What is the best inhaler for intermittent asthma?

From the Guidelines

For intermittent asthma, a short-acting beta-agonist (SABA) inhaler such as albuterol is the best option. The typical dose is 1-2 puffs (90-180 mcg) as needed for symptom relief, not to exceed 4-6 puffs per day 1. Albuterol works quickly, usually within minutes, by relaxing the smooth muscles around the airways, making breathing easier during an asthma attack or before exercise to prevent symptoms.

Key Points to Consider

• These rescue inhalers should be carried at all times by people with asthma.
• If you find yourself using your SABA inhaler more than twice a week, this indicates your asthma may not be well-controlled and you should consult your healthcare provider about possibly adding a daily controller medication 1.
• The proper technique for using an inhaler is important: shake the inhaler, exhale fully, place the mouthpiece between your lips creating a seal, inhale slowly while pressing down on the canister, hold your breath for 10 seconds, then exhale slowly.
• Using a spacer device with your inhaler can improve medication delivery to the lungs.

Additional Considerations

• According to the 2020 focused updates to the asthma management guidelines, individuals aged 12 years and older with mild persistent asthma may benefit from intermittent ICS dosing, but this should be discussed with a healthcare provider 1.
• The choice between daily controller medication and as-needed ICS/SABA therapy should be made through shared decision-making with your patient, considering factors such as symptom perception and concerns about ICS side effects 1.

From the FDA Drug Label

The provided drug label does not directly address the question of the best inhaler for intermittent asthma.

The FDA drug label does not answer the question.

From the Research

Best Inhaler for Intermittent Asthma

The best inhaler for intermittent asthma can depend on various factors, including the severity of symptoms, patient preferences, and guidelines from reputable health organizations.

• According to the study 2, the Global Initiative for Asthma (GINA) recommends using symptom-driven or daily low-dose inhaled corticosteroids (ICS) for adults and adolescents with mild asthma, rather than relying solely on short-acting beta-2 agonists (SABAs).
• A study 3 found that regular use of short-acting beta-2 agonists did not have a significant impact on airway calibre measurements, but it did reduce the need for rescue medication and decreased the number of days with asthma symptoms.
• Another study 4 compared the effectiveness of different ICS and long-acting beta-2 agonist (LABA) combinations, including fluticasone/salmeterol and budesonide/formoterol, and found that these combinations were often more effective than monotherapy in improving lung function and symptom control.
• A more recent study 5 found that the combination of fluticasone furoate/vilanterol (FF/VI) was associated with better asthma control and fewer exacerbations compared to budesonide/formoterol (B/F) in a real-world setting.
• The use of combination inhaled corticosteroid and short-acting beta2 agonist (ICS-SABA) inhalers, such as ICS-albuterol, has been approved for as-needed treatment or prevention of bronchoconstriction and to reduce the risk of asthma exacerbations in patients 18 years of age and older 6.
• The GINA guidelines recommend as-needed ICS-formoterol as the preferred asthma reliever therapy, but also suggest using ICS whenever an as-needed SABA is used 6.

Key Considerations

• The choice of inhaler should be based on individual patient needs and preferences, as well as guidelines from reputable health organizations.
• Patients with intermittent asthma should work with their healthcare provider to determine the best treatment plan, which may include a combination of ICS and SABA or LABA therapy.
• Regular monitoring and follow-up with a healthcare provider are essential to ensure that the treatment plan is effective and to make any necessary adjustments.
• It is essential to consider the potential benefits and risks of different treatment options, including the risk of asthma exacerbations and the potential for side effects.