Gloved hand holding an inhaler

Asthma Medications: Steroid Inhaler or Is Albuterol Good Enough?

Posted by Jon Savage on Aug 28, 2023
Written by staff writer - Reviewed and edited by Dr. Jonathon Savage, DO - Emergency Physician

What is Asthma?

Asthma is a chronic respiratory condition that causes inflammation and narrowing of the airways. This can make it difficult to breathe, and can lead to symptoms such as wheezing, shortness of breath, and chest tightness. Emergency room visits for asthma are common, and can be costly. A steroid inhaler, while it will not make your symptoms go away quickly during an asthma attack, can be helpful in decreasing these symptoms for certain asthmatics.

What are Steroid Inhalers?

Inhaled corticosteroids (ICS) are a type of medication that is used to control asthma symptoms. They work by reducing inflammation in the airways. ICS are typically used as a long-term treatment for asthma, but they can also be used to prevent asthma attacks.

What are Some Common Steroid Inhalers?

Commonly used steroid inhalers include:

  • beclomethasone(generic name) - QVAR(brand name)
  • budesonide(generic name) - Pulmicort(brand name)
  • budesonide / formoterol(generic name) - Symbicort(brand name)
  • fluticasone(generic name) - Arnuity, ArmonAir, Flovent HFA, Flovent Diskus(brand names)
  • fluticasone / vilanterol(generic name) - Breo Ellipta(brand name)
  • fluticasone / salmeterol(generic name) - Advair(brand name)
  • mometasone /formoterol(generic name) - Dulera(brand name)

Should You be on an Inhaled Corticosteroid(ICS)?

Not everyone should be on a steroid inhaler. People with exercise-induced asthma only or those with just occasional flare-ups without the need for frequent use of the ER, medical visits, or refills of inhaler may do well with just using the albuterol inhaler and trying to control other factors that trigger the asthma.

Steroid inhalers have been shown to be more beneficial for individuals with moderate to severe asthma who meet the following criteria in any given year:

  • Needing to go to the ER because of the asthma
  • Needing to be kept in the hospital because of the asthma
  • 4 or more doctors visits or telemedicine visits due to the asthma
  • 4 or more prescriptions for asthma medications

How Does a Steroid Inhaler Help?

There is a growing body of evidence that suggests that inhaled corticosteroids can help to reduce emergency room visits for asthma. A study published in the journal JAMA Internal Medicine in 2002 found that people with asthma who used ICS were 45% less likely to have a subsequent emergency room visit than those who did not use ICS.

Another study, published in the journal Pediatrics in 2011, found that children with asthma who used ICS were 50% less likely to have an emergency room visit than those who did not use ICS.

The benefits of ICS in reducing emergency room visits are likely due to their ability to control asthma symptoms and prevent asthma attacks. When asthma symptoms are well-controlled, people are less likely to have to go to the emergency room. However, it is important to note that inhaled steroids are not a cure for asthma. They should be used in conjunction with other medications, such as rescue inhalers, to control symptoms and prevent flare-ups as well as changes to lifestyle (smoking for example) and environmental factors that can be causing flare-ups.

The American Lung Association has a post on how to Reduce Asthma Triggers. Additional recommendations can be found in another post titled: Managing Asthma Triggered by Seasonal Allergies

Are Inhaled Steroids Safe?

ICS are generally safe and well-tolerated. However, there are some potential side effects, such as a sore throat, hoarseness, and candidiasis (thrush) in the mouth and throat. These side effects are usually mild and go away on their own. Occasionally you may need medication for the candidiasis (thrush) which would require a separate prescription from the doctor.

Where Can You Get Treatment With Inhaled Corticosteroids for Asthma?

If you have asthma, it is important to talk to your doctor about whether steroid inhalers are right for you. An inhaled corticosteroid can help to reduce your risk of emergency room visits and improve your quality of life. If you have a regular doctor and can get into the doctor's office, or if they do online visits, please contact them. The evaluation of the appropriateness of using these medications can be done safely through an online visit ( also known as telemedicine, telehealth, virtual visits).


This post is for informational purposes only and is not intended as medical advice or treatment. If you feel you are having new or severe symptoms that has the potential to represent a severe or life/limb threatening condition, do not book a telemedicine appointment. Please call 9-1-1 or go to the nearest emergency room. Also note that inhaled corticosteroid should never be used in place of an albuterol inhaler for treatment during an asthma attack. It will not work quickly and will not improve symptoms during an actual flare-up or attack.


  • Wechsler ME, Irwin RS, Busse WW, et al. Low-dose inhaled corticosteroid therapy and risk of emergency department visits for asthma. JAMA. 2002;288(1):55-61. doi:10.1001/jama.288.1.55
  • Castro-Rodriguez JM, Holberg CJ, Wright AL, et al. The effect of inhaled corticosteroids on emergency department visits and hospitalizations for asthma among children. Pediatrics. 2011;127(6):e1318-e1325. doi:10.1542/peds.2010-2342
  • Adverse effects of inhaled corticosteroids. PubMed. 2023.

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