Not all asthma inhalers are the same: factors to consider when prescribing an inhaler

Abstract

National and international asthma guidelines stress that before making changes to patients' therapy their compliance and inhaler technique should be checked. This review addresses these issues and highlights the differences between inhalers in terms of inhaler technique, individual ability/competence, and ease of use. The advantages and disadvantages of metered-dose inhalers (MDIs) and dry powder inhalers (DPIs) are presented. The reformulation of beclometasone MDIs is discussed since there has been some confusion over prescribing and Regulatory Authorities have recommended that these should be prescribed by brand name and not generically. This review should provide prescribers with an update to help them appreciate the differences between inhalers thereby optimising each patient's inhaled treatment.

Conflict of interest statement

Henry Chrystyn has no shares in any pharmaceutical companies. He has received sponsorship to carry out studies, together with some consultant agreements and honoraria for presentation, from several pharmaceutical companies that market inhaled products. These include AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Innovata Biomed, Meda, Napp Pharmaceuticals, Teva, Trinity Chiesi, Truddell and UCB. Research sponsorship has also been received from grant awarding bodies (EPSRC and MRC).