Nurse takes blue inhaler away!

Hi new to this forum and looking to see if anyone has heard of this .... my daughter 20 and in university has severe asthma and has done since being really young. She has taken for quite sometime Budesonide/Formoterol (turbohaler) as a preventor. At her asthma check up at the university doctors (1st one), the nurse has taken her blue inhaler off her and told her to use her preventor as this too has relievers in it. I'm extremely concerned at this, but know the doctors won't talk to me. Anyone doing this, anyone had experience of this?

30 Replies

  • My 23 year old son has asthma and I can't say I've ever heard of this.I think you're right to be concerned. I certainly would be if my son's blue inhaler was taken away x

  • I've not heard of this either. The whole point of the blue inhaler is as a rescue for emergencies to be quick acting. Yes some preventers have an element of this but as far as I am aware (I could be wrong) they aren't meant to be used in place of the rescue inhaler as they meant to aid long term while the rescue inhaler is literally a quick fix.

    If it were me I would talk to you daughter about her raising this with the doctors and asking the rational and justification behind this decision considering she a severe asthmatic.

  • I've just looked it up and Budesonide/Formoterol (turbohaler) also known as Symbicort can be used two ways. According to net.doctors "It can be taken regularly to prevent asthma attacks (maintenance therapy), with a separate reliever inhaler (eg salbutamol) used to relieve asthma attacks. Alternatively, it can be used regularly to prevent asthma attacks AND used as a reliever when needed to relieve asthma attacks (maintenance and reliever therapy). The maintenance and reliever approach is only suitable for adults aged 18 years and over using the Symbicort 100/6 or Symbicort 200/6 strengths."

    So I guess it depends on what strength your daughter is taking as is over the age requirement.

  • Could they be referring to the SMART regime? (Ive tried to copy a link from the Asthma Uk website but it wouldnt work)

    Would have thought they ought to have discussed this better with your daughter if that's the case though.

  • Ah just seen Beth_19 reply, this describes the SMART regime.

  • Symbicort SMART leaflet here:-

  • Why don't you ask at the chemist they will know

  • I have a Fostair inhaler which is a preventive inhaler morning and night and can de used in the day as a reliever inhaler aswell. The specialist told me i should only use this inhaler but i also have a blue inhaler and i find the blue inhaler give me a quicker relieve than the Fostair but does not last so long. So trying to use the Fostair more but like to carry blue inhaler aswell just in case

  • I only use this inhaler as both as I'm doing the SMART. But I have back up from ventolin nebs for when lungs are really bad. I don't think they should have taken her reliver away if she has better control with 2 puffers. Sounds like they are just trying to save money which is very wrong. As I do the SMART I am allowed 2 puffers so I don't run out. If your daughter can't get on with just using it as the SMART maybe they will let her have reliver back.

  • Using the one actually costs the NHS more per prescription....I've seen the costs it costs the NHS something like £33.39 per fostair inhaler as compared to much less per ventolin.... and if your using the one for both you are most definitely going to be costing the nhs more... I would suspect the nurse thought she was doing your daughter a good turn (1 prescription instead of two or better asthma control )


  • Yes. I used to use symbicort like this and is was very effective for a time (until I needed a higher dose preventer). There is a limit to the amount you can take though because the steroid component. I believe that the thinking is that the formeterol is as quick acting as the blue inhaler and in taking the combined inhaler you are getting more steroid when you need it. I doubt it is cost cutting as I believe this is an expensive inhaler. I always find talking to a pharmacist useful.

  • Thank you all for your advice, I think I'll firstly look at the leaflet suggested and speak with a pharmacist and then ask her to go back to the docs and ask for more information. Thanks again :-)

  • I, too, thought they may have been thinking of the SMART regime. I also take Symbicort and it has worked well for me, and I hope to be on the SMART regime before too long. However, I had reason to consult with the Asthma UK nurses only the other day about a matter relating to this and she explicitly said you also still need ventolin, the blue inhaler, in case you have an asthma attack and need to take a higher than normal puffs. So your daughter would be well advised to go back to see a doctor, perhaps, and sort this out. I wish her well!

  • I have to be honest, I'd feel very anxious if I didn't have a blue inhaler to hand even though I'm also on a dual purpose inhaler. I actually rarely use it, but I like to know it's there.

  • I have Severe Asthma and on the same inhaler as your daughter. I am on the low dose one because it is more flexible, and I can use it upto 12 times a day, and regularly prescribed 3 puffs twice a day. I also have a ventolin\salbutamol inhaler, but do not use it very often. I am also surprised they have taken the ventolin\salbutamol off her because you don't need to rinse your mouth out after taking it, like you do the turbohaler. Maybe she is relying too much on her ventolin still and not using her turbohaler? Ventolin can affect the heart if you use it too much. Just wondering, but like you I would like to know why they have taken it away. I have had Severe Asthma for over 50 years, and have never had my ventolin taken off me. Got to go to Addenbrookes now, otherwise would write more.

  • Im on Symbicort too and use it as a reliever when needed. However I still have a blue inhaler just in case and also to use before exersize.

  • There are a lot of positives with SMART but it's not suitable for everyone. The nurse shouldn't be putting her on SMART unless she has discussed it with your daughter first and she has agreed.

  • Is she on symbicort?

    If she is then she's been moved to the smart regime! Where you use one inhaler for your preventer and reliever. It can work really well!

    Hope this helps!!

  • I have asthma and take duo resp spiromax which is roughly 80% steroid 20% reliever and have been advised by aras team to use this 4-6 times daily only need to use blue one if struggling or having asthma attack and its working fine but she should still have blue inhaler on hand in case her asthma excacerbates

  • To my knowlege u need both. Preventor is used everyday when well to help prevent asthma flare ups. Preventor usually has a steriod and medication to open airways. blue inhaler is the emergency one whichbi feel should be carried everywhere with us. blue inhaler is needed in emergency when we feel tight or wheezy or short of breath. I would seek second opinion on this. I would alwsys carry blue inhaler. Think nurse has got it wrong. Phone asthma uk helpline

  • The nurse sounds like she doesn't really understand Asthma. Your daughter needs to go to a doctor and get the blue inhaler as well as a letter to the nurse. It is always good to have the blue inhaler (I am assuming it is Ventolin) on hand for emergencies.

  • I can't see there being much of a saving from taking the Ventolin inhaler away. Increased use of the preventer would be more expensive. A Ventolin inhaler costs around £7 whereas some preventer inhalers can cost as much as £49.

  • No one should just take an inhaler from her they should tell her to limit her use to see if she no longer needs it. I would be extremely concerned and get to go back with you. If she has a genuine reason she can explain it then.

  • Hello I am sorry to hear about this. I find it very unusual that a medic would withdraw the blue reliever. Was she given any other reliever in its place? I take a Bricanyl turbo inhaler which is another automatic reliever. Your daughter should go to another GP surgery to get reassessed. Hope u get it sorted.

  • My dad uses a combined inhaler for preventer and reliever (was symbicort but recently changed to something else) and this works well for him.

  • I am a brittle asthmatic and I know what the nurse is talking about. I am on three inhalers and various tablets as well as a blue reliever inhaler. I am on Fostair (pink) and Spireva and the Fostair works as both a preventer AND a reliever and actually I use the Fostair much more than the blue one because I find it works so much better. Although I have never heard of a nurse actually taking it away...that isn't right I don't think. My consultant would want me to have every possible chance of saving myself - which means AS MANY INHALERS AS POSSIBLE if and when I need them. She should have perhaps instead given her an action plan with the advice on which inahlers to take rather than just take it away. I would certainly question it! I see one of the best asthma specialists in the UK and he would agree with me.

  • I myself am a nurse with severe asthma myself and under no account should she have taken her reliever inhaler away. I would question why and ask her full name and then state you will report her to the NMC Nursing and Midwifery Council for not adhering to the Code of Professional conduct see below.

    My Symbicort 400/12 has part reliever in it but if she had an attack there is protocol if you read asthma UK, despite the fact she would have been prescribed this by her own GP. I cant believe this honestly, and you need to report her for putting your daughter's health at risk. Read our code of conduct the first section page 5 section 4, pdf below. Also just to also tell you I've been under the care of a respiratory consultant for 4 years and they know I have Symbicort and take about 4 puffs Ventolin a day (blue one)

    Honestly she should not be interfering with your daughters treatment and you need to get int touch ASAP. Although the combination inhalers have small amount reliever in them if she had an attack the first thing they would say is take 5 puffs of Ventolin and now she hasn't got it. Please act on this.

  • My asthma nurse changed me onto Symbicort and the Smart regime, but I found it didn't help my symptoms as a preventor or as an emergency inhaler. I spoke to Asthma UK who were lovely and explained that the steroid in Symbicort was less potent than the steroid in my Seretide preventor and that could be the cause of it it's ineffectiveness. I went back to my surgery but saw a Doctor not an asthma nurse and he put me on Fostair and re-prescribed my Ventolin and said I could try the Smart regime again with Fostair but I didn't have to if it didn't work for me and to carry on using Ventolin as and when required. I would get your daughter to see her GP if she's worried or phone Asthma UK for advice.

  • Hi hun,

    I'm so sorry your going through this. First I am not a Dr. however, I do suffer from asthma as well. I have suffered with it since I was a teen. I am 29 now. I can honestly say my dr's freak out if my rescue inhalers even expire past a few days. You have every right to be concerned! I would tell her to go to her regular Dr. and get a new rescue inhaler. Rescue inhalers contain albuterol. The albuterol is fast acting, and it's what opens up the breathing passages so you can breathe faster. I'm sorry for the grammar. I'm not the best at it. lol However I hope I was able to help. P.S. She might be able to put you down on her chart if she's willing in the privacy act. :) Usually people put their husbands down. That way you can know what's going on. I wouldn't trust the nurse on campus that's for sure! However if she does happen to go into an attack without a rescue inhaler make sure to have someone throw a ice pack or bag of frozen vegetables on her throat. Then call ambulance. But see a REAL Dr A.S.A.P!

    God bless

  • the nurse should not have taken the blue inhaler of her see your docter and the fostair is not a reliever is is to open your lungs up the ventolin blue inhaler is

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