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Inhalers have been key to asthma management��. The most common, salbutamol, comes in a familiar blue-coloured inhaler (or “puffer”).��

This kind of “rescue inhaler” brings quick relief from asthma symptoms. You may know these inhalers by their brand names such as Ventolin, Asmol or Zempreon.��

But there is����that using this kind of inhaler without treating the underlying condition may not only be ineffective – it could actually increase the risk of an asthma attack.��

Next month, the National Asthma Council is releasing����that reflect this shift. Here’s what’s changing and what you need to know.

Bronchodilators such as salbutamol act by relaxing smooth muscle in the airways. While they don’t address inflammation, which is the��, bronchodilators are effective at quickly opening up constricted airways.

This means for people experiencing typical asthma symptoms – such as tightness of the chest and shortness of breath – a puff of salbutamol����within ten minutes. The effect can last up to six hours.

Salbutamol is����people with asthma and other respiratory conditions, such as chronic obstructive pulmonary disease (which includes chronic bronchitis and/or emphysema). As part of a management plan made with a doctor, salbutamol is used to relieve shortness of breath when it occurs.

In Australia,����is purchased over the counter (without a prescription) in pharmacies. Many of these purchases����for people with infrequent asthma symptoms, meaning less than twice a month.

��Ƿɱ𱹱��,����there are safer and more effective ways for people with infrequent asthma to manage it in the long term.

Treating symptoms is only one part of asthma management. Salbutamol doesn’t address the root cause – why the airways of people who get asthma become constricted in the first place.

It’s a bit like taking pain relief for a swollen elbow without treating the tendonitis causing the pain.

In asthma, chronic inflammation is usually a result of��.��

��have airways that overreact to triggers in the environment. These triggers include pollens, moulds and dust mites, or air that is cold or humid.

Over the long term, chronic inflammation����in the airways. The airway walls become thicker and produce more mucus, allowing less space for air to flow through them.��

Using short-acting treatments such as salbutamol without addressing chronic inflammation in the airways poses risks.

Salbutamol can become less effective with regular use.����people with shortness of breath don’t gain the relief they expect and need, and paradoxically, their airways may become more “twitchy” (sensitive to environmental triggers) and inflamed. One response to this is people use more salbutamol and the problem is compounded.

Strong data����increased use of short-term inhalers such as salbutamol to higher risk of asthma flare-ups, hospital admissions and even death.��

�ʳܰ����󲹲����Բ�����salbutamol inhalers per year is considered��.

According to����in Australia and��, needing salbutamol for symptom relief on more than two days a week is an indicator of poorly controlled asthma, requiring review and possibly anti-inflammatory treatment.

In 2019, the Global Initiative for Asthma, an independent not-for-profit organisation,����its recommendations for salbutamol use. This is based on its committee of asthma experts reviewing the evidence.

Australian asthma guidelines from the National Asthma Council are set to follow suit.��

The council’s 2025 Australian Asthma Handbook����that salbutamol alone is inadequate treatment for asthma in adults or adolescents.��

Previously, the guidelines recommended people with infrequent symptoms to use salbutamol when needed and “alone” – that is, without an anti-inflammatory preventer.��

The new recommendations specifically warn against anyone with asthma using a short-acting bronchodilator such as salbutamol by itself, due to the increased health risks mentioned above.��

People with asthma who use salbutamol, for example, should also use an anti-inflammatory treatment that provides preventive cover, such as an inhaled corticosteroid.��

The 2025 Australian Asthma Handbook now recommends anti-inflammatory relievers����when it comes to asthma treatment in adults and adolescents.��

These inhalers contain, in a single dose (one puff), both a bronchodilator (to relieve symptoms) and a low-dose anti-inflammatory corticosteroid (to treat underlying inflammation).��

They are recommended instead of salbutamol-only inhalers for symptom relief, even for those whose symptoms are infrequent.

When used in place of salbutamol-only inhalers, anti-inflammatory relievers����improvements in quality of life for people with asthma, as well as lower risks of hospitalisations and death.

In the case of children with asthma,����emphasise the use of anti-inflammatory inhalers and discourage over-reliance on bronchodilators.

Currently, combination anti-inflammatory relievers are only available with a prescription from a doctor. These prescriptions with repeats can allow people with asthma up to 12 months of treatment.��

In Australia you can still buy salbutamol in a pharmacy without a prescription, after consultation with a pharmacist.��

However, if you have asthma and you’re concerned about the new guidance, you should speak to your pharmacist or doctor for advice.

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