Calling Dr. Bauer

Several readers have asked about the benefits of one “brand” of inhaler compared to another. We have a poster in each of our clinic rooms that shows all of the inhalers on the market. This helps our patients tell us exactly what they are using at home. It’s hard to keep up, since every year or so there seems to be a new inhaler on the market.

International and national lung societies have published many guidelines for proper inhaler use. The broad outlines include when to use short acting bronchodilators (like albuterol), long acting bronchodilators, and/or inhaled steroids. Dosage strengths and frequency of use can be prescribed according to accepted standards of care.

The most variable aspect of inhaler use is the different delivery systems. The oldest inhaler is the classic “metered dose inhaler” or MDI that we puff once or twice into our mouth (or even better into a spacer). This delivers a small dose of a liquid aerosol. The other main delivery system is called a “dry powdered inhaler”. There are many versions of these inhalers. Some twist, some click and some twirl before each dose.

Several different drug companies/brands may all deliver the same medication. ProAir, Ventolin and Proventil are all the exact same albuterol medication! Often, the choice of inhaler boils down to patient preference. Proper technique is critical for adequate drug delivery to the lung. Some patients do better clicking and inhaling rather than squeezing and puffing. These days, some brands of the same medication are covered by an insurance company that may decline coverage of the same medication from a different drug company.

If it sounds confusing, it’s because it is! Most important is to use an inhaler you are comfortable with and that can reliably deliver the medication deep into your lungs! Your pulmonary doctor and respiratory therapist should be a good resource for further questions.