Are there side effects from asthma inhalers? An In-Depth Look at Common and Long-Term Concerns

October 14, 2025 •

5 min read

According to the CDC, approximately 1 in 13 people in the United States have asthma, relying on medication delivered via inhalers to manage their condition effectively. While these treatments are life-saving for controlling symptoms and preventing attacks, many wonder: Are there side effects from asthma inhalers? The answer is yes, though they vary widely depending on the medication type and can often be managed with proper technique and guidance from a healthcare provider.

Quick Summary

Asthma inhalers, including rescue bronchodilators like albuterol and controller corticosteroids, have potential side effects that range from mild and temporary to more serious long-term issues at high doses. Understanding these risks, employing proper inhaler techniques, and discussing concerns with a doctor are crucial for safe and effective asthma management.

Key Points

Albuterol side effects are often temporary: Rescue inhalers can cause shakiness, a fast heart rate, and nervousness, which typically pass within a few hours.
Controller inhalers cause local side effects: Inhaled corticosteroids can cause oral thrush and hoarseness, but proper technique and rinsing your mouth can prevent this.
High-dose, long-term ICS require monitoring: While low doses are very safe, high doses over long periods can affect bone density, growth in children, and vision.
Using a spacer is key: This simple device improves medication delivery, reducing the amount in your mouth and minimizing localized side effects.
The benefits of inhalers outweigh the risks: Untreated asthma is more dangerous than managed side effects, and a doctor can help optimize your treatment plan.
Frequent rescue inhaler use is a warning sign: Needing your rescue inhaler more than twice a week (excluding exercise) indicates poor asthma control and requires a doctor's reassessment.

Understanding Different Types of Asthma Inhalers

Before diving into the side effects, it is helpful to understand that asthma inhalers contain different types of medication for different purposes. These fall into two main categories: rescue inhalers and controller inhalers.

Rescue Inhalers (Short-Acting Bronchodilators): These are used to provide quick relief during an asthma attack. They work by relaxing the muscles around the airways, making breathing easier. The most common medication in this category is albuterol.

Controller Inhalers (Inhaled Corticosteroids): These are used daily to reduce the inflammation in the airways that causes chronic asthma symptoms. They do not provide immediate relief and are essential for long-term asthma control.

Common Side Effects of Rescue Inhalers

Side effects from short-acting bronchodilators like albuterol are often related to its systemic effect on the body's beta-2 receptors, which are found in both the lungs and the heart. These side effects are typically temporary and subside within a few hours.

Nervousness or Shakiness: A feeling of jitteriness or tremors, especially in the hands, is one of the most frequently reported side effects.
Increased Heart Rate or Palpitations: You may experience a rapid or pounding heartbeat after using your inhaler. This usually isn't cause for concern in people with no pre-existing heart conditions but should be discussed with a doctor.
Headache: Mild to moderate headaches are a potential side effect.
Throat Irritation: The propelled medicine can sometimes cause a sore or irritated throat.
Hyperactivity: Particularly in children, increased excitability or hyperactivity can occur.

Common Side Effects of Controller Inhalers

Inhaled corticosteroids (ICS) are powerful anti-inflammatory medications. While generally well-tolerated, they can cause localized side effects. The risk of side effects from ICS is lower than from oral steroids because the medicine is delivered directly to the lungs.

Oral Thrush (Candidiasis): A yeast infection can develop in the mouth or throat, appearing as white patches.
Hoarseness (Dysphonia): Changes to the voice, or a hoarse voice, can be a result of the medication.
Cough: Some users may experience a cough after inhalation.

These side effects are largely preventable by using a spacer device and rinsing your mouth and gargling with water after each use.

Potential Long-Term Systemic Side Effects of High-Dose ICS

For long-term users, especially those on high doses, there is a small risk of systemic side effects. Your doctor will weigh these risks against the much greater danger of uncontrolled asthma.

Reduced Bone Mineral Density (Osteoporosis): Prolonged use of high-dose ICS can affect bone density. Long-term studies suggest this risk should be monitored, particularly for adults.
Growth Suppression in Children: Some studies have shown a temporary delay in growth velocity in children, but long-term data suggests it does not impact final adult height. Poorly controlled asthma itself can also suppress growth.
Skin Thinning and Bruising: This can occur with high-dose, long-term use.
Cataracts and Glaucoma: An increased risk of eye-related issues like cataracts and potentially glaucoma has been associated with long-term ICS use, necessitating regular eye exams.

Side Effects of Other Asthma Medications

Some long-acting bronchodilators, used in combination inhalers, also have potential side effects:

Long-Acting Beta-Agonists (LABAs): Can cause muscle cramps, tremors, and palpitations.
Long-Acting Muscarinic Antagonists (LAMAs): Can lead to a dry mouth or throat, or a metallic taste.

Comparison of Inhaler Side Effects

This table provides a quick overview of the potential side effects associated with the main types of asthma inhalers.


Feature	Rescue Inhalers (e.g., Albuterol)	Controller Inhalers (e.g., Fluticasone, Budesonide)
Purpose	Quick relief during an asthma attack	Long-term control of inflammation
Mechanism	Relaxes airway muscles	Reduces airway inflammation
Common Side Effects	Nervousness, shakiness, fast heart rate, headache, throat irritation	Oral thrush, hoarseness, cough, sore throat
Commonality	Common, especially with frequent use	Common, but preventable with technique
Prevention	Use only as directed; proper technique	Use a spacer, rinse and gargle after use
Long-Term Risk	Not for frequent, long-term use. Can lead to worsening control if overused.	Low risk at low-medium doses. Higher doses over long periods require monitoring for bone density, eye health.

Managing and Minimizing Inhaler Side Effects

By being proactive and following your doctor's advice, you can minimize or prevent many of the potential side effects associated with your inhalers. Here are some effective strategies:

Use a spacer: A spacer is a device that attaches to your metered-dose inhaler (MDI). It helps deliver the medication more efficiently to your lungs, reducing the amount that ends up in your mouth and throat and minimizing localized side effects like thrush and hoarseness.
Rinse and gargle after use: For inhaled corticosteroid users, rinsing your mouth and gargling with water immediately after each dose is one of the most effective ways to prevent oral thrush. Be sure to spit out the water to prevent systemic absorption.
Check your inhaler technique: Poor technique is a common reason for both reduced effectiveness and increased side effects. Ask your doctor, nurse, or pharmacist to demonstrate the correct method and have them observe you to ensure you are doing it right.
Track your usage: If you find yourself needing to use your rescue inhaler frequently (more than two times a week, not counting exercise), it’s a sign that your asthma is not well-controlled. This is the time to speak to your healthcare provider about adjusting your controller medication, not to just use more of your rescue inhaler.
Report side effects: If you experience bothersome side effects that don’t subside, or any serious side effects like a rapid heart rate or worsening breathing, contact your doctor immediately. They may be able to adjust your dose or switch you to a different medication.

Conclusion: Benefits Far Outweigh the Risks

While it is important to be aware of potential side effects, for the vast majority of people with asthma, the benefits of using inhalers to control their condition far outweigh the risks. Uncontrolled asthma can lead to dangerous, life-threatening asthma attacks and permanent damage to lung function. Regular use of controller inhalers and proper use of rescue inhalers are the cornerstones of effective asthma management.

Communicating openly and honestly with your healthcare provider is key. They can help you find the right balance of medications to manage your symptoms with the fewest possible side effects, ensuring you can lead a full and active life.

For more information on asthma management and medication, refer to resources from reputable health organizations like the National Institutes of Health.

Frequently Asked Questions

Yes, albuterol is a bronchodilator that can cause a faster heartbeat (tachycardia) and palpitations due to its effect on beta-2 receptors, which are also in the heart.

To prevent oral thrush, a yeast infection, always use a spacer with your inhaled corticosteroid and rinse your mouth and gargle with water immediately after each use. Be sure to spit out the water.

While oral steroids can cause weight gain, inhaled steroids used at standard doses are not typically associated with weight gain, as the medication is delivered directly to the lungs with minimal systemic absorption.

Long-term, high-dose use of inhaled corticosteroids can potentially lead to systemic issues like reduced bone density or cataracts. However, these risks are typically monitored by a doctor, and the benefits of controlling asthma usually outweigh the risks.

Studies on inhaled corticosteroids and growth in children have shown mixed results, but any delay in growth is typically temporary and does not affect final adult height. Poorly controlled asthma can also impede growth, making appropriate treatment vital.

Paradoxical bronchospasm is a rare, life-threatening side effect where a bronchodilator inhaler causes a sudden, unintended tightening of the airways instead of relaxation. If this happens, stop use and seek immediate medical attention.

If you experience severe side effects like chest pain, a dangerously rapid or irregular heart rate, or worsening breathing, you should call your doctor or get medical help immediately.