Asthma Health Center

Bronchodilators and Asthma

A bronchodilator is used by almost all people with asthma as a way to open the airway passages.

Short-acting bronchodilators are used as a "quick relief" or "rescue" medication, while long-acting bronchodilators are used every day to control asthma -- in conjunction with an inhaled steroid. 

What Are the Types of Bronchodilators for Asthma?

For treating asthma symptoms, there are three types of bronchodilators: beta-agonists,  anticholinergics, and theophylline. These bronchodilators are available in inhaled, tablet, liquid, and injectable forms, but the preferred method of taking the beta-agonists and anticholinergics is by inhalation.

What Are Short-Acting Bronchodilators?

Short-acting bronchodilators are called "quick-acting," "reliever," or "rescue" medications. These bronchodilators relieve acute asthma symptoms or attacks very quickly by opening the airways. The rescue medications are best for treating sudden asthma symptoms. The action of inhaled bronchodilators starts within minutes after inhalation and lasts for two to four hours. Short-acting bronchodilators are also used before exercise to prevent exercise-induced asthma.

For more information, see WebMD's article on Asthma Inhalers.

Short-acting bronchodilators can be used in an asthma nebulizer (breathing machine) in the form of a liquid to treat an asthma attack at home. 

For in-depth information, see WebMD's article on Asthma Nebulizers (Breathing Machines).

Overuse of short-acting bronchodilators, whether in asthma inhalers, in tablets, or in liquid, is a sign of uncontrolled asthma that needs better treatment. If you need to use your short-acting bronchodilators more than twice a week, talk with your doctor about improving your asthma controller therapy.

Short-Acting Bronchodilator Inhalers Available in the United States Include:

• Albuterol ( AccuNeb , Proventil HFA, Ventolin HFA, also available as a generic solution for nebulizers)
• Alupent ( Metaproterenol , available as a generic solution for nebulizers, see below)
• Levalbuterol (Xopenex)
• Pirbuterol (Maxair)

What Are Long-Acting Bronchodilators for Asthma?

The long-acting bronchodilators are used to provide control -- not quick relief -- of asthma. They should only be used in conjunction with inhaled steroids for long-term control of asthma symptoms. The long-acting bronchodilators are used twice a day.

Long-Acting Bronchodilator Asthma Inhalers Available in the United States Include:

• Advair and Symbicort (a combination of a long-acting beta-agonist bronchodilator and an inhaled steroid)
• Serevent (salmeterol)
• Foradil (formoterol)
• Perforomist (formoterol solution for nebulizers)

Long-acting beta-agonist bronchodilators increase the risk of death from asthma and should only be used as additional treatment for people who are also using an inhaled steroid. For details, see their black-box warning.

Are There Common Side Effects of Bronchodilators Used for Asthma?

Bronchodilators can have side effects such as:

• Nervous or shaky feeling
• Increased heart rate or palpitations
• Upset stomach
• Trouble sleeping
• Muscle aches or cramps 

How Do the Anticholinergic Bronchodilators Work?

The anticholinergics are bronchodilators mainly used for treating COPD (chronic obstructive pulmonary disease such as emphysema) and not commonly used for asthma. 

Atrovent (an anticholinergic bronchodilator) is available as an inhaler and also in a nebulizer solution. A dry throat is the most common side effect. If the medication gets in the eyes, it may cause blurred vision for a short period of time. An long-acting anticholinergic inhaler (Spiriva, tiotropium) is also available for patients with  COPD (as proven by airway obstruction that persists after an inhaled bronchodilator).