What Are the Different Asthma Inhalers? A Comprehensive Guide

October 6, 2025 •

4 min read

According to the CDC, over 25 million Americans have asthma, and for many, inhalers are an essential part of managing symptoms. Understanding what are the different asthma inhalers, their purpose, and proper usage is key to effective disease management and preventing life-threatening asthma attacks. This comprehensive guide will walk you through the various types of inhalers available today.

Quick Summary

Asthma inhalers are classified as either quick-relief or long-term control, delivered via devices like metered-dose, dry powder, or soft mist inhalers. Each type of medication and device serves a specific purpose for managing asthma symptoms or preventing future attacks.

Key Points

Quick-relief vs. long-term control: Inhalers are categorized by function; quick-relief (e.g., albuterol) treats attacks, while long-term control (e.g., corticosteroids) prevents symptoms daily.
Device types vary: The main device types are metered-dose inhalers (MDIs), dry powder inhalers (DPIs), and soft mist inhalers (SMIs), each requiring a different breathing technique.
Technique is crucial: Proper inhalation technique, such as using a spacer with an MDI or a forceful breath for a DPI, is vital for medication to reach the lungs effectively.
Rinse for steroids: After using an inhaled corticosteroid, rinsing your mouth with water and spitting it out helps prevent side effects like oral thrush.
Overuse of rescue inhaler is a warning: If you are using your rescue inhaler more than twice a week, it signals uncontrolled asthma that needs adjustment by a doctor.
Combination inhalers simplify treatment: Many maintenance inhalers combine a corticosteroid and a long-acting bronchodilator into a single device for convenience.
Choosing depends on the patient: The best inhaler depends on an individual's asthma severity, ability to use the device, and specific medication needs.

Two Main Categories: Relievers vs. Controllers

Asthma inhalers are broadly divided into two main categories based on their function: quick-relief (reliever) inhalers and long-term control (controller) inhalers.

Quick-Relief (Rescue) Inhalers

These are used to treat an asthma attack or worsening symptoms when they occur, providing rapid relief within minutes.

How They Work: Quick-relief inhalers contain short-acting beta-agonists (SABAs) that relax the smooth muscles around the airways. This opens the breathing tubes, making it easier to breathe and helps clear mucus.
Key Medications: The most common SABA is albuterol (brand names ProAir HFA, Ventolin HFA).
When to Use: They are essential for managing sudden symptoms like wheezing, chest tightness, or coughing, and may also be used before exercise to prevent exercise-induced asthma. If you find yourself using a rescue inhaler more than twice a week, it is often a sign that your asthma is not well-controlled and you should consult a doctor.

Long-Term Control (Maintenance) Inhalers

These inhalers are used daily on a long-term basis to prevent asthma symptoms and reduce inflammation in the airways. They are not for immediate relief during an attack.

How They Work: Controller inhalers address the underlying cause of asthma, which is chronic inflammation. The most common are inhaled corticosteroids (ICS) that reduce swelling and mucus production. Others include long-acting bronchodilators.
Key Medications:
- Inhaled Corticosteroids (ICS): Examples include fluticasone (Flovent HFA), budesonide (Pulmicort), and mometasone (Asmanex).
- Long-Acting Beta-Agonists (LABAs): These bronchodilators provide longer-lasting relief than SABAs and are always combined with an ICS in asthma treatment to prevent serious attacks. Examples include salmeterol and formoterol.
- Combination Inhalers: These devices combine an ICS and a LABA for convenience. Common brands include Advair (fluticasone/salmeterol), Symbicort (budesonide/formoterol), and Breo Ellipta (fluticasone furoate/vilanterol).
- Long-Acting Muscarinic Antagonists (LAMAs): Like tiotropium (Spiriva Respimat), these are another type of long-acting bronchodilator sometimes used for moderate to severe asthma.

Types of Inhaler Devices

Beyond the medication inside, the delivery method of an inhaler also varies. The three most common types are metered-dose, dry powder, and soft mist inhalers.

Metered-Dose Inhalers (MDIs)

Mechanism: MDIs are the most classic type, featuring a pressurized canister that delivers a fine spray of medication when pressed.
Usage: Users must coordinate pressing the canister with a slow, deep breath. Using a spacer device can help improve delivery, especially for those with difficulty coordinating their breath.

Dry Powder Inhalers (DPIs)

Mechanism: DPIs deliver medication as a dry powder that the user inhales using a quick, deep breath. They do not use a propellant.
Usage: The technique is different from an MDI; it requires a strong, fast inhalation to pull the powder into the lungs effectively.

Soft Mist Inhalers (SMIs)

Mechanism: SMIs release a slow-moving, fine mist of medication, which can be easier for some patients to inhale. They are also propellant-free.
Usage: The user needs to breathe in slowly and deeply as the mist is released, similar to a slow MDI inhalation but without needing a spacer.

Comparison of Inhaler Device Types


Feature	Metered-Dose Inhaler (MDI)	Dry Powder Inhaler (DPI)	Soft Mist Inhaler (SMI)
Mechanism	Pressurized canister releases a spray of medication.	Quick, deep breath activates and inhales the dry powder.	Spring-based system releases a slow-moving mist.
Inhalation	Requires coordination with a slow, steady inhalation.	Requires a forceful and quick inhalation.	Requires a slow, steady inhalation.
Spacer Use	Recommended to improve delivery, especially for children or those with coordination issues.	Not used with DPIs.	Generally not used.
Coordination	Can be challenging for some, but spacers help.	Less challenging for those who can take a strong, fast breath.	Easier for those with coordination difficulties.
Side Effects	Can contribute to thrush if containing steroids; mouth rinsing is key.	Less risk of thrush, but still recommended to rinse mouth after use if containing steroids.	Similar to MDIs; mouth rinsing for steroids.

Choosing the Right Inhaler

Selecting the best inhaler is a personal decision made with a healthcare provider based on several factors:

Asthma Severity: Mild, intermittent asthma may only require a rescue inhaler. Persistent asthma requires daily maintenance inhalers.
Inhaler Technique: A patient's ability to coordinate their breath and activate the device is crucial. Providers can assess if a patient is better suited for an MDI, DPI, or SMI.
Cost and Convenience: The cost, availability, and number of inhalers a patient needs to manage can influence the choice. Minimizing the number of different device types can reduce confusion.
Environmental Impact: Propellants in MDIs contribute to greenhouse gas emissions. DPIs and SMIs are more environmentally friendly options to consider.

Inhaler Side Effects and Proper Use

Side effects vary by medication type:

SABAs (Rescue Inhalers): Common side effects include a nervous or shaky feeling, rapid heart rate, or headaches.
Inhaled Corticosteroids (ICS): Mild side effects can include a sore throat, cough, or oral thrush (yeast infection in the mouth). Rinsing the mouth with water and spitting it out after each use is vital to prevent thrush.

To ensure your inhaler is effective, always follow the specific instructions from your doctor or pharmacist. If you have trouble, ask for a demonstration. Using a spacer with an MDI can greatly improve drug delivery to the lungs.

Conclusion

Navigating the world of asthma inhalers requires understanding the difference between quick-relief and long-term control medications, as well as the different types of delivery devices. By working closely with a healthcare professional to choose the right device based on your specific needs, technique, and lifestyle, you can effectively manage your asthma, prevent attacks, and lead a full, active life. Proper education on inhaler use and consistent adherence to your treatment plan are the most powerful tools for staying in control of your asthma.

For more information on proper technique for various devices, the American Lung Association provides useful guides on how to use inhalers.

Frequently Asked Questions

A rescue inhaler provides quick relief for sudden asthma symptoms or attacks, typically containing a short-acting bronchodilator like albuterol. A maintenance inhaler is used daily to prevent symptoms by reducing inflammation over time, and usually contains a corticosteroid.

A spacer is a plastic tube that attaches to a metered-dose inhaler (MDI) and holds the medication, allowing you to inhale it more slowly. It is recommended for people who have difficulty coordinating their breath with the MDI, including children and older adults, to ensure more medication reaches the lungs.

You should rinse your mouth and gargle with water after using an inhaler that contains a corticosteroid. This helps prevent a yeast infection in the mouth called oral thrush, a common side effect of these medications.

Rescue inhalers containing short-acting beta-agonists like albuterol can cause side effects such as a nervous or shaky feeling, a faster heart rate, or palpitations.

If your inhaler isn't providing adequate relief, it's crucial to consult your healthcare provider. This could indicate an incorrect inhaler technique, a need to adjust your medication, or that your asthma is not well-controlled.

A combination inhaler is a single device that contains two or more different medications, most commonly an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA). It is used for long-term control of moderate to severe asthma.

A nebulizer is a machine that turns liquid asthma medication into a fine mist, which is then inhaled through a mouthpiece or face mask. It is often used by young children, infants, or people who cannot use a standard inhaler effectively, as it requires less coordination.