Combination inhalers

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

What is a combination inhaler?

An asthma combination inhaler combines two kinds of medicine in one device: a long-acting reliever and a corticosteroid preventer.

  • The long acting reliever medicine gives ongoing relief from symptoms such as breathlessness and a tight chest.
  • The  preventer medicine helps prevent inflammation in your airways over the long term.

Combination inhalers might be prescribed to both adults and children, depending on which type. Some examples of combination inhalers are Seretide, Symbicort and Fostair.

When is a combination inhaler prescribed?

Your GP may prescribe a combination inhaler when your asthma symptoms are not well controlled 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.

Do you still need a reliever inhaler as well?

Even though there's a reliever medicine in your combination inhaler, you still need a separate reliever inhaler as well. This is because the long-acting reliever medicine in your combination inhaler does not give quick relief in an emergency. 

So if your asthma symptoms come on, or if you're having an asthma attack, you need your short-acting reliever inhaler (usually blue). 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 could mean 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. 

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.

How will a combination inhaler help your asthma - and after how long?

As long as you're taking your combination inhaler as prescribed, you should start to see improvements from the long-acting reliever part of the inhaler within minutes.

You might feel less wheezy and breathless, or be coughing less during the day and night. You'll probably need your short-acting reliever inhaler (usually blue) less often too.

You may also notice that you're sleeping better. This is because the long-acting reliever in your combined inhaler lasts for 12 hours which means you should see an improvement in night time symptoms.

The preventer part of your combination inhaler builds up protection over time. You should notice things starting to improve after a few days.

And after a few weeks, once your preventer medicine has cut down the inflammation in your airways, you'll really start to get the full benefit of taking it regularly. 

For example, you probably won't react as badly to your asthma triggers, you may sleep better, or find you can do things like climb stairs without asthma symptoms.

Whenever your GP gives you a new medicine for your asthma you should get another appointment four to eight weeks later, either in the surgery or over the phone, to check it's working well for you. 

Possible side effects of combination inhalers

As long as you’re taking your combination inhaler as prescribed, and using the best technique, the risk of side effects is low. Side effects 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 June 2018

Next review due June 2021