Asthma Inhaler Options: Relievers, Controllers & How to Choose

If your chest tightens or you cough at night, the right inhaler can make a big difference. Inhalers fall into clear groups: quick-relief devices for sudden symptoms and controller inhalers to keep inflammation down. Knowing the types helps you and your clinician pick what fits your life, not just your lungs.

Common inhaler types and what they do

Reliever inhalers: these act fast when you’re wheezy. Short-acting beta-agonists (SABA) like albuterol (salbutamol) are the standard. They open airways within minutes and are the go-to for sudden attacks. Some people use a short-acting antimuscarinic (ipratropium) if SABA isn’t enough.

Controller inhalers: taken daily to prevent symptoms. Inhaled corticosteroids (ICS) — such as fluticasone or budesonide — reduce airway inflammation. Long-acting beta-agonists (LABA) like formoterol or salmeterol are often paired with ICS in one device for better control. There’s also long-acting muscarinic antagonists (LAMA) like tiotropium for certain adults.

Combination inhalers: these put an ICS and LABA together so you need fewer devices. Popular combos include brands many patients know (for example, products like Symbicort, Advair, Dulera, Breo). For some people, one of these combinations doubles as both daily control and quick relief — that strategy is called SMART (single maintenance and reliever therapy) and usually uses budesonide-formoterol.

Delivery and devices: Metered-dose inhalers (MDI) spray a measured dose and often work best with a spacer if your hand-breath coordination is shaky. Dry powder inhalers (DPI) are breath-activated — no timing needed, but you must inhale fairly strongly. Soft mist inhalers give a slow fine mist and are easier to inhale for some people. Nebulizers turn liquid medicine into a mist and are useful for young kids or during severe attacks.

How to pick and use an inhaler

Talk with your clinician about symptoms, lifestyle, and cost. Ask for a demonstration and practice until you’re confident. Use a spacer with an MDI if you struggle with coordination. Rinse your mouth after using ICS to lower the risk of thrush and hoarseness.

Other practical tips: check the expiry and dose counter, store inhalers away from heat, keep a reliever near you, and carry your written asthma action plan. If your reliever is needed more often than your doctor expects, or if you wake at night with symptoms, ask for a plan review — that often means stepping up controller treatment.

Severe asthma may need options beyond inhalers, like biologic injections (omalizumab, mepolizumab, benralizumab, dupilumab). Those are for specific cases and require specialist care. If you’re unsure about side effects, costs, or how to switch devices, your healthcare team can help find the safest, simplest choice for your daily life.