Inhaler Update

Changes to Salbutamol Inhalers


As part of our practice commitment to provide excellent care and protect our planet, we are reviewing the prescriptions for some inhalers.


Which of your inhalers does this affect?

This affects your reliever (blue) inhaler, which you use only when you have symptoms. You may know it as your salbutamol inhaler, or by the brand-name Ventolin. Your pharmacy may dispense a salbutamol inhaler with a different brand name. It appears on your medication list as either of the following:

  • Ventolin Evohaler 100microgram/ dose
  • Salbutamol CFC-Free Inhaler 100microgram/ dose

Why are we changing these inhalers?

Your reliever (blue) inhaler is a metered dose inhaler, sometimes called an aerosol spray inhaler or a ‘puffer.’ This contains a propellant gas in the canister which is a powerful greenhouse gas that contributes to climate change. The propellants used in inhalers make up 5% of the carbon emissions the NHS generates each year. The NHS is therefore reviewing the use of inhalers to ensure we are using the inhalers that are least harmful to the planet (green), whilst ensuring they are equally as effective for treating your asthma.

Did you know using up a Ventolin inhaler creates the same carbon dioxide as driving from Downend to Leeds in a car? (170 miles!)

Salamol is a greener alternative to Ventolin. It contains Salbutamol (the same drug as in Ventolin inhalers) and is your rescue inhaler. It is the same dose as your previous inhaler.

The good news is that a Salamol CFC free inhaler creates about one third of the carbon emissions compared with your previous inhaler and research shows it is equally as effective as Ventolin, if used correctly. 

Is Salamol less effective than Ventolin? A randomised, blinded, crossover study in New Zealand - PubMed

Greener Practice - SALAMOL

Do you use a reliever (Blue) Inhaler?

Aerosol spray inhalers (pressurised metered dose inhalers) use propellant gases to deliver medication to the airways. These propellants are powerful greenhouse gases which contribute to climate change. Some aerosol spray inhalers have a lower carbon footprint than others even though they contain the same medicine. Salamol and Ventolin contains the same medicine: salbutamol. 

They work in the same way and have the same number of doses. However, Salamol has a lower carbon footprint than Ventolin because it contains less propellant gas. In order to reduce the carbon footprint of our patients' salbutamol inhalers we are changing the prescription to Salamol. This will not affect your asthma care. You may however notice a change in the taste of the inhaler. This is normal.

Ventolin is equal to travelling 175 miles in a car. But, Salamol is equal to 74 miles in a car.

What else can I do to help the environment?

Make sure your asthma is well controlled and you know how to use your inhaler. Having well-controlled asthma is the best thing you can do for yourself and the planet. If you have asthma and are using 3 or more reliever inhalers a year, this may suggest your asthma is not well controlled. Please speak to your GP practice to book an asthma review.

Return used inhalers to the pharmacy so they can be disposed of in an environmentally safe way.

Speak to your health care professional to ask if you are suitable for a dry powder inhaler. These inhalers do not contain any greenhouse gases and so have a much lower carbon footprint.


How will your prescription change?

The World Health Organisation has said that climate change is the greatest risk to health in the 21st century. We want to prescribe inhalers that release less greenhouse gases, to reduce the impact on climate change.

From now on, all prescriptions we issue for blue reliever inhalers will be for the lower carbon footprint Salamol inhaler (Salamol CFC-Free Inhaler 100microgram/ dose).


Why has the quantity of your Salbutamol inhaler been reduced?

Please visit this website which provides further information on why reduced quantities of Salbutamol inhalers are prescribed.

Changes to inhaler prescriptions: what they might mean - Asthma + Lung UK Blog


What do you need to do?

It is really important that you use your inhaler correctly to achieve the best effect. The Salamol CFC free inhaler requires a slow and steady breath, (rather than a sharp quick breath) to achieve the maximum dose into your lungs. Because Salamol contains less propellant than Ventolin, you may notice that you don’t feel the ‘spray’ of the inhaler as much. This is completely normal and providing you do a steady and slow inhale; the medicine will still work just as effectively. Some people notice a change in the taste of the inhaler and this is normal.

If you use a spacer device to help you use your medication this may need to be changed. If you find your new inhaler does not quite fit your current spacer, please contact our practice medicines management team who will arrange for a prescription for a new spacer.

See below for a video demonstrating how to use your inhaler:

How to use a pMDI inhaler

The best way to protect you and control your asthma, together with protecting the environment, is to get your inhaler regime right.

Good control of asthma should mean you do not have to use your reliever very often.

If you are using your rescue inhaler (blue in colour) more than 3 x a week (using more than 1 inhaler per month) it is a sign your asthma is not well controlled. Please contact the practice to arrange an Asthma review if this applies to you. Additional information on using the ‘wrong inhaler’ to manage your Asthma can be found here One million people in UK at risk of asthma attack because they could be relying on 'wrong inhaler'. Learn more on the Asthma and Lung UK website


What if you don’t want your prescription to change?

Please discuss this with your Asthma health care professional at your next visit or contact the surgery.