Generic Asthma Inhalers

Controllers, Rescue Inhalers, and Nebulizers

Several inhalers and nebulizer solutions used for treating asthma are available as generic formulations, including albuterol, levalbuterol, ipratropium, budesonide, fluticasone/salmeterol, and others. They are bioequivalent to the brand versions, which means that they are expected to have the same action on the body.

Asthma Inhaler
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Brand name inhalers may be more familiar to you than generic versions, especially if you have been using asthma inhalers prior to the approval of these generic versions. Generics are worth exploring with your healthcare provider, pharmacist, and insurer, particularly because they may cost you less.

Brand-Name Inhaler Examples and Their Generics
Brand Generic Used For
Advair Diskus, Advair HFA fluticasone/salmeterol Long-term management
Xopenex levalbuterol  Acute symptoms
Flovent HFA fluticasone Long-term management
Proventil HFA, Ventolin HFA albuterol Acute symptoms
Pulmicort Flexhaler budesonide Long-term management
Atrovent HFA ipratropium Acute symptoms

The number of generic asthma inhalers has been increasing since 2016 and continues to increase as patents expire. Typically, medications that have been around for many years are more likely than new medications to be available in generic versions.

Controllers

Controllers are long-acting inhalers that often don't have immediate effects. They are used on a daily basis at scheduled times to prevent asthma symptoms (maintenance therapy).

For example:

  • Fluticasone and budesonide are steroids that reduce inflammation—a factor that contributes to asthma symptoms.
  • Salmeterol is a long-acting bronchodilator (LABA)—a drug that opens the airways in the lungs. It works by stimulating beta receptors in the lungs. This ingredient is a component of the fluticasone/salmeterol combination.

Combination asthma inhalers that contain more than one active ingredient will not necessarily be available in a generic version, even if each of the individual ingredients is available separately as a generic.

Rescue Inhalers

Rescue inhalers are used to stop symptoms once they occur. They work by opening the lung airways quickly, usually without long-lasting effects.

Examples of generic rescue inhalers include:

  • Albuterol, a short-acting beta-agonist (SABA) that opens the airways of the lungs
  • Levalbuterol, also a SABA
  • Ipratropium, an anticholinergic that opens the airways in the lungs by counteracting the action of acetylcholine, which narrows the airways

SMART Therapy

In some cases, a single inhaler is used for both control and rescue treatments. This is called Single Maintenance And Reliever Therapy (SMART). An example of this is Symbicort (budesonide/formoterol). Because the formoterol component of the medication is a long-acting beta-agonist that is also quick-acting, it can treat acute symptoms. Not everyone on this medication is prescribed to take it as both a controller and a rescue medication. If you have questions about how you are supposed to use this medication in your asthma treatment plan, be sure to ask your physician.

Nebulizers

A nebulizer is a device that can be used to administer asthma medication quickly. It is often used in the hospital for treating an asthma attack. There are also nebulizers for home use.

You can't place medication from your asthma inhaler into your nebulizer. If your healthcare provider recommends that you use such a device, they will give you a prescription for your asthma medication as a nebulizer solution formulation.

Generic nebulizer solutions are available, including:

  • Albuterol
  • Budesonide
  • Levalbuterol

This solution gets placed into the machine and you inhale the medication through a fine mist delivered through a mask that you wear over your nose and mouth or a mouthpiece that is inserted into your mouth that allows you to inhale the medication once the machine is turned on.

Safety and Effectiveness

Generic medications have the same active ingredients as the brand name versions. When it comes to effectiveness, research suggests that switching from a brand name to a generic asthma inhaler does not adversely affect health.

While there are a few drawbacks that have been noted with generic asthma inhalers, they aren't related to the medication itself.

One issue with generics is that some patients stop taking their inhalers when their prescription is switched to a generic version. Research suggests that this may be due to a lack of familiarity with the new dispensing device or a concern that the medication was changed without patient consent.

Furthermore, some combination inhalers are not available as generics. Switching from a brand combination inhaler to separate generics can be confusing if you got used to an all-in-one option.

If you're not comfortable with the idea of using multiple inhalers instead of a single combination, or if you are having a problem with your generic medication, talk to your healthcare provider or pharmacist—and be as specific as possible about your concerns. For example, perhaps one inhaler design is easier for you to use than another.

Making a Switch

If you are switching between brand and generic inhalers, you will need to make some adjustments. Note that packaging for each version may also differ. There can also be a learning curve, and you should ask for instructions or a demonstration so you know how to use your inhaler properly.

For example, you might need to learn how to use a new device or store your new medication differently.

If you need to prepare your medication for inhalation yourself, know that you usually can't use the generic medication in a brand inhaler device, or vice versa. Be careful to avoid mixing them up if your healthcare provider switches your prescription from one to the other.

This can be tricky if you pick up a new version before you have finished using up your old inhaler medicine.

When You Don't Want a Generic

You may have your own reasons for wanting to use a brand version of your inhaler, and that's fine.

Know, though, that your health insurer might require that you try a generic medication for a specified period of time before they agree to approve a brand version.

You might also have to pay a higher co-pay for a brand drug than you would for a generic.

If you don't want the generic version of your inhaler, make sure your healthcare provider writes a prescription specifically for the non-generic formula. Some insurers require that pharmacists default to the generic unless otherwise noted.

A Word From Verywell

You might be using several asthma medications to prevent and alleviate your symptoms. Typically, brand medications have the brand name and the generic name on the container, which can help you keep track of all of your medications so you won't take more than one version of the same thing.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
Daniel More, MD

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and formerly practiced at Central Coast Allergy and Asthma in Salinas, California.