Asthma inhalers come in two main types: the preventer, which is used every day to reduce airway inflammation and prevent symptoms, and the reliever, which opens the airways quickly when symptoms appear. Correct use includes shaking the inhaler, using a spacer, and rinsing the mouth after a steroid inhaler, along with a written action plan prepared by your doctor. Needing your reliever inhaler more often is a sign that your asthma is not under control [3].
Asthma inhalers are the main treatment for this long-term disease, but they only help if you know which inhaler to use and when, and if the medicine actually reaches your lungs. In this guide we explain the difference between the preventer and reliever inhalers, the correct steps for use, the role of the spacer, and what to do during an attack. This information is educational and does not replace an assessment by your doctor or pharmacist.
What is the difference between preventer and reliever asthma inhalers?
Asthma is a long-term condition in which the airways become inflamed and narrow, causing wheezing, coughing, shortness of breath, and chest tightness [1]. For this reason, an asthma treatment plan includes two types of medicine: quick-relief medicines that ease or stop symptoms, and controller medicines that are taken daily to prevent symptoms by reducing inflammation and preventing airway narrowing [1].
| Comparison | Preventer inhaler (Controller) | Reliever inhaler |
|---|---|---|
| Purpose | Prevents symptoms and attacks over the long term | Relieves symptoms quickly when they appear |
| When to use | Every day, regularly, as directed by your doctor, even when you feel well | When needed, or before a known trigger if your doctor advises it |
| How it works | Reduces airway inflammation | Opens the airways quickly |
| Should you always carry it? | Used at its scheduled time | Yes, it should be with you at all times |
NHS guidance recommends that treatment be determined according to the severity of symptoms. It may be a single inhaler used only when needed (AIR), a single inhaler for both daily prevention and relief (MART), or two separate inhalers: a daily preventer and a reliever used when symptoms occur. The guidance states that a patient should never be given a reliever inhaler on its own [3]. The right option for you is determined by your doctor. The names and formulations available in Jordan may differ, so ask your pharmacist about your inhaler type. Do not switch one inhaler for another or stop one on your own decision.
You can consult the Asthma Inhaler Prescription page and the Asthma Treatment page in the directory to find the type of service you are looking for, and the Asthma page to learn about the condition itself.
How do you use asthma inhalers correctly, step by step?
Correct use is essential for the medicine to work as it should. There are different types: the pressurized metered-dose inhaler (pMDI), the dry powder inhaler, and the soft mist inhaler. Your doctor, nurse, or pharmacist should show you how to use your inhaler [3]. The following steps usually apply to a pressurized metered-dose inhaler:
- Remove the cap and make sure the mouthpiece is clean, that the inhaler contains medicine, and that it has not expired.
- Shake the inhaler well. The NHS recommends shaking it between each puff [3].
- Sit or stand with your back straight, and breathe out gently, away from the inhaler.
- Close your lips around the mouthpiece, start a slow, deep breath in, and press the inhaler once at the start of the breath.
- Hold your breath for a few seconds if you can, then breathe out slowly.
- If your doctor has prescribed more than one puff, wait briefly, shake the inhaler, and repeat the steps.
- Replace the cap. If your preventer contains a steroid, rinse your mouth (see Section 4).
Dry powder inhalers are different: they usually do not need shaking and require a quick, deep breath in. Ask your pharmacist to show you how to use your specific inhaler in person. Illustrated educational materials are also available, including picture series on using an inhaler and spacer from the U.S. National Library of Medicine [1].
Why is it recommended to use a spacer with an inhaler?
A spacer is a tube or chamber that connects the inhaler to your mouth. It makes it easier to coordinate pressing the inhaler with breathing in, and it delivers a larger amount of medicine to the airways instead of it sticking to the mouth and throat. The NHS recommends using it with a reliever inhaler during an attack if you have one available [3].
How to use it
- Attach the inhaler to the spacer after shaking it.
- Press one puff into the spacer, then breathe slowly through the mouthpiece, or take a deep breath and hold it briefly.
- Repeat for each puff separately, and do not press several puffs at once.
- For young children, a spacer with a mask that covers the mouth and nose is used. Your doctor or pharmacist will determine the appropriate type.
- Clean the spacer according to the manufacturer's instructions, and make sure it is dry before use.
Should you rinse your mouth after using a steroid inhaler?
Many preventer inhalers contain an inhaled steroid to reduce airway inflammation. Some of the medicine may settle in the mouth and throat, so doctors and pharmacists usually advise rinsing the mouth with water and spitting it out after each use. You may also brush your teeth. This helps reduce the likelihood of hoarseness or oral thrush (candidiasis). A spacer also helps reduce the amount that sticks to the mouth.
Not every preventer inhaler contains a steroid, so ask your pharmacist about yours. If white patches appear in your mouth or hoarseness persists, tell your doctor. Do not stop the inhaler on your own, as your doctor may change the type or adjust the technique.
When does needing your reliever inhaler more often indicate that asthma is not under control?
If you find that you need your reliever inhaler more than before, this is a warning sign. The NHS advises seeing your doctor if treatments are not helping, if you need your inhaler more, if your symptoms are not improving, if they stop you from your usual activities, or if they wake you at night [3]. MedlinePlus notes that frequent attacks may mean that your treatment needs to be adjusted [1].
In practice:
- Record in a notebook or on your phone how many times a week you used your reliever, and whether coughing woke you at night.
- Bring this record and your inhalers to your appointment.
- Do not simply increase your use of the reliever on your own. The problem is usually inflammation, which requires an appropriate preventive plan.
- Make sure you use your preventer at its scheduled time and in the correct way, as poor adherence and poor technique are among the causes of poor control.
In children, signs of poor control include night-time coughing, tiredness, irritability, and dark circles under the eyes [2]. Read the article Asthma in Children: Wheezing, Night Cough, and the Inhaler Plan.
What is an asthma action plan?
An asthma action plan is a written plan prepared with your doctor. The NHS explains that your care team will go over how and when to use your medicines, how to monitor your asthma, how to avoid triggers, and what to do if your symptoms get worse. It is recorded in an action plan that you take with you to every appointment, and you are given a printed or digital copy [3]. The NHS also recommends a review at least once a year, which includes checking that you are using your inhaler correctly and updating the plan [3].
What should the plan include?
- The name of each inhaler, whether it is a preventer or a reliever, and when to use it.
- Signs of improvement and deterioration, and peak flow meter readings if your doctor requests them. This device may be given for use at home for several weeks to monitor lung function [3].
- The personal triggers you avoid.
- The steps to take when symptoms increase and when to call for emergency help.
Common triggers include dust mites, mold, pollen, animal fur, cold air, air pollution, smoking, and infections such as colds and influenza [1]. Among the precautions the NHS mentions: avoid smoking, get the flu vaccine, and consult your doctor or pharmacist before taking any medicine for another condition, because aspirin, ibuprofen, and beta blockers may trigger symptoms in some people [3]. For information on cough and cold medicines, see Cough and Cold Medicine: When to Use It with Caution. If you also suffer from nasal allergies, the article Nasal Allergy: How It Differs from a Cold and How It Is Treated contains useful information. To distinguish between types of infection, see Bacterial and Viral Infections.
What should you do during an asthma attack, and when should you call 911?
An attack is a clear worsening of symptoms. It may come on gradually or suddenly, and it can sometimes be life-threatening [1]. The NHS advises sitting with your back straight, staying calm, and using your reliever inhaler. In its guidance for those with a blue reliever inhaler: one puff every 30 to 60 seconds until improvement, to a maximum of 10 puffs, shaking the inhaler between puffs and using a spacer if available. For those with an AIR or MART inhaler: one puff every 1 to 3 minutes, to a maximum of 6 puffs [3]. These are general NHS guidelines. The usual dose determined by your doctor or pharmacist is the primary reference, and if your personal plan specifies a different maximum, follow it [3].
Call 911 or go to the nearest emergency department immediately if:
- You feel worse at any point.
- You have not improved after the maximum amount of reliever inhaler.
- You do not have an inhaler with you.
- A child is coughing severely, has severe difficulty breathing, or has pallor or blueness of the face, lips, or nails [2].
The NHS adds that if symptoms do not improve within 10 minutes and an ambulance has not arrived, the inhaler may be repeated up to the same maximum, and that you should not drive yourself to the emergency department [3]. Treatment of a severe attack in hospital may include oxygen, a nebulizer, and steroid tablets or injections [3]. To learn the principles of first aid, see First Aid.
Even if you recover from an attack, it is advised to see your doctor within two days to discuss treatment and reduce the risk of another attack [3].
Asthma inhalers for children and pregnant women, and common mistakes
Asthma often begins in childhood, usually before the age of five [2]. Not every child needs a preventer inhaler, as this depends on the severity of asthma and how often symptoms occur [2]. Doses for children are determined by weight and by prescription from a doctor or pharmacist guidance, and are not based on another person's dose. For young children who are unable to undergo lung function testing, a doctor may suggest a trial of treatment for several weeks [2].
If you are pregnant, tell your doctor that you have asthma, as controlling it is important for your health and the health of your baby [3]. Do not stop your inhaler out of fear without consulting your doctor.
Common mistakes
- Stopping the preventer inhaler when you feel better without consulting your doctor.
- Forgetting to shake the inhaler, or pressing it long after you have started to breathe in.
- Relying on the reliever alone.
- Not always carrying the reliever inhaler. The NHS advises that it should be with you at all times [3].
- Using an empty or expired inhaler, or sharing an inhaler with others.
How do you find an asthma inhaler doctor or the right clinic in Jordan?
Asthma is usually treated by pulmonologists, and allergy and immunology, pediatric, or general medicine specialists may also be involved depending on age and condition. Start from the Pulmonologists in Jordan page, then choose your governorate: Amman, Irbid, or Zarqa. Pages for other governorates are available in the directory. There are also health centers affiliated with the Ministry of Health and maternal and child health centers in the governorates, where you can ask about follow-up and vaccinations.
What to check in the profile
- The specialty, listed qualifications, and experience in managing asthma.
- The location, working hours, and contact or booking methods, if available in the profile.
- Whether they see children or pregnant women, if you need that.
Questions to ask at the appointment
- Which of my inhalers are preventers and which are relievers, and when do I use each one?
- Do I need a spacer? Can you observe how I use my inhaler?
- Does my inhaler contain a steroid, and how should I care for my mouth afterwards?
- What are my triggers, and what does my written action plan include?
- When should I come back, and what signs require emergency care?
Medication prices and general regulation in Jordan are overseen by the Jordan Food and Drug Administration (JFDA), and your pharmacist can explain how to use your inhaler. Please note that the ClinicsJo directory lists doctor and clinic profiles to help with searching and contacting, and does not provide consultations, prescriptions, or an assessment of treatment quality.
Frequently asked questions
What is the difference between a preventer and a reliever asthma inhaler?
The preventer inhaler is used every day, regularly, as your doctor directs, to reduce airway inflammation and prevent symptoms. The reliever is used when symptoms appear to open the airways quickly, and it should always be with you. Do not replace one with the other, and do not stop any inhaler without consulting your doctor or pharmacist.
Should you rinse your mouth after using an asthma inhaler?
If your preventer inhaler contains an inhaled steroid, it is usually recommended to rinse your mouth with water and spit afterwards. Brushing your teeth may also be added, to reduce the likelihood of hoarseness or thrush in the mouth. Ask your pharmacist whether your inhaler contains a steroid, and tell your doctor if white patches appear or hoarseness persists.
When do I need a spacer with my inhaler?
A spacer helps more of the medicine reach the airways, and it is useful for people who find it difficult to coordinate pressing the inhaler with breathing in. It is used especially with children, with a suitable mask. Health authorities recommend using it with a pressurized metered-dose inhaler if one is available. Ask your doctor or pharmacist which type is suitable and how to clean it.
What does it mean if I need my reliever inhaler a lot?
Needing the reliever inhaler more often is a sign that asthma is not under control, as is night-time coughing or disruption of daily activity. Do not simply increase your use on your own. Instead, see your doctor with a record of how many times you used it, as your preventer treatment or your technique may need to be reviewed.
What is an asthma action plan and why do I need one?
It is a written plan prepared with your doctor that specifies your medicines and when to take them, how to monitor your symptoms and triggers, what to do when symptoms worsen, and when to seek emergency help. It helps you and your family act quickly and correctly. It is reviewed at the regular check-up and updated when your treatment changes.
When should I call 911 during an asthma attack?
Call 911 or go to the nearest emergency department if symptoms worsen, if you have not improved after using your reliever inhaler at the dose your doctor specified, or if you do not have an inhaler with you. In children, severe coughing, obvious difficulty breathing, and pallor or blueness of the face and lips indicate an emergency. Do not drive yourself.
Sources and references
- Asthma | Asthma Attack — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Asthma in Children | Asthma Symptoms — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Asthma — NHS (UK National Health Service). Accessed: 2026-10-26.
