What is the difference between a rescue inhaler and maintenance therapy?

The function an inhaler has depends on the active substance and the treatment regimen. Some are used regularly as a long-term therapy, others as needed. Certain combinations of inhaled corticosteroid and a fast-acting bronchodilator (ICS/Formoterol) serve both purposes at once: treating the inflammation and providing rapid relief when needed. A purely as-needed treatment without corticosteroid is no longer recommended today.

Is inhaled cortisone harmful?

The inhaled amounts are very small and act almost exclusively locally in the bronchial tubes — the feared cortisone side effects from tablets practically do not occur. Untreated asthma is significantly more stressful for the body.

Do I have to use the maintenance therapy even when I feel well?

Yes — especially then. Being symptom-free is the effect of the treatment, not a sign that it has become unnecessary. Whether the dose can be reduced is decided by your doctor based on your progress.

Why is inhalation technique so important?

Only when inhaled correctly does the active ingredient reach deep into the bronchial tubes; with incorrect technique, much of it remains in the mouth and throat. Therefore, have your technique checked regularly at the surgery or pharmacy — especially when changing devices.

Can I exercise with asthma?

Yes, exercise is expressly encouraged with well-controlled asthma and strengthens the lungs. In the case of exercise-induced asthma, your doctor can adjust the treatment so that physical activity is well tolerated.

Asthma Inhalers — Procedure, Preparation & Cost

Asthma inhalers are medications for inhalation that act directly in the bronchial tubes — where the asthma is located. A distinction is made between preparations that rapidly dilate the airways and those that permanently calm the underlying inflammation; often both are combined. Because the active ingredient reaches the lungs directly, very small amounts are sufficient — this makes the treatment effective and at the same time gentle.

Typical Areas of Use

Asthma in adults and children
Episodes of shortness of breath and wheezing
Chronic cough associated with asthma
Exercise-induced asthma
Chronic obstructive pulmonary disease (COPD)

How It Works

1The diagnosis is first confirmed, usually with a lung function test and, depending on the situation, an allergy test.
2Your doctor puts together the treatment according to a step-by-step scheme. Adults, adolescents, and children aged 6 years and above should not be treated with a fast-acting reliever spray alone: the treatment should include an anti-inflammatory inhaled corticosteroid, because this has been shown to make severe asthma attacks less frequent. Which corticosteroid-containing reliever or maintenance therapy is suitable depends on age, symptom control, and risk of attacks.
3You will practice the inhalation technique directly in the surgery or pharmacy — the correct technique is crucial in determining how much active ingredient reaches the lungs.
4Follow-up appointments will assess how well the asthma is controlled, and treatment will be adjusted step by step — upwards or downwards.

How to Prepare

Note the situations in which shortness of breath or coughing occurs — for example, during exertion, pollen season, or infections.
Bring any inhalers or sprays you are already using so that your technique can be checked.
Mention any other conditions and medications, particularly beta-blockers.

Side Effects & Risks

Fast-acting bronchodilator sprays can temporarily cause palpitations, trembling, or restlessness.
Cortisone-containing inhalers can promote hoarseness and oral thrush (fungal infection in the mouth) — rinsing your mouth after inhalation helps prevent this.
With incorrect inhalation technique, too little active ingredient reaches the lungs, which can appear like treatment failure.
Excessive use of the rescue inhaler is a warning sign of poorly controlled asthma and should be assessed by a doctor.

Afterwards — and When to Seek Help

Pay attention to how often you need the rescue inhaler — increasing use, waking at night due to shortness of breath, or limitations in daily life are signs that the treatment should be adjusted. Rinse your mouth after inhaling cortisone-containing medications. If shortness of breath rapidly increases despite using the rescue inhaler, speaking becomes difficult, or symptoms persist for hours, seek medical help — in case of severe shortness of breath, call the emergency number 144.

Cost & Insurance

Physician-prescribed asthma inhalers are usually covered by mandatory basic insurance, as are lung function tests and follow-up check-ups — the Franchise and co-payment apply as usual. This is for guidance only, without guarantee; if in doubt, your health insurer will provide information.

Frequently Asked Questions

What is the difference between a rescue inhaler and maintenance therapy?: The function an inhaler has depends on the active substance and the treatment regimen. Some are used regularly as a long-term therapy, others as needed. Certain combinations of inhaled corticosteroid and a fast-acting bronchodilator (ICS/Formoterol) serve both purposes at once: treating the inflammation and providing rapid relief when needed. A purely as-needed treatment without corticosteroid is no longer recommended today.
Is inhaled cortisone harmful?: The inhaled amounts are very small and act almost exclusively locally in the bronchial tubes — the feared cortisone side effects from tablets practically do not occur. Untreated asthma is significantly more stressful for the body.
Do I have to use the maintenance therapy even when I feel well?: Yes — especially then. Being symptom-free is the effect of the treatment, not a sign that it has become unnecessary. Whether the dose can be reduced is decided by your doctor based on your progress.
Why is inhalation technique so important?: Only when inhaled correctly does the active ingredient reach deep into the bronchial tubes; with incorrect technique, much of it remains in the mouth and throat. Therefore, have your technique checked regularly at the surgery or pharmacy — especially when changing devices.
Can I exercise with asthma?: Yes, exercise is expressly encouraged with well-controlled asthma and strengthens the lungs. In the case of exercise-induced asthma, your doctor can adjust the treatment so that physical activity is well tolerated.