Author Archives: Jackie Aim

Relievers – long acting – inhalers

Long-acting bronchodilators should only be taken along with inhaled corticosteroids – this is usually done as part of a combination inhaler but can be given as a separate inhaler as long as you are also taking the inhaled corticosteroid regularly.


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Medicine name Device How its taken Side effects
Salmeterol (Serevent®) Metred dose inhaler, Accuhaler, Easyhaler Work on the lung tissue to relax it and open up the airways. Work for a long time so they are usually taken once or twice a day. Common side effects include: shakiness, headaches and palpitations. If you experience symptoms that suggest an allergic reaction seek medical advice as soon as possible. Information on other side-effects can be found in the Patient Information Leaflet in the pack or through the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or asthma team.Formoterol (Atimos®, Foradil®)Metred dose inhaler, Turbohaler, Aerolizer

Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.

Relievers – short acting bronchodilators – inhalers

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Medicine name Device How its taken Side effects
Salbutamol (Ventolin®, Airomir®, Salamol®, Salbulin®) Metered dose inhaler, Clickhaler, Easyhaler, Easi-Breathe, Accuhaler Reliever – taken when asthma symptoms start All medicines have side-effects
  • Common ones include shakiness, headaches and palpitations
  • If you experience symptoms that suggest an allergic reaction seek medical advice as soon as possible
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or asthma team.Terbutaline (Bricanyl®)Turbohaler

Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.

Frequently Asked Questions (FAQs)

Q: How often should my medication be reviewed?

A: The medicine that you are prescribed will be reviewed once a year when you have your annual asthma review. If at any time you feel that the medicine is not relieving your symptoms as well as they used to, you should make an appointment with your GP or practice nurse to have a review. Your local community pharmacist may be able to advise you too, for example, to check that you are using the inhalers correctly.

Q. Can my medicine go out of date?

A. All medicine should have a use by date on the box or bottle. Keep to this date and ask your pharmacy to dispose of any old medicine. Never put medicine into a different bottle or container.

Q. What should I do if I think I am having side effects?

A. Discuss with your GP, specialist nurse or local pharmacist. They can all give advice about any side effects.

Q. Is it safe to stop taking my medicine when I am feeling well again?

A. You should follow the guidance you were given from your GP, specialist nurse or pharmacist. Even though you may feel much better you should not stop medicine unless you have been told to do so. Some medicine is given to prevent symptoms over a long period  of time. Always finish the whole course if you have been given an antibiotic.

Q. I feel sick when I take my medicine, what can I do?

A. Ask for advice from your GP, specialist nurse or pharmacist. There may be alternative medicines you can try or you may be given something to stop the sick feeling. Check if you should take the medicine before, with or after food as this can have an effect on sickness.

Q. I am using my inhaler more often to get the same effect as I used to. Is this normal?

A. No if you need to take your inhaler more often this can be a sign that you need to have a change or increase in your inhaler. It may be that the way you have been taking your inhaler is not as effective as it could be. Discuss with your GP, specialist nurse or pharmacist. They can check the way you have been taking your inhaler.

Q. I am more breathless and cough at night, can medicine help this?

A. There may be different reasons for breathlessness at night. The temperature of your room, the position you sleep in or if you are more anxious at night. The treatment for breathlessness at night will depend on the cause. There are medicines to settle your cough, you should discuss night time symptoms with your GP or specialist nurse.

Q. I had a nebuliser when I was in hospital and this really worked. Can I get one for home?

A. Very few people with asthma will need a nebuliser at home. If you do,  you will have an assessment by a doctor and one will be prescribed for you. Most people who are taking their inhalers correctly will not need a nebuliser. It is not advisable to buy a nebuliser yourself because unless it has been prescribed for you, a GP will not prescribe the medicine to go into the nebuliser.

Combination inhalers

Steroid inhalers are useful in more severe COPD or if you experience frequent flare ups/exacerbations. They can help to prevent flare ups of your COPD and need to be taken regularly, as they do not have their effect straight away.

If a steroid and a long acting bronchodilator are needed regularly, it is easier to give them in a combination inhaler.

Combination inhalers are also available which contain two long acting relievers, if you need both of these medicines it is easier to give them in one inhaler.

A new combination is available containing two different bronchodilators, to open up the airways.

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Medicine name Device How its taken Side effects
Beclometasone/Formoterol (Fostair®) Metered dose inhaler
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly once a day.
 The more common side effects include shakiness, headaches and palpitations. If you experience symptoms that suggest an allergic reaction seek medical advice as soon as possible.
With steroids you can get an increased number of infections including oral thrush. Some practical tips on avoiding oral thrush are:

  • Wash your mouth out and/or brush your teeth after using your inhaler
  • Make sure you are using your inhaler correctly
  • You may need to use a spacer device

High doses of steroids can cause long term effects – It is important you attend regular COPD reviews to assess your treatment and reduce the risk of long term side-effects.

Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

Most side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Budesonide/Formoterol (Symbicort®, Duoresp®) Turbohaler, Spiromax
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly twice a day.
Fluticasone/Salmeterol (Seretide®) Accuhaler
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly twice a day.
Fluticasone/Vilanterol (Relvar Ellipta®) Ellipta
  • Combination of a steroid and a long acting reliever.
  • Used when a steroid alone does not control symptoms
  • Taken regularly once a day.
Umeclidinium/Vilanterol (Anoro Ellipta®) Ellipta
  • Combination of a long acting anti-muscarinic and a long acting reliever.
  • Taken regularly once a day.

Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.

Relievers – long acting (LABA)

These Long Acting Beta Agonist (LABA) relievers work in a similar way to the short acting bronchodilators but as the name suggest, their effect lasts for longer, between 12 – 24 hours. depending on drug.

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Medicine name Device How its taken Side effects
Salmeterol (Serevent®) Metered dose inhaler, Accuhaler Reliever – taken regularly twice a day. All medicines have side-effects

  • The most common side effects are muscle cramps, headaches, feeling shaky and palpitations.
  • Other possible side effects include rash, fast heart beat and nervousness.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Formoterol (Oxis®) Turbohaler, Easyhaler Reliever – taken regularly twice a day. All medicines have side-effects

  • The most common side effects are headaches and palpitations.
  • Other possible side effects include agitation, disturbed sleep, fast heart beat and cramps.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Indacaterol (Onbrez®) Breezhaler Reliever – taken regularly once a day. All medicines have side-effects

  • The most common side effect is cold-like symptoms.
  • Other possible side effects include inflammation of the sinuses, dizziness, palpitations, chest pain and headache.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Olodaterol (Striverdi®) Respimat Reliever – taken regularly once a day. All medicines have side-effects

  • Possible side effects include rash, swelling of the mouth and face and difficulties breathing.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.

Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.

Relievers – long acting (LAMA)

Long acting relievers work in a similar way to the short acting anti-muscarinics but as the name suggest, their effect lasts for longer, 12-24 hours, depending on drug. If you are taking one of these long acting anti-muscarinics, then you should no longer be taking a short acting anti-muscarinic (ipratropium).

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Medicine name Device How its taken Side effects
Tiotropium (Spiriva®) Handihaler, Respimat Reliever – taken regularly once a day. All medicines have side-effects

  • The most common side effect is dry mouth. Eating citrus fruits (e.g. oranges) or taking sips of water may help.
  • Other possible side effects are constipation, diarrhoea, cough and headache. These drugs are not normally used if people suffer from certain bladder conditions or angle-closure glaucoma.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Aclidinium (Eklira®) Genuair Reliever – taken once every morning and evening. All medicines have side-effects

  • The most common side effect is dry mouth. Eating citrus fruits (e.g. oranges) or taking sips of water may help.
  • Other possible side effects are constipation, diarrhoea, cough and headache. These drugs are not normally used if people suffer from certain bladder conditions or angle-closure glaucoma.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Glyccopyronium (Seebri®) Breezhaler Reliever – taken regularly once a day. All medicines have side-effects

  • The most common side effect is dry mouth. Eating citrus fruits (e.g. oranges) or taking sips of water may help.
  • Other possible side effects are constipation, diarrhoea, cough and headache. These drugs are not normally used if people suffer from certain bladder conditions or angle-closure glaucoma.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.
Umeclidnium (Incruse®) Ellipta Reliever – taken regularly once a day. All medicines have side-effects

  • The most common side effect is dry mouth. Eating citrus fruits (e.g. oranges) or taking sips of water may help.
  • Other possible side effects are constipation, diarrhoea, cough and headache. These drugs are not normally used if people suffer from certain bladder conditions or angle-closure glaucoma.
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.

Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.

Relievers – short acting

Relievers (or bronchodilators) are inhaled medicines which help by opening up the airways. Salbutamol and terbutaline help relax the muscles in the airways. They work fairly quickly, within about 15 minutes and last for 4 to 6 hours.

Ipratropium gives relief in COPD and usually works within 30 to 60 minutes. It lasts for 3-6 hours and is usually taken three or four times a day. It works in a different way to salbutamol and terbutaline and is normally only used for COPD. It is described as a short acting antimuscarinic.

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Medicine name Device How its taken Side effects
Salbutamol (Ventolin®, Salamol®) Metered dose inhaler, Easyhaler, Easi-Breathe, Accuhaler Reliever – taken when symptoms start All medicines have side-effects
  • Common ones include shakiness, headaches and palpitations
  • If you experience symptoms that suggest an allergic reaction seek medical advice as soon as possible
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or asthma team.Terbutaline (Bricanyl®)TurbohalerIpratropium (Atrovent®)Metered dose inhalerReliever – taken when symptoms start All medicines have side-effects

  • Common ones include headache, dizziness, dry mouth, feeling sick (nausea), stomach upset or discomfort
  • If you experience symptoms that suggest an allergic reaction seek medical advice as soon as possible
  • Information on other side-effects can be found in the Patient Information Leaflet in the pack or on the electronic Medicines Compendium (eMC) website.

These side effects are short lasting and common. They are not a reason to stop taking the inhaler. Most people tolerate these mild side effects. If you are in any doubt contact your GP or respiratory team.


Please note:

These are the most commonly used inhalers at the time of publication of this website. If you do not see your inhaler you can speak to your GP or pharmacist or check the patient information leaflet for your inhaler and medication.

Asthma allergens

PetDustmitepollen

An asthma allergen is a usually harmless substance which starts an immune response in the airway and lung. The body produces histamine which makes the airway and lungs become inflamed and swollen.

The most common asthma allergens are:

  • Animal allergens: allergens found in their saliva, flakes of skin, fur and urine, particularly from cat and dog, are potent triggers of asthma symptoms. Also found in bedding from small animals. it is almost impossible to remove all pet allergens from your home. Even after a pet has been removed their dander can still be present for up to 6 months. However you may be able to reduce the levels of allergen by regular damp dusting surfaces in your home. Use a damp micro fibre cloth to brush over the cat or dogs fur every day. Wash your hands after handling your pet and do not let your pet sleep on your bed or sit on your furniture.
  • House Dust Mite: Many people are sensitive to the droppings of house-dust mites. They live in the dust that builds up around the house, particularly in carpets, bedding, soft furnishings and soft toys. It is very difficult to remove all dust mites at home and often products are expensive.
  • Pollen: 79% of people with asthma find pollen can trigger their asthma. There are many different types of pollen and this typically is a seasonal form of asthma which is worse when each kind of pollen is in the air. Plan ahead when the weather is bad. Keep a track of weather report and pollen levels.

Self management

There are a number of smart phone apps to track pollen and weather in your area.

There are other allergens which can cause asthma.