Types of rescue inhalers for asthma

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Types of Rescue Inhalers for Asthma: Key Medications and Combinations

Short-Acting Beta2-Agonist (SABA) Rescue Inhalers

The most common type of rescue inhaler for asthma is the short-acting beta2-agonist (SABA) inhaler. Albuterol is the most widely used SABA and provides quick relief from asthma symptoms by relaxing the muscles around the airways, making it easier to breathe. These inhalers are often referred to as "reliever" or "rescue" inhalers and are typically used as needed when symptoms arise 1356810.

Combination Rescue Inhalers: SABA Plus Inhaled Corticosteroid (ICS)

Recent research has introduced combination rescue inhalers that contain both a SABA (such as albuterol) and an inhaled corticosteroid (ICS) like budesonide. These combination inhalers, such as the fixed-dose albuterol–budesonide inhaler (marketed as AIRSUPRA™), are designed to provide rapid symptom relief while also addressing airway inflammation, which SABAs alone do not treat. Studies have shown that using a combination inhaler as needed can reduce the risk of severe asthma exacerbations compared to using albuterol alone 1235.

Inhaled Corticosteroid (ICS) as Rescue Therapy

Some studies have explored the use of inhaled corticosteroids, such as beclomethasone dipropionate, as a rescue treatment in combination with albuterol. This approach can be effective for children with mild persistent asthma, offering better protection against exacerbations than albuterol alone and potentially reducing the need for daily ICS therapy, which can have side effects like growth impairment in children .

Other Combination Inhalers: ICS with Formoterol

Another type of combination rescue inhaler includes an inhaled corticosteroid with formoterol, a rapid-onset long-acting beta2-agonist (LABA). These inhalers can be used both for regular maintenance and as-needed relief (sometimes called "single inhaler therapy" or MART—maintenance and reliever therapy). This approach has been shown to provide better asthma control and reduce exacerbations compared to SABA-only rescue inhalers 79.

Color-Coded and Propellant-Free Inhalers

To help patients distinguish between rescue and maintenance inhalers, some pharmacies use color-coded labels (e.g., red for rescue, green for maintenance). This improves medication adherence and self-management. Additionally, some inhalers are available in propellant-free forms, which are more environmentally friendly, though the medication types remain the same 810.

Conclusion

The main types of rescue inhalers for asthma are SABA-only inhalers (like albuterol), combination SABA-ICS inhalers (such as albuterol–budesonide), and, in some cases, ICS-formoterol inhalers used as both maintenance and rescue therapy. Combination inhalers are increasingly recommended because they address both bronchoconstriction and inflammation, reducing the risk of severe asthma attacks. Color-coded labeling and environmentally conscious inhaler options are also being adopted to improve patient outcomes and sustainability 12345678+2 MORE.

Sources and full results

Most relevant research papers on this topic

Albuterol-Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma.

A fixed-dose combination of 180 g of albuterol and 160 g of budesonide significantly reduces the risk of severe asthma exacerbation compared to albuterol alone in patients with uncontrolled moderate-to-severe asthma.

RCTLarge Human TrialRigorous Journal

2022·

55citations

·A. Papi et al.

Albuterol–budesonide fixed-dose combination rescue inhaler for asthma: a plain language summary of the MANDALA study

The albuterol-budesonide inhaler (AIRSUPRA) showed promising results in improving asthma symptoms in adults aged 18 years and older.

2024·

4citations

·A. Papi et al.

Efficacy and safety of as-needed albuterol/budesonide versus albuterol in adults and children aged ≥4 years with moderate-to-severe asthma: rationale and design of the randomised, double-blind, active-controlled MANDALA study

As-needed albuterol/budesonide versus albuterol as rescue therapy effectively reduces asthma exacerbations and improves bronchoconstriction control in adults and children aged 4 years with moderate-to-severe asthma.

RCTLarge Human TrialRigorous Journal

2021·

12citations

·B. Chipps et al.

Use of beclomethasone dipropionate as rescue treatment for children with mild persistent asthma (TREXA): a randomised, double-blind, placebo-controlled trial

Daily inhaled corticosteroids are the most effective treatment for preventing asthma exacerbations in children, while using beclomethasone dipropionate as a rescue treatment is more effective than using rescue albuterol alone.

RCTLarge Human TrialVery Rigorous JournalHighly Cited

2011·

265citations

·Fernando D. Martinez et al.

Estimating Inhaled Corticosteroid Exposure from Short-Acting β2-Agonist–Inhaled Corticosteroid Rescue

A SABA-ICS rescue inhaler strategy combined with 80 g of budesonide can reduce inhaled corticosteroid exposure by 33% in patients with moderate-to-severe asthma, potentially improving overall health.

Observational Study

2023·

0citations

·Nijra L Lugogo et al.

Evaluating the relationship between the type of rescue medication and the adequacy of asthma maintenance therapy.

The use of a combination of rapid onset bronchodilator and inhaled corticosteroid for asthma symptoms relief does not impair maintenance therapy, and having no reliever medication is less likely to cause suboptimal therapy.

Observational Study

2023·

2citations

·E. Ponte et al.

Scientific rationale for using a single inhaler for asthma control

Using a budesonide/formoterol combination inhaler for regular maintenance and rescue therapy can provide more effective asthma control and reduce exacerbations than using a short-acting 2-agonist or formoterol alone.

Rigorous JournalHighly Cited

2007·

148citations

·P. Barnes

Improving asthma self-management education through inhaler labeling

Color-coded asthma medication labels, applied by pharmacies, effectively improve asthma self-management education by helping patients differentiate between rescue and maintenance inhalers.

Observational Study

2024·

0citations

·Lea C. Dikranian et al.

Patients' and physicians' perspectives on the burden and management of asthma: Results from the APPaRENT 2 study.

Physicians prefer a preventive regular dosing approach for patients with moderate to severe asthma, aligning with GINA 2021 Track 2 recommendations, but many patients on maintenance and reliever therapy (MART) request additional rescue inhalers.

Observational StudyRigorous Journal

2022·

17citations

·K. Chapman et al.

Inhalers and sustainability

This decision aid explains that some asthma inhalers have a bigger carbon footprint than others, and choosing the right type for you and your asthma treatment is crucial.

2023·

0citations

·Team Dftb

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