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. Ensure you always carry your reliever. Remember, to regularly check your inhaler technique with your healthcare provider.

If you have mild asthma

For people with 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 the severity of your symptoms.
• 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 below Asthma first aid. 
• 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 are using more than 8 puffs a day in total (regular + reliever use)
• or, you feel you need to see your doctor.

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 professional.

AIR Asthma Action Plan for Spiromax(external link), Asthma and Respiratory Foundation, NZ, 2025

AIR Asthma Action Plan for MDI with spacer,(external link) Asthma and Respiratory Foundation, NZ, 2025

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 the 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 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 the 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 risk of asthma attacks.

You can also use your AIR inhalers (Symbicort or DuoResp Spiromax) during an asthma attack. In an asthma attack, symptoms can quickly worsen so it's important to act quickly. You can use up to a maximum of 12 puffs daily, if needed. This quickly reduces inflammation of the airways and helps you to breathe more easily.

It is an emergency when

• Your symptoms are getting more severe quickly.
• Or, you are finding it hard to speak or breathe.
• Or, your budesonide/formoterol is not helping much.
• Or you are using your budesonide/formoterol every 1 to 2 hours.

If your symptoms are not improving, dial 111 for an ambulance immediately. 

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