@dr.erika.reiser: If you have asthma and your only inhaler is a blue puffer (Ventolin/salbutamol), this one's for you. This is one area where I think many of us in primary care have been a little slow to adopt newer evidence (myself included). Over the last several years, asthma guidelines have shifted away from using Ventolin alone for mild asthma. Asthma is an inflammatory disease and ventolin opens the airways, but it doesn't treat the underlying inflammation, which is where steroids come in.  Large clinical trials have shown that, for many people aged 12+ with mild asthma, using an as-needed combination inhaler (such as budesonide-formoterol/Symbicort) instead of Ventolin alone can reduce severe asthma flare ups by about 65%, reduce emerg visits and hospitalizations, and reduce the need for oral steroids.  
A few important points: 
-This recommendation applies to adults and adolescents (generally age 12+) with mild asthma.
- It doesn't apply to everyone with asthma, particularly those who need more intensive treatment.
- Ventolin isn't "bad" and it's still an excellent rescue inhaler. The issue is relying on it as your only treatment. The biggest downside in Canada is cost. Symbicort is considerably more expensive than Ventolin. If cost is a barrier, another evidence-based option is using an inhaled steroid whenever you use your Ventolin. It's not quite as effective as the combination inhaler, but it's a reasonable alternative and cheaper then a combo puffer.  As always, don't change your medications based on Instagram. If this sounds like you, it's worth bringing up with your family doctor or asthma care provider at your next visit. #asthma #puffers #asthmaexacerbation #evidencebasedmedicine

dr.erika.reiser

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Saturday 08 August 2026 14:49:15 GMT