Asthma Spray – Which are there and how are they used correctly?

There are numerous asthma sprays, because you can quickly lose track. To make sure that does not happen to you, has summarized the most important information about the various asthma sprays for you.

For asthma patients, various asthma sprays are possible. There is a seemingly endless list of drugs that work differently. But the multitude of asthma sprays does not seem so confusing, if you know that they can be assigned to two main groups: the so-called controllers and relievers.

  1. Controller: Long-term asthma sprays

Controllers are asthma sprays that are used as long-term medications. They suppress the chronic inflammation of the respiratory tract and thus relieve the swelling and mucus formation in the bronchi. As a result, these asthma sprays cause asthma attacks to be less frequent and less severe.

The effect of the controller only starts after about a week, which is why they are used in the long term as daily asthma sprays. This is the only way they can act as a preventative measure

  1. Reliever: emergency asthma sprays

Relievers are so-called beta-2 mimetics  or beta-2 agonists. These emergency or on-demand asthma sprays contain adrenaline-like substances that relax the cramped muscles of the bronchi. This expands the airways and makes breathing easier. Through this effect, relievers are also called bronchodilators. In addition, they contribute slightly to the removal of the mucus. Since the effect already occurs within a few minutes, these asthma sprays are suitable as emergency medications against an acute respiratory distress. As a long-term asthma spray they are unsuitable because they only fight the complaints and not the inflammation. So they do not affect the asthma itself. With very frequent use, it can also happen that the bronchi on the one hand be sensitive to external stimuli and on the other to get used to the spray, so that its effect wears off. However, this does not happen when relievers are used as needed only when needed. The adrenaline-like substances, however, can lead to side effects. These include tachycardia, tremors, restlessness and insomnia, but do not last long. If the drug enters the bloodstream through an overdose, it can lead to metabolic changes such as hypoglycaemia and mineral deficiency.

Reliever is available as a short-acting and long-acting variant:

  1. Short-acting relievers (SABA):
  • Duration of action from 2 to 6 hours
  • Medicines include salbutamol and albuterol
  1. Long-acting Reliever (LABA):
  • work for 6 to 12 hours
  • Active substances are z. B. formoterol and salmeterol
  1. Combination preparations as asthma spray

Combi preparations contain agents of the controllers and relievers, ie cortisone and a beta-2-mimetic. These include Viani, Foster and Inuvair.

Who needs which asthma spray?

Depending on the severity of the asthma, various asthma sprays are displayed. The organization GINA (Global Initiative for Asthma) has created a step model, according to which the therapy with asthma sprays is aimed.

  • ICS : inhaled corticosteroids (cortisone) = controller
  • SABA : short-acting reliever
  • LABA : long effective reliever
  • Anti-IgE: immunoglobulin E, omalizumab. In case of severe allergic asthma every 2 to 4 weeks injected by the doctor. Prevents long-term allergic symptoms.

Powder inhaler or metered dose inhaler? Which asthma spray is useful when?

Asthma sprays are available in the form of a powder inhaler or as a metered dose inhaler. The effectiveness of both asthma sprays does not differ, but they are suitable for different situations:


  • Drug is finely distributed with a spray
  • are easy to inhale (which makes them suitable for severe asthma or during an asthma attack)
  • Inhalation and release must be well coordinated (only this way the medication can spread well and evenly)


  • Active ingredient is released as a powder
  • a strong breath draws in the active ingredient (this requires a higher tidal volume and the mouthpiece of the inhaler must be firmly enclosed by the lips)
  • These asthma sprays are not suitable for severe asthma or during an asthma attack
  • the small powder particles can trigger coughing
  • Triggering and inhalation need not be coordinated