Combination inhalers

A combination inhaler combines two kinds of medicine - a preventer and long-acting reliever.

Combination inhalers in brief

  • Some people with asthma are prescribed a combination inhaler. This device combines two kinds of medicine: a long-acting reliever to relieve ongoing symptoms, such as breathlessness and a tight chest, and a corticosteroid preventer to help prevent inflammation in your airways over the long term.
  • When you're prescribed a combination inhaler, you also need to keep a reliever inhaler (usually blue) on you at all times to use if you have any asthma symptoms, such as coughing, wheezing, shortness of breath and tightness in the chest.
  • Take your combination inhaler every day, even when you're feeling well.
  • Your GP, asthma nurse or pharmacist should show you how to use your inhaler properly so that every dose is effective.

Who might get benefits from a combination inhaler?

You've probably been prescribed a combination inhaler because your asthma symptoms are not well managed with your usual medicines. Perhaps you're still reacting to your asthma triggers a lot, or your asthma's reached a point where you just can't get on top of it. Everyone's asthma is different and there'll be different reasons why your GP or asthma nurse thinks a combination inhaler will help you. If you're not sure why you're on a certain asthma medicine make sure you talk to your GP or asthma nurse about it.

Combination inhalers might be prescribed to both adults and children, depending on which type.

How does a combination inhaler help asthma?

A combination inhaler, such as Seretide, Symbicort or Fostair, contains two medicines:

  • a long-acting reliever (Long-Acting Beta-Agonists) to relieve ongoing symptoms, such as breathlessness and a tight chest
  • a corticosteroid preventer to prevent inflammation in your airways over the long term.

Do you still need a reliever inhaler as well?

Even though there is a reliever part in your combination inhaler, you still need your usual reliever inhaler as well. This is because the long-acting reliever medicine in your combination inhaler does not give quick relief if your asthma symptoms come on or if you're having an asthma attack. You need your usual reliever inhaler for this, as it works quickly in an emergency, which is why you should always carry it with you.

The good news is that using your combination inhaler as prescribed and discussed with your GP or asthma nurse could mean that you have fewer asthma symptoms, so you won't need to use your reliever inhaler so often.

The only time you won't also need a reliever inhaler is when you've been put on a SMART or MART regime.

How often do you need to use your combination inhaler?

You should take your combination inhaler as prescribed, every day, even when you're feeling well. This is because it's designed to work away in the background to prevent inflammation in your airways and to relieve ongoing symptoms. You'll only notice an improvement if you're taking it as prescribed.

As with any type of inhaler it's very important to take your combination inhaler in the right way. Ask your GP, asthma nurse or pharmacist to show you the right technique.

What kind of benefits can you expect - and after how long?

You may notice a difference from the long acting reliever medicine within a couple of days. You should notice fewer symptoms: you might feel less wheezy and breathless, or be coughing less during the day and night. 

The preventer medicine will take a bit longer to reduce the inflammation because it builds up protection over time. It could take a few days or up to two weeks for you to notice a difference. You're likely to notice that you don't react as badly to your asthma triggers, or that you're sleeping better, or you can do things like climb stairs without asthma symptoms.

Using your combination inhaler as prescribed, you should notice fewer symptoms, better sleep, and that you're able to do more. You'll probably need your reliever inhaler (usually blue) less often.

Possible side effects of combination inhalers

There’s a low risk of side effects when using long-acting reliever inhalers and preventer inhalers separately. So as long as you’re taking your combination inhaler as prescribed, it’s unlikely you will experience any side effects. If you do, these might include a sore tongue, hoarse voice and/or a mouth infection called thrush.

Talk to your GP or asthma nurse if you notice any side effects so they can help you manage these, and still get the benefits of your asthma medicine. You can also speak to an asthma nurse specialist on our Helpline on 0300 222 5800 (9am - 5pm; Mon - Fri) to talk about your medicines, and any concerns you have about side effects.

Last updated April 2016

Next review due April 2019