Are You Overusing Your Asthma Rescue Inhaler?


Sarah Handzel, BSN, RN

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As many as 25 million people living in the United States have asthma. This chronic, or long-term, lung disease causes your airways to become swollen and narrowed in response to certain triggers. For people living with asthma, rescue inhalers containing medications like albuterol (Proventil HFA, Ventolin HFA) provide immediate relief in the middle of an asthma attack.

But rescue inhalers are only intended to be used occasionally. However, some research shows as many as 27% of asthma sufferers use their rescue inhalers more than is necessary, including 12% of patients who use them every day.

Even if you use your rescue inhaler during an asthma attack, you may still have to take systemic steroids, like prednisone, to manage your symptoms. Rescue inhaler overuse, combined with frequent prednisone use, may indicate you have a severe form of asthma. In this case, it’s important to talk with your doctor about your symptoms, the frequency of your asthma attacks, and your medication use. If you have severe asthma, your doctor may need to modify your asthma action plan.

Using Rescue Inhalers

Rescue inhalers, like albuterol, are part of a class of medications known as adrenergic bronchodilators. During an asthma attack, smooth muscle tissue inside your airways swells and narrows, making breathing difficult. Rescue inhalers work by quickly relaxing and opening the smooth muscle tissue inside your airways. These medications help you regain control of your breathing sooner and can help reduce the severity of an asthma attack.

But rescue inhalers are only intended to be used during an asthma attack. They are not long-term control medications that you use every day. The medication inside rescue inhalers is short-acting and won’t control your symptoms for extended periods of time. Also, rescue inhalers don’t target inflammation, the root cause of asthma.

According to the National Institutes of Health (NIH), people living with asthma shouldn’t use rescue inhalers more than twice each week. Over-using rescue inhalers can lead to serious side effects. Studies show people over-using rescue inhalers actually experience more frequent asthma symptoms, including cough, wheezing, chest tightness, and nighttime awakenings. Additionally, you’re more likely to experience side effects of the medication itself, such as headache, shakiness, nervousness, and muscle aches.

Recent studies suggest overusing rescue inhalers puts you at higher risk of developing serious psychological problems, like depression. Also, some people using albuterol inhalers experience cardiac symptoms, including a rapid heartbeat (tachycardia) and feeling like your heart is pounding or fluttering (palpitations).  These are serious side effects and should be reported to your doctor immediately.

Prednisone Use May Indicate Severe Asthma

In addition to rescue inhaler use, many people living with severe asthma must often use systemic corticosteroids, like prednisone, to stop asthma attacks. Prednisone and other corticosteroids work by stopping your body’s inflammatory response. They are called systemic medications because they target inflammation throughout your entire body, not just in your lungs.

While many find prednisone to be effective at helping them breathe easier, you may be more at risk for developing complications, especially if you use this medication frequently over a long period of time. Corticosteroids like prednisone also suppress your immune system, increasing your risk for infection. Long-term use of these types of medications may increase your risk of glaucoma (increased pressure inside your eyes), adrenal insufficiency (a medical condition in which your adrenal glands don’t produce large enough quantities of certain hormones), and osteoporosis (a loss of bone density).

Because of these potential complications, it’s important to let your doctor know if you frequently use prednisone during your asthma attacks. Frequent use of this medication may indicate your asthma has gotten worse or that you have a severe form of the condition.

Rescue inhalers are key components of asthma action plans for many people living with the disease. But they are still only intended to be used occasionally, for short periods of time. If you find yourself using rescue inhalers frequently, or you must also frequently use prednisone during an attack, talk with your doctor about your medications and symptoms. Your doctor will work with you to change your asthma action plan to provide the best symptom relief possible.

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