What are long-acting bronchodilators and what do they do?
Some people with asthma are prescribed a long-acting bronchodilator as an ‘add on’ treatment.
Long-acting bronchodilators relax the muscles around your airways, to help keep your airways open. They’re prescribed in addition to your regular steroid preventer treatment, to help prevent asthma symptoms such as breathlessness.
They’re called long-acting because the effect lasts at least twelve hours. Your short acting reliever inhaler (usually blue) lasts for up to four hours and is only for when your symptoms get worse or you're having an asthma attack.
The important thing to understand is that a long-acting bronchodilator helps to keep your airways open – but doesn’t treat the inflammation in your airways.
So if you’ve been prescribed a long-acting bronchodilator make sure you:
- Continue to take your steroid preventer medicine
“Inflammation makes your airways more sensitive and irritable,” says Dr Andy Whittamore, Asthma UK’s in-house GP. “Without a steroid preventer this will get worse and worse. If you’re not using a steroid preventer, you’re more likely to react to your asthma triggers and have an asthma attack.”
- Keep a reliever inhaler with you
“You’ll still need your reliever inhaler (usually blue) if your symptoms suddenly get worse and you need to get on top of your symptoms quickly,” says Dr Andy Whittamore.
“A few long-acting bronchodilators can relieve symptoms quickly as they come on, for example MART or SMART inhalers, but not all of them can. Make sure your GP or asthma nurse explains what your long-acting bronchodilator can and can’t do.”
Why your GP may prescribe a long-acting bronchodilator
Your GP may prescribe a long-acting bronchodilator medicine for you (or your child aged 5 and over) if your asthma is not well controlled, even though you’re taking your steroid preventer inhaler and any other medicines you’ve been prescribed regularly, such as LTRAs (leukotriene receptor antagonists).
What kinds of long-acting bronchodilator are there?
There are three kinds of long-acting bronchodilator:
- LABAs (long acting Beta 2 agonist), for example salmeterol and formoterol. People with asthma are most likely to be prescribed a LABA.
- LAMAs (long acting muscarinic antagonist), for example tiotropium. LAMAs are mainly prescribed for people with COPD (chronic obstructive pulmonary disease) but are sometimes helpful for people with more difficult or severe asthma who are in specialist care.
- Theophylline, which comes as a tablet or a capsule. You can read more about Theophylline here.
Your GP may prescribe a combination inhaler
A combination inhaler has two medicines in one device – a long-acting bronchodilator to relax the muscles around your airways and a preventer medicine to reduce inflammation.
Examples of combination inhalers which include both a long-acting bronchodilator and a steroid preventer include:
- Symbicort (budesonide with formoterol)
- Seretide (fluticasone with salmeterol)
- Flutiform (fluticasone with formoterol)
- Fostair (beclometasone with formoterol)
“Your GP or asthma nurse will work with you to find the inhaler, or set of inhalers, which works best for you and your asthma,” explains Dr Andy Whittamore. “The fewer inhalers you have to worry about the better, which is why combination inhalers are usually easier and safer.”
What are the possible side effects of long-acting bronchodilators?
Like all medicines, long-acting bronchodilators can cause side effects, but not everyone gets them.
Don’t forget that any medicine is only ever available if clinical trials have shown that the benefits of taking it outweigh the risks. Talk to your GP or asthma nurse if you’re worried so you can weigh up the benefits you get from the medicine and see if you can reduce the side effects.
Whenever your GP makes a change to your usual prescription, you should get another appointment four to eight weeks later. This is a good chance for you to check the new medicines are working and are right for you.
5 top tips for getting the best from your long-acting bronchodilator
Asthma UK’s in-house GP Dr Andy Whittamore says:
1. Take your long-acting bronchodilator regularly as prescribed.
“This kind of medicine only benefits you if you take it every day. You might find it useful to set a reminder on your phone or make a note in your diary or on your calendar.”
2. Don’t be tempted to stop your bronchodilator if your symptoms improve
“If your symptoms do improve, it means that the medicine is working. So, continue taking it if you want to carry on getting the benefits.”
3. Make sure you’re taking a steroid preventer medicine too
“You still need steroid preventer medicine too if you want to avoid symptoms and an asthma attack. The safest way is to use a combination inhaler.”
4. Always carry your usual blue reliever inhaler with you
“Stay safe when you get symptoms by always keeping your reliever inhaler handy. The only time you won't also need a reliever inhaler is when you've been put on a SMART or MART regime.”
5. Ask your GP to show you the best way to take your inhaler
“Different inhalers have different ways of working, so it’s worth checking that you’re taking yours in the right way. In between appointments, use Asthma UK’s inhaler videos to remind you of the technique, especially if you’re using a new inhaler.”
Need more advice?
Talk to your GP or asthma nurse if you have any concerns about any of your medicines.
And you can speak to one of our asthma nurse specialists on our Helpline by calling 0300 222 5800 (9am-5pm; Monday-Friday). Or you can WhatsApp them on 07378 606 728
Last reviewed March 2019
Next update due March 2022