Rescue vs. Long-Acting Inhalers: What’s the Difference?

The thing most commonly associated with asthma is undoubtedly the inhaler. Inhalers are a key part of treatment for asthma, which causes inflammation in the airways and restricts breathing.

“[Inhalers] are medications that relax the muscle in the bronchial tubes [or airways], dilate the bronchial tubes, and hence make it easier to breathe,” says Sidney Braman, MD, of Mount Sinai in New York City.

Despite most people’s familiarity with this life-saving device, many are surprised upon being diagnosed with asthma that there is more than one type of inhaler. Asthma inhalers, also called bronchodilators, come in two main forms: short-acting (or “rescue”) inhalers and long-acting inhalers.

Rescue inhalers are a “short-acting medication,” says Dr. Braman. “It’s inhaled; it can act within minutes.” Although it’s quick to offer relief, the effects of a rescue inhaler don’t last as long as a long-acting inhaler.

You would use a rescue inhaler during what most people call an “asthma attack.” This is when the individual is exposed to a trigger, such as cigarette smoke or exercise, and this causes a spasm in the bronchial tubes. The airways narrow and muscles constrict. (Learn more about causes of asthma attacks here.)

Rescue inhalers quickly work to relieve the spasm, relax and dilate the muscles, and allow easier breathing. Obviously, it is important for people with asthma to keep these rescue inhalers on hand.

“These attacks can sometimes not be predicted, and indeed you don’t want to be caught without this rescue inhaler,” says Dr. Braman. “It can lead to obviously distress symptoms, breathing problems, and—if not treated immediately—can progress and get worse and worse and lead to a life-threatening event.”

Long-acting inhalers are more of an everyday, preventative medication, but not everyone with asthma will use (or should use) a long-acting inhaler. Depending on what your doctor prescribes, you might use your long-acting inhaler once or twice a day, and it works all day to relax the bronchial tube. These are less often used for kids, and they should not be used without discussing the pros and cons with a pediatrician.

During an asthma attack, only rescue inhalers should be used. Long-acting inhalers take longer to offer relief, so it’s not appropriate for an emergency situation.

Inhalers aren’t the only treatment for asthma. Many people who use long-acting inhalers may also use an anti-inflammatory steroid treatment.

“Since asthma is an inflammation in the bronchial tubes, anti-inflammatory medications are extremely important,” says Dr. Braman. They minimize the level of inflammation in the airways, which can reduce swelling, mucus production, and breathing problems.

Long-acting bronchodilators and anti-inflammatory medications are often combined into a single inhaler for ease of use. This is referred to as a “combination inhaler.”

Two other treatments used for asthma include anticholinergics—which prevent muscle bands from tightening around the airways to relieve cough, mucus production, wheezing, and chest tightness—and targeted therapies. The latter is a new option meant for severe asthma only: It is given via shot or IV at the doctor’s office once a month.

No matter what your doctor prescribes, taking control of your asthma and adhering to treatments is crucial. Untreated asthma can cause the airways to remodel, or change, and the lungs may scar.