Asthma Repeat Inhaler Treatment

Repeat asthma treatment can sometimes be reviewed online when the diagnosis and current inhaler regimen are already established. The clinician will review recent symptoms, reliever use, night waking, activity limitation, exacerbations, inhaler technique, adherence and whether the current treatment remains appropriate.

New or unexplained breathlessness, severe deterioration or symptoms suggesting an acute asthma attack require urgent clinical assessment rather than routine repeat supply.

No. Repeat supply should confirm that the inhaler is still appropriate, asthma is adequately controlled and there are no signs of overuse, poor adherence, significant side effects or deterioration requiring a treatment review.

Increasing reliever use can indicate poor asthma control or worsening disease. It should trigger review of adherence, inhaler technique and anti-inflammatory treatment rather than simply supplying more reliever inhalers.

People with asthma should have a personalised written asthma action plan explaining regular treatment, what to do if symptoms worsen and when to seek urgent help.

Frequent daytime symptoms, night waking, exercise limitation, increasing reliever use, repeated exacerbations or needing oral steroids can all indicate inadequate asthma control.

An exacerbation is a worsening of asthma symptoms beyond usual day-to-day variation, often with increasing wheeze, cough, chest tightness or breathlessness and a greater need for reliever treatment.

Night waking due to asthma is a sign of poor control and should prompt treatment review rather than being managed only by repeated reliever use.

Increasing exercise limitation can indicate worsening asthma control. Your treatment, adherence and inhaler technique should be reviewed.

Salbutamol is a short-acting beta-2 agonist bronchodilator, often called a reliever inhaler. It works quickly to relax airway muscle and relieve wheeze, chest tightness and breathlessness.

For common 100 microgram inhalers, current UK product information generally lists one inhalation as the starting dose for acute symptoms, increased to two inhalations if necessary. Follow the exact instructions for the inhaler supplied and your asthma action plan.

No. Current UK asthma guidance does not recommend SABA-only treatment for people aged 12 and over with confirmed asthma. Salbutamol should not delay or replace appropriate inhaled corticosteroid-containing treatment.

Frequent or increasing use suggests asthma may be poorly controlled. Current product information also advises that reliance on frequent supplementary salbutamol should trigger medical review.

Possible effects include tremor, headache, a faster heartbeat, palpitations and muscle cramps. Marked palpitations, chest pain or worsening breathlessness should be assessed promptly.

Clenil Modulite contains beclometasone dipropionate, an inhaled corticosteroid. It is a preventer inhaler that reduces airway inflammation and is taken regularly rather than only when symptoms occur.

The dose depends on asthma severity and inhaler strength. Current UK product information lists a usual adult starting dose of 200 micrograms twice daily, with higher doses used in more severe asthma and reduction to the lowest effective dose once control is achieved.

Yes, when Clenil has been prescribed as your preventer it should be taken regularly as directed, including when you feel well, because its purpose is to control underlying airway inflammation.

Yes. Rinsing the mouth and spitting out the water after inhaled corticosteroid doses can help reduce local side effects such as oral thrush and hoarseness.

A spacer can improve delivery from a pressurised metered-dose inhaler. Current product information requires a Volumatic spacer in children and adolescents aged 15 years and under, and in adults and adolescents aged 16 years and over when the total daily dose is 1,000 micrograms or more.

Fostair contains beclometasone and formoterol. It combines an inhaled corticosteroid with a long-acting bronchodilator and is used for regular asthma treatment where combination therapy is appropriate.

Fostair 100/6 can be prescribed as maintenance and reliever therapy in suitable adults. In that regimen, the regular maintenance dose is taken every day and extra inhalations are used as needed for symptoms according to the prescribed plan.

Current UK product information lists one inhalation twice daily as the maintenance dose for adults using Fostair 100/6 maintenance and reliever therapy. One additional inhalation is taken when symptoms occur, with another after a few minutes if symptoms persist. The maximum is 8 inhalations in a day.

No. Fostair 200/6 is licensed as maintenance therapy only. Current product information specifically states that the lower 100/6 strength is the formulation available for maintenance and reliever therapy.

Frequent rescue inhalations indicate that asthma control needs review. Product information advises people requiring frequent rescue use to seek medical advice so their treatment can be reassessed.

Symbicort contains budesonide and formoterol. It combines an inhaled corticosteroid with a rapid-onset long-acting bronchodilator and can be used in different asthma regimens depending on strength, age and the prescribed plan.

Yes. Symbicort Turbohaler 200/6 is licensed for maintenance and reliever therapy in adults and adolescents aged 12 years and over when clinically appropriate.

Current UK product information lists a usual maintenance dose of two inhalations per day, taken either as one inhalation morning and evening or two inhalations at one time. One additional inhalation is used when symptoms occur, with another after a few minutes if needed.

For Symbicort 200/6 maintenance and reliever therapy, more than 8 inhalations in a day is not normally needed. Up to 12 may be used for a limited period under the product licence, but anyone needing more than 8 daily should seek medical advice and have treatment reassessed.

Some Symbicort Turbohaler strengths are licensed as as-needed reliever therapy in adults and adolescents aged 12 years and over with mild asthma. This should only be used when it is the person's prescribed asthma regimen.

MART means maintenance and reliever therapy. The same inhaled corticosteroid-formoterol combination inhaler is used both every day for maintenance and when needed for symptoms.

AIR means anti-inflammatory reliever therapy. An inhaled corticosteroid-formoterol combination inhaler is used as needed for symptoms, providing both bronchodilation and anti-inflammatory treatment.

Current NICE/BTS/SIGN guidance favours inhaled corticosteroid-formoterol pathways. It recommends moving people with confirmed asthma who are using SABA alone to low-dose ICS/formoterol used as needed, and using MART where greater treatment intensity is required.

Poor inhaler technique can make effective medicines appear ineffective. Technique, adherence and trigger exposure should be checked before stepping treatment up wherever possible.

Yes. Once asthma has been well controlled for an appropriate period, treatment may be stepped down to the lowest effective dose under clinical supervision. Inhaled corticosteroids should not usually be stopped abruptly without a plan.

Seek urgent medical help if you are severely breathless, struggling to speak in full sentences, becoming exhausted or drowsy, developing blue or grey lips or skin, or if your reliever treatment is not providing adequate relief.

A shorter duration of relief or rapidly increasing need for reliever treatment can indicate a worsening asthma attack and requires urgent reassessment.

Asthma control remains important during pregnancy. Do not stop prescribed inhalers without medical advice. Pregnancy should be disclosed so the current regimen can be reviewed and continued or adjusted appropriately.

Local effects include oral thrush, sore throat and hoarseness. Higher long-term doses can produce systemic corticosteroid effects, so treatment should be kept at the lowest dose that maintains good asthma control.

Yes. Formoterol can cause tremor, palpitations, headache or a faster heartbeat in some people. Persistent or severe symptoms should be reviewed.

A recent exacerbation, emergency attendance, oral steroid course or hospital treatment should trigger a clinical asthma review rather than routine repeat supply alone.

Review should include symptom control, exacerbations, reliever use, adherence, inhaler technique, side effects, smoking status where relevant and whether the person has an up-to-date written asthma action plan.

If repeat treatment is clinically appropriate, the inhaler will be supplied with directions that match the existing prescribed regimen. Follow the dispensing label and your personalised asthma action plan.