AIR and SMART asthma therapy

Key points about AIR and SMART asthma therapy

AIR and SMART asthma therapy refers to the use of combination inhalers Symbicort and DuoResp Spiromax to manage asthma.
AIR stands for anti-inflammatory reliever. It’s the use of your combination inhaler occasionally for relief of asthma symptoms. This is usually used in people with mild asthma who get symptoms intermittently.
SMART stands for single maintenance and reliever therapy and it's the use of your combination inhaler for prevention AND relief of asthma symptoms. This is usually used in people with moderate to severe asthma.
Read about AIR and SMART asthma therapy.

HN 0789 female pharmacist working in dispensary of community pharmacy 1

AIR and SMART asthma therapy refers to the use of the combination inhalers Symbicort and DuoResp Spiromax to manage asthma.

AIR stands for anti-inflammatory reliever. It's used for mild asthma. Read more about AIR.
SMART stands for single maintenance and reliever therapy. It's used for moderate to severe asthma. Read more about SMART.

These inhalers have a combination of 2 medicines, budesonide and formoterol, in a single inhaler.

Budesonide works by reducing inflammation. It works within hours and the effect lasts several hours.
Formoterol works to open your airways quickly (within minutes) and the effect will last at least 12 hours after the dose.

Note: Symbicort and DuoResp Spiromax are different devices – Symbicort is a turbuhaler and DuoResp Spiromax is a breath activated inhaler. The choice of which brand to use depends on which inhaler you find easiest to use. Your healthcare provider will show you how to use your inhaler. Good technique gives good asthma control. Read more about inhalers.

AIR is used for mild asthma

It's the use of your combination inhaler (Symbicort 200/6 or DuoResp Spiromax 200/6) for relief when you get asthma symptoms, eg, shortness of breath, wheezing, chest tightness and cough.
AIR is usually for people with mild asthma symptoms. 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 by occasional allergens, eg, other people’s pets
- you only need help managing your symptoms when you exercise.

SMART is used for moderate to severe asthma

It's the use of your combination inhaler (Symbicort 100/6, Symbicort 200/6 and DuoResp Spiromax 200/6) for the prevention AND relief of asthma.
You will need to use your inhaler every day AND when you get asthma symptoms, eg, shortness of breath, wheezing, chest tightness and cough.
This is usually for people with moderate to severe asthma symptoms.
Note: SMART is also sometimes called MART (maintenance and reliever therapy).

The following are examples of AIR and SMART action plans.

Fill this in with your doctor, nurse or other healthcare professional.
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 (exacerbations).

AIR Asthma Action Plan

SMART Asthma Action Plan

Symbicort Asthma Action Plan

air asthma action plan

Asthma and Respiratory Foundation, NZ, 2021

English(external link)
Samoan(external link)

SMART Asthma Action Plan(external link)
Allergy & Asthma Network, US

Symbicort Asthma Action Plan(external link)
National Asthma Council, Australia, 2020

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.

Usually, relief inhalers contain only a bronchodilator, which works to open the airways.
Preventer inhalers (also called maintenance inhalers) are usually corticosteroids which work to reduce swelling and inflammation of the airways.

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

AIR therapy

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 medicine so it can reduce inflammation which caused your symptoms.
This lowers your risk of having more symptoms or an asthma attack in the future.

SMART therapy

Using your combination 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 additional doses of your combination inhaler – up to a maximum of 6 inhalations, if needed. This quickly reduces inflammation of the airways and opens them.
Using SMART therapy is better for improving breathing and controlling symptoms in the long term and for reducing risk of asthma flare-ups (exacerbations).

You should also use your reliever inhaler during an asthma attack. In an asthma attack, symptoms can quickly worsen so it's important to act quickly.

Examples of a reliever inhaler are:

Symbicort®
DuoResp Spiromax®
Ventolin®
SalAir®
Bricanyl®.

Note: You should use a spacer if it can be used with your reliever inhaler. A spacer can help you get more of the medicine into your lungs and use your inhaler better. Read more about spacers for inhalers.