Changes to inhaler prescriptions: what they might mean

Dr Andrew Whittamore looks at recent changes to reliever inhaler prescriptions and explains what they mean and how closer monitoring of reliver inhaler use can improve asthma management. He also gives his advice on what you can do to make sure you’re getting the full benefits of your medicines.

Recently, our helpline team has received a number of calls from people with asthma who are worried because their reliever inhaler prescriptions have changed. I want to explain why this might be happening and give advice on what you can do to make sure you’re getting the full benefits of your medicines.

So what’s happening?

In some cases, people are not being prescribed two reliever inhalers on each prescription as they have been in the past. Others are being told that they are requesting more reliever inhalers too soon. In April 2022, new targets were introduced by the NHS for GP practices to encourage people to use their asthma preventer inhalers as prescribed and rely less on their reliever inhalers. These targets were introduced to help improve people's asthma management and treatment, which for too long has been a neglected part of asthma care.

Why is it a problem to rely on my reliever inhaler?

Reliever inhalers are vital in quickly treating asthma symptoms when they come on and can be lifesaving during asthma attacks. However, they’re only a temporary fix because they don’t treat the inflammation and swelling in the airways which causes symptoms and attacks in the first place. Using your preventer inhaler every day as prescribed, even if you feel well, will build up protection in your airways over time. This means that if you do come into contact with a trigger, such as cold air or pollen, you are less likely to react badly and have an asthma attack.

Why is important to monitor use of reliever inhalers?

If you’re using your reliever inhaler three or more times a week, it indicates your asthma is not well controlled. This could be because you aren’t taking your preventer inhaler as often as prescribed, or you need help using your inhalers correctly. It could also be a sign that you need different preventer medicines that work better for you.

Some people may be taking their preventers regularly and in the right way but still getting asthma symptoms three or more times per week. This indicates that they might have a more serious form of asthma called severe asthma and need to be referred for specialist treatment.

Of course, reliever inhalers should not be restricted from people who may need them when they do get asthma symptoms or in the event of an asthma attack. But it’s all about finding the right balance of treatment to make sure your asthma is managed and controlled in the best way possible.

So, if my reliever inhaler prescription has been changed, what can I do to stay well?

1. Talk to your GP or asthma nurse

Don’t worry in silence – make an appointment with your GP or asthma nurse to discuss any concerns you have about your treatment or care and keep them updated as to how you are doing.

2. Make sure you take your medicines as prescribed

One of the best ways you can safeguard your health is to make sure you use your medication properly. In the case of preventer inhalers, this means taking them every day as prescribed. With reliever inhalers, use them when necessary and make sure you carry it with you at all times.

3. Ask for a preventer inhaler

Many people with asthma have not been prescribed a preventer inhaler. If you have been diagnosed with asthma and haven’t got a preventer inhaler, please do speak to your GP about getting one.

4. Make sure you are using your inhalers in the best way

Whichever inhaler you're prescribed, you need to know how to use it effectively. You could speak to your GP, asthma nurse, or a pharmacist for help with this or take a look at the Asthma + Lung UK website which has a guide here.

5. Get an asthma action plan if you don’t have one

This is a written plan which tells you and anyone with you, which medicines you take, what to do if your symptoms are getting worse, and when to call 999. You can download an asthma action plan here.

6. Keep a check on how often you use your reliever inhaler

If you are using your reliever inhaler three or more times per week, you are at a higher risk of having an asthma attack, so you should contact your GP for an urgent review. You can also find out more about what to do if your asthma symptoms are getting worse on our website.

I can understand that asthma can be very frightening for some people and that being prescribed fewer reliever inhalers might make them anxious. But it helps GP surgeries monitor patients with asthma more closely and reduce the number of people who are being put at risk by poor asthma control. We want to see healthcare professionals working with patients to explain any changes to their prescriptions and provide support in managing their condition including preventative treatment.

If you need any support or advice on your asthma visit our website for expert health advice. Or contact our friendly Helpline team on 0300 222 5800 or email helpline@asthmaandlung.org.uk. Lines open 9am-5pm, Monday to Friday. You can also contact the Helpline on WhatsApp on 07378 606 728.