AIR (anti-inflammatory reliever) asthma therapy

Follow your AIR asthma action plan to help manage your symptoms. This a written plan to help you manage your asthma each day. It also tells you how to recognise and cope with worsening symptoms. Make sure you always carry your reliever with you. Remember to regularly check your inhaler technique with your healthcare provider.

If you have mild asthma

If you have mild symptoms, you only need to use your Symbicort or DuoResp Spiromax inhaler occasionally, when you get asthma symptoms, eg, shortness of breath, wheezing, chest tightness and cough.

Mild asthma is when:

• you only get asthma symptoms occasionally (less than twice a month)
• you only need help managing your asthma at certain times of the year, eg, during pollen season
• you only need help for symptoms triggered occasionally, eg, by other people’s pets
• you only need help managing your symptoms when you exercise.

If you have moderate to severe asthma

Use your Symbicort or DuoResp Spiromax for the prevention AND relief of asthma symptoms.

• If your asthma symptoms occur more frequently your healthcare provider will recommend that you use your inhaler (1 or 2 puffs) EVERY DAY, either once or twice daily, as a preventer. Your dose will depend on how bad your symptoms are. 
• Also, if your asthma symptoms get worse or you have an asthma attack, you can use extra doses of your inhaler – up to a maximum of 12 puffs daily if needed. This quickly reduces inflammation of the airways and helps you to breathe more easily. For more information, see asthma first aid below. 
• Note: The use of your anti-inflammatory reliever for the prevention AND relief of asthma symptoms is also called ‘Single inhaler Maintenance and Reliever Therapy’ (SMART).

Your asthma is getting severe when:

• your asthma symptoms are getting worse (wheeze, tight chest, a cough or feeling breathless), or
• your inhaler is only helping for 2 to 3 hours, or
• you're using more than 8 puffs a day in total (regular + reliever use), or
• you feel you need to see your healthcare provider.

How do I know when my asthma is under control?

Your asthma is under control when:

• you don’t have asthma symptoms most days (wheeze, tight chest, a cough or feeling breathless)
• you have no cough or wheeze at night
• you can do all your usual activities and exercise freely
• most days you do not need extra budesonide/ formoterol inhalations.

The following are AIR asthma action plans. It’s a written plan to help you manage your asthma each day. It also tells you how to recognise and cope with worsening symptoms. Fill this in with your doctor, nurse or other healthcare provider.

AIR Asthma Action Plan for Spiromax(external link)

AIR Asthma Action Plan for MDI with spacer(external link)

When you have asthma, inflammation in your airways can cause asthma symptoms and asthma attacks. Your airways get narrow and inflamed when you come across your asthma triggers, making it harder to breathe.

• Reliever inhalers usually have a bronchodilator, which works to open your airways.
• Preventer inhalers (also called maintenance inhalers) are usually corticosteroids which reduce swelling and inflammation of the airways.

The main benefit of AIR therapy is that you use 1 inhaler for both the relief of asthma symptoms when needed, and for prevention of asthma when it's used every day.

✔ Using a combination inhaler provides fast relief of asthma symptoms and opens up your airways quickly when you have asthma symptoms.

✔ It also contains a corticosteroid so it can reduce inflammation which caused your symptoms.

✔ This lowers your risk of having more symptoms or an asthma attack in the future.

✔ For moderate to severe asthma, using your combination AIR inhaler everyday prevents asthma and keeps your asthma under control.

✔ If your asthma symptoms get worse, or you have an asthma attack, you can use extra doses of your inhaler – up to a maximum of 12 puffs per day, if needed. This quickly reduces inflammation of your airways and helps you to breathe more easily.

✔ Using AIR therapy is better for improving breathing and controlling symptoms in the long term and for reducing the risk of asthma attacks.

You can also use your AIR inhalers (Symbicort or DuoResp Spiromax) during an asthma attack. It's important to carry your reliever inhaler with you at all times, because anyone with asthma can have a severe asthma attack. An asthma attack may be mild, moderate or severe and can take anything from a few minutes to a few days to develop. Symptoms may be mild or moderate and can quickly get worse so it's important to act fast.

Symbicort or DuoResp Spiromax

• • Use 1 puff initially and repeat if needed, up to 12 puffs daily. These inhalers quickly reduce inflammation of your airways and help you to breathe more easily.
  • If you have an asthma action plan follow the instructions on there.

Severe symptoms – call 111 if:

• • you're gasping for breath
  • you can't speak a full sentence in 1 breath
  • you're blue around the mouth
  • your peak flow reading's getting worse (if checked)
  • you've used a reliever inhaler but it's not helping much.

Continue to use your inhaler every few minutes until the ambulance arrives. Read more about asthma first aid.