bronchodilator that quickly relaxes airway muscles, providing fast relief during an asthma attack or when symptoms occur.

The most common preventer inhalers contain corticosteroids such as beclometasone, found in products like Clenil and Soprobec. Corticosteroids reduce inflammation and prevent asthma flare-ups.

Which asthma inhaler is the strongest?

Asthma inhalers are used for different things and contain different types of medication. Comparing their strength isn’t necessary in determining the best inhaler for your needs.

Generally speaking, reliever inhalers, like those containing salbutamol, contain the strongest form of medication. This is because they’re designed for immediate relief during an asthma attack or flare up – and should only be used occasionally as prescribed.

Combination inhalers are stronger than standard preventer inhalers, because they contain both steroids and long-acting bronchodilator treatment. They’re prescribed when a preventer inhaler can’t control asthma symptoms well enough.

Preventer inhalers are the ‘weakest’ of the 3, but this is because they’re intended for daily use to help manage your asthma long-term.

You don’t always need the ‘strongest’ inhaler to get your asthma symptoms under control, you just need the one that your doctor has approved for you.

What are the different colour inhalers in the UK?

The different colours of inhalers in the UK are:

• blue inhalers – relievers for providing quick symptom relief
• brown, red, or pink inhalers – preventers, used daily to reduce airway inflammation and prevent symptoms
• purple or white inhalers – combination inhalers, which combine the benefits of preventers and long-acting bronchodilators for better symptom management

If you’re unsure about the function of your inhaler, check the label and patient information leaflet, or consult your doctor for guidance.

What's the best asthma inhaler for adults?

The best asthma inhaler for adults depends on your symptoms and treatment needs. Most adults start with a blue reliever inhaler (like Ventolin) for immediate symptom relief. If symptoms persist, a brown preventer inhaler (like Clenil or Soprobec) is typically added to reduce airway inflammation and prevent attacks.

For those requiring stronger control, a combination inhaler like Symbicort or Seretide may be prescribed. Always consult your doctor to determine the right inhaler for your condition.

How do I know which inhaler is right for me?

Your doctor will recommend the best inhaler based on your asthma severity, symptoms, and lifestyle. If you experience occasional symptoms, a reliever inhaler is likely enough. For more frequent symptoms or flare-ups, a preventer inhaler may be recommended to reduce airway sensitivity.

For persistent asthma that isn’t able to be controlled by preventers, a combination inhaler may be prescribed. If you’re unsure or feel your current inhaler isn’t working effectively, get in touch with your doctor for a review.

What should I do if I need to use my reliever inhaler more often than usual?

If you find yourself needing your reliever inhaler more than 3 times a week, or you’re waking up at night to use it, it may indicate that your asthma isn’t well-controlled. Speak to your doctor as soon as possible – they may recommend adjusting your treatment plan, such as increasing the dose of your preventer inhaler or prescribing a combination inhaler.

Do not wait for symptoms to get worse before seeking medical advice, as uncontrolled asthma increases the risk of serious flare-ups and asthma attacks.