Living with Asthma? Differences Between Daily and Rescue Inhalers

For approximately 25 million people living with asthma- COPD -related conditions in the United States (including nearly 5 million children), daily life involves at least one – and often two – inhalers to help open airways and improve lung function.

Understanding the difference between these daily inhalers (sometimes referred to as “maintenance” or “controller” inhalers) can improve your health, reduce unnecessary medication costs, and even prevent long-term damage to your respiratory system.

Daily vs. Rescue Inhalers

Daily (Maintenance or Controller) Inhaler: Inhaled corticosteroids, as well as other long-acting beta agonists (LABAs), work to reduce inflammation and provide ongoing disease management. Unlike rescue inhalers that should only be used in an emergency situation, controller inhalers are used routinely, often once or twice daily — even when the patient isn’t experiencing any symptoms.

Rescue Inhaler: These are short-acting beta agonists (SABAs). They work almost immediately to relieve shortness of breath, wheezing, and coughing by relaxing the muscles of the lungs so that the airways can open up and air can travel freely in and out. Rescue inhalers can be lifesavers during an asthma attack. The most commonly prescribed rescue inhalers are albuterol and levalbuterol.

Risks of Overusing Rescue Inhalers

As with any kind of ultra-repetitive physical exertion to your bones, joints, or muscles, overuse of asthma or COPD inhalers and medications can lead to significant health issues (worsen conditions leading to hospitalization, quality of life, etc.). One study estimated overuse of rescue inhalers is a $7-15 billion annual expense.

Chronic overuse of rescue inhalers can lead to:

- masking symptoms that may otherwise indicate an underlying problem/disease
- acquired tolerance of a rescue inhaler’s medication can gradually reduce its effectiveness
- tachycardia (increased heart rate)
- insomnia
- nervousness and irritability

Understand the Differences

For adults and children, understanding and memorizing the differences between rescue and maintenance inhalers can be easily achieved with a few minutes of learning and practicing:

- Know the difference: Whether by name, inhaler color, or any other method helpful to differentiate a rescue vs. maintenance inhaler, ensure the person using the inhaler(s) easily knows and can identify which inhaler/medication is for daily or emergency useage.
- Ask for help. Ask your doctor, pharmacist, or nurse to show you how to take the medicine. Sometimes a training device that doesn’t contain medicine is available to help you learn.
- Show what you learned. After learning how to take the medicine, use the inhaler in front of the doctor, nurse, or pharmacist.
- Get instructions. Ask for printed instructions or a video demonstrating how to use the inhaler.
- Learn about your medicines. If you need to use more than one inhaler, learn which one has the “rescue” medicine and which one has the “maintenance” medicine. Learn the correct names of the medicines.
- Learn to identify the correct medicine. If the inhaler devices look similar, ask your pharmacist to help you come up with a way to quickly identify the correct medicine. Do not use color to identify the inhaler. Maybe a special label can be used.

ACN Asthma Education Resource (.PDF)

Schedule an appointment with your doctor if you have any questions about using your inhaler, or if your breathing isn’t well-managed with your medications. Signs that your breathing isn’t well-managed include waking up in the night with asthma symptoms or unexpectedly needing your rescue inhaler more than twice per week.

Need support? If you’re an ACN member, our care coordination team can help you schedule an appointment with your provider: