Long-acting reliever inhalers

A long-acting reliever inhaler works alongside your preventer inhaler to make breathing easier.

Long-acting reliever inhalers in brief

  • Some people with asthma are prescribed a long-acting reliever inhaler as an 'add-on' treatment. They work alongside your usual preventer inhaler every day to open up your airways and help make breathing easier.
  • There are two different types of long-acting reliever inhalers: long-acting beta agonists (LABA) and long-acting muscarinic receptor antagonists (LAMA).
  • Long-acting reliever inhalers should only be used if you've also been prescribed a steroid preventer inhaler to use every day. It is dangerous to use a long-acting reliever inhaler without also using a steroid preventer inhaler.
  • Your GP, asthma nurse or pharmacist should show you how to use your inhaler properly so that every dose is effective.
  • Your long-acting reliever inhaler will not help during an asthma attack. Keep your fast-acting reliever inhaler (usually blue) with you at all times so you can use it if you have any asthma symptoms, such as coughing, wheezing, shortness of breath and tightness in the chest.

There are two different types of long-acting reliever inhalers:

  1. Long-acting beta agonists (LABA) - for example, Serevent Evohaler (Salmeterol), Vertine Metered-Dose Inhaler (Salmeterol), Formoterol Easyhaler (Formoterol), Oxis Turbohaler (Formoterol) and Foradil Dry Powder Inhaler (Formoterol).
  2. Long-acting muscarinic receptor antagonists (LAMA) - for example, Spiriva Respimat (Tiotropium bromide).

How do long-acting reliever inhalers help asthma?

Long-acting reliever inhalers keep your airways opened up by relaxing the muscles around them. This helps you breathe more easily.

In addition to the above, long-acting muscarinic receptor antagonist (LAMA) inhalers have also been shown to reduce the amount of mucus produced in your airways.

The key things you need to know:

  • Your long-acting reliever inhaler doesn't replace your usual, short-acting reliever inhaler, which is just for emergencies (it's usually blue). Your long-acting reliever medicine helps to ease day to day problems that can occur if you’re having trouble getting enough breath. If your symptoms suddenly get worse - perhaps because of an asthma trigger - your short-acting reliever inhaler is what you need to get on top of your symptoms quickly.
  • Long-acting reliever inhalers should only be used if you've also been prescribed and are correctly using:
    - a steroid preventer inhaler to use every day as prescribed
    - a short-acting reliever inhaler to keep with you at all times for use when your symptoms flare up or in an emergency.
  • It is dangerous to use a long-acting reliever inhaler without a steroid preventer inhaler. This is because a long-acting reliever inhaler helps to keep your airways open, but doesn't treat the underlying inflammation in your airways. The inflammation makes your airways more sensitive and irritable. Without using a steroid preventer inhaler alongside a long-acting reliever inhaler, this underlying inflammation will just get worse and worse. This means your airways are more sensitive to your asthma triggers, and more likely to react to them, putting you at an increased risk of an asthma attack. So, basically, a long-acting reliever inhaler doesn't sort the whole problem out on its own.
  • Your GP or asthma nurse will sometimes 'mix and match' your medicines depending on your individual needs and your asthma symptoms to make sure you're taking the right combination for you. So, for instance:
    The medicine in a LABA inhaler and the medicine in a preventer might be prescribed in one device known as a combination inhaler

    A LAMA inhaler is sometimes prescribed as well as a LABA inhaler when someone is finding asthma symptoms difficult to manage using a preventer inhaler and a long-acting reliever.

Who might get benefits from long-acting reliever inhalers?

LABA inhalers are prescribed for adults and children age five and older who have poorly controlled asthma, even though they're taking their preventer inhaler and any other medicines they've been prescribed regularly, and in the right way.

LAMA inhalers are prescribed for adults who have poorly controlled asthma, even though they're taking their preventer inhaler and any other medicines they've been prescribed regularly, and in the right way.

How often do you need to take them?

The relief of a long-acting reliever inhaler lasts longer than your short-acting reliever, usually around twelve hours instead of four. Unlike your short-acting reliever inhaler you need to take your long-acting reliever every day (some only once and some twice) even when you're not getting any asthma symptoms.

Possible side effects of long-acting reliever inhalers

Like all medicines, long-acting reliever inhalers can cause side effects. The important thing to remember is that a medicine is only ever available if clinical trials have shown that the benefits of taking it outweigh the risks.

Long-acting relievers may cause similar side effects to short-acting relievers. If you've been prescribed a long-acting reliever inhaler, you should be monitored at the beginning of your treatment and reviewed regularly. If you and your GP or asthma nurse find there is no benefit for you when you're using a long-acting reliever, you need to stop it and discuss alternative treatment options.

Get the best from your long-acting reliever inhaler

You'll get the most benefits out of your long-acting reliever inhaler if:

You use it as part of your package of medicines. Use it as prescribed, alongside your preventer inhaler or in your combination inhaler. Make sure you still use your short-acting reliever inhaler when you need it (when your symptoms flare up or in an emergency).

You remember to take it every day, exactly as prescribed. You might find it useful to set a reminder in your phone or make a note in your diary or on your calendar.

You don't stop taking it if your symptoms improve. If your symptoms do improve, it means that the medicine is working and you need to keep taking it to keep getting the benefits.

Your inhaler technique is correct. Ask your GP, asthma nurse or pharmacist to check it. This is especially important when you're using different types of inhalers because the techniques might be different for different inhalers. Even if you've been using inhalers for years, it's worth double-checking that your technique is correct. It's not uncommon to get confused, or even overwhelmed, when you're using lots of different inhalers, so don't be afraid to ask.

You can speak to your GP or asthma nurse if you have any concerns about any of your medicines. Our asthma nurse specialists are also just a call away on 0300 222 5800 (9am - 5pm; Mon - Fri).

Last reviewed April 2016

Next review due April 2019