Maintenance and reliever therapy

Some people with asthma are prescribed Maintenance and Reliever Therapy (MART).

Maintenance and Reliever Therapy in brief

  • Some people with asthma are prescribed MART (Maintenance and Reliever Therapy). This inhaler combines a preventer and reliever as part of a specific treatment regime.
  • There are various MART brands available in the UK, including Symbicort SMART Regime, Fostair MART Regime and DuoResp Spiromax MART Regime.
  • When you're prescribed this combination inhaler you don't need another reliever inhaler for emergency symptoms, but your GP will explain this to you.
  • Take your MART 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.

Maintenance and Reliever Therapies (MART)

MART stands for Maintenance and Reliever Therapy. This is when you have been prescribed an inhaler to be used as both your preventer and your reliever as part of a specific treatment regime.

Not everyone using a combination inhaler is on one of these regimes.

If you're not sure about the therapy you're on, and how it helps your asthma, speak to one of our asthma nurse specialists on our Helpline on 0300 222 5800 (9am - 5pm; Mon - Fri). 

Who might get benefits from Maintenance and Reliever Therapies?

Maintenance and Reliever Therapies are designed for adults (aged 18 or over). They are usually prescribed for more difficult asthma and for people with asthma who might benefit from being able to increase the dose they're taking throughout the day when their symptoms get worse. They can do this up to a maximum dose when they're on these therapies.

Please note - even though you may be using the Symbicort Turbohaler, that does not automatically mean you are on the Symbicort SMART regime. For example, children under 18 may be on Symbicort but are unlikely to be on the Symbicort SMART regime.

What Maintenance and Reliever Therapies are there?

Ask your GP or asthma nurse if you are on a MART regime. Common brands in the UK include:

  • Symbicort SMART Regime
  • Fostair MART Regime
  • DuoResp Spiromax MART Regime.

These use a combination inhaler which includes both preventer and reliever medicines.

SMART and MART regimes help your asthma in the same way - they are just made by different companies and their inhalers have different drugs in them.

How do Maintenance and Reliever Therapies help asthma?

Whichever therapy you're on, you'll follow a specific action plan, which will help your asthma by:

  • preventing inflammation in the airways, so that you're less likely to react to your asthma triggers
  • relieving on-going asthma symptoms
  • relieving any symptoms when they come on.

If your symptoms get worse at any point during the day you can take up to the maximum dose you've discussed with your GP or asthma nurse. This should be written in your asthma action plan.

Do you need a reliever inhaler as well if you're on these regimes?

One key difference when you're on a Maintenance and Reliever Therapy, whether it's SMART or MART, is that you don't need another reliever inhaler (usually blue) for emergency symptoms. When your symptoms get worse you increase the dose of your SMART or MART inhaler, according to what's written in your MART action plan.

Is the Asthma UK asthma attack advice the same for SMART/MART regimes?

No. Asthma UK's asthma attack information is not designed for people using the SMART or MART regimes. You should have been advised by your GP or asthma nurse about what to do in an asthma attack and given a written asthma action plan specifically for your therapy. If you have not been advised or still feel unclear, speak to them as soon as possible.

Possible side effects of Maintenance and Reliever Therapies

As with the combination inhalers, there's not as much evidence about side effects specifically for SMART or MART regimes and it's likely that any side effects will be the same as for the preventer and reliever inhalers.

However, people on SMART or MART regimes may be on higher doses of asthma medicines and being on a higher dose can increase the risk of having side effects from the medicine. It's really important to go to your annual asthma review and other regular appointments so that your GP or asthma nurse can go through your asthma action plan with you and check how well your asthma is being controlled.

If you have any further questions about SMART or MART regimes, please speak to your GP or asthma nurse, or call our asthma nurse specialists on 0300 222 5800 (9am - 5pm; Mon - Fri).

Last reviewed July 2015