Asthma reliever medicine

Do you or a loved one have asthma and only use a blue inhaler or reliever medicine such as salbutamol (Respigen®, SalAir®, Ventolin®) or terbutaline (Bricanyl®)? If you do, it’s time to talk to your doctor. Asthma guidelines have changed. Find out why and what you should do instead.

Asthma treatment has changed

If you are using only your blue reliever inhaler to control your asthma, talk to your healthcare provider about changing to a single 2-in-1 inhaler. 

The treatment of asthma has changed. It is now recommended that if you have asthma, you should use a single 2-in-1 inhaler containing both a preventer and a reliever medicine, to treat asthma symptoms.

The treatment has changed because evidence has shown that the single 2-in-1 inhaler is better for improving lung function and controlling symptoms in the long term and for reducing risk of asthma flare-ups (exacerbations).

The single 2-in-1 inhaler contains the medicines budesonide and formoterol in a single inhaler.

  • Budesonide is a corticosteroid which works by reducing inflammation. It works within hours and the effect lasts several hours.
  • Formoterol is a long acting beta2 agonist, which works to open your airways quickly (within minutes) and the effect will last at least 12 hours after the dose.

The long effect of these medicines means your symptoms are reduced for a longer time. This is important as even if you only have symptoms off and on or occasionally, you will have some degree of chronic inflammation in your airways. The single 2 in 1 inhaler is the most effective way of controlling this.    

Examples of the single 2-in-1 inhalers include Symbicort Turbuhaler, DuoResp Spiromax and Vannair. Each brand is a different device and the choice of which brand to use depends on which inhaler you find easiest to use. Your doctor, nurse or pharmacist will show you how to use your inhaler. Good technique gives good asthma control.

How to use budesonide/formoterol

Budesonide/formoterol is a 2-in-1 treatment used for both the prevention and relief of symptoms. Only one inhaler is needed. You do not need an extra inhaler as a reliever. You can use budesonide/formoterol in 2 ways, depending on how severe your asthma is.

For mild symptoms, use budesonide/formoterol occasionally as required for relief of asthma. Research has shown that a budesonide/formoterol inhaler, taken as needed, reduces the risk of a severe asthma attack by between 30–60% compared to the usual reliever inhalers. This is called anti-inflammatory reliever (AIR) therapy. See the AIR asthma action plan for more information.

For moderate to severe symptoms, use budesonide/formoterol every day PLUS when required for relief of asthma symptoms.

Asthma first aid

You should also use your reliever inhaler during an asthma attack. In an asthma attack, symptoms can quickly worsen so it's important to act quickly. Examples of a reliever inhaler are: Symbicort, Vannair, DuoResp Spiromax, Ventolin, Respigen, SalAir or Bricanyl. Note: You should use a spacer if it can be used with your reliever inhaler. Read more about asthma first aid.

(Asthma and Respiratory Foundation NZ)

Can I still use my reliever medicines salbutamol or terbutaline?

For people not changed to the AIR treatment, reliever medicines salbutamol or terbutaline can be used as a single dose before exercise to prevent asthma symptoms or alongside other inhalers such as steroid inhalers when you have shortness of breath or wheezing. Read more about asthma treatment.


  1. NZ adolescent and adult asthma guidelines 2020 Asthma + Respiratory Foundation, NZ
Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 19 May 2021