06/05/2026
⚠️ People using a blue inhaler to help treat their asthma are being urged to contact their GP ⚠️
The call comes after changes in guidelines following research which showed long-term use of the medication could make the condition worse.
For decades the blue inhaler - known medically as a short-acting beta2 agonist or SABA - has been a lifeline for millions of people with asthma.
It contains salbutamol (such as Ventolin), and is a reliever or rescue inhaler used to provide immediate relief from breathing difficulties, quickly opening airways and relaxing muscles during asthma attacks, wheezing, coughing, or chest tightness caused by asthma or COPD.
However NICE, the National Institute for Health and Care Excellence, changed its guildelines and currently recommends that patients move away from the traditional blue inhaler which "masks the problem without fixing it".
Instead it says they should use combination inhalers that don't just relieve symptoms but tackle the underlying inflammation that causes attacks in the first place.
NICE warns "overuse is linked to a higher risk of attacks, hospital admissions and death". Nearly half of all blue inhaler users in England (48%) were prescribed more than two in 2024 to 2025, a level that specialists consider a warning sign.
Dr Amina Al-Yassin, a GP and clinical lead for children and young people's services at Brent Integrated Care Partnership. said: "They make people feel better, but only briefly. We now know that over time, they are likely to make asthma worse. Seeing a blue inhaler used alone is now a dangerous sign to me."
With good asthma control, a person should have few or no symptoms and rarely need to use their reliever inhaler. Following the new guideline, people aged 12 and over who are newly diagnosed or need step‑up treatment are expected to move to combination inhalers.
These combine an inhaled steroid and a long-acting beta2 agonist (LABA) medicine called formoterol in a single device. They treat the inflammation and prevent flare-ups while also providing immediate relief.
The new treatment plans are known as AIR (Anti-inflammatory Reliever) which uses the inhaler only as needed, and MART (Maintenance and Reliever Therapy), which uses the inhaler daily as well as when needed, for those with more frequent or severe symptoms.
Professor Ewan Maule, director of medicines and pharmacy, North East and North Cumbria Integrated Care Board (ICB), said: "For over 50 years, the blue inhaler has been prescribed for people with asthma, providing quick relief for breathing difficulties. We now know that asthma is not just about keeping the airways open, it’s also about controlling the inflammation, or swelling, that causes the symptoms in the first place.
"By upgrading to a combined treatment inhaler patients not only get the relief they need but also benefit from treatment that treats the root cause of their asthma. This can lead to fewer flare-ups, fewer hospital visits, and better long-term lung health."
The ICB advised: "Anyone currently using a blue reliever treatment inhaler is being encouraged to contact their GP practice to review their asthma plan to see if a new combination inhaler might work better for them."
GP practices provide two main treatments for asthma:
- Anti-Inflammatory reliever (AIR) - for people who only experience asthma symptoms less than twice a month, during certain times of the year, such as pollen season, when around pets, or during exercise
- Maintenance and reliever therapy (MART) plan, for people who have asthma symptoms more regularly
Claire Adams, ICB respiratory clinical lead added: "Having the right plan and using the right inhaler, in the right way, can make all the difference in managing asthma effectively.
"The new combination inhalers offer more protection and better control, helping people to live well and breathe more easily.
"Reviewing your asthma action plan with a healthcare professional will ensure you understand how to use the right inhaler correctly and get the best protection for your lungs, helping you to live symptom-free!" For more information on switching from ‘blue to new’, contact your GP surgery.
✍ Elaine Blackburne
