Changing to a lower-carbon inhaler

Find out what types of lower-carbon inhalers are available and how to use them

Asthma + Lung UK is working in collaboration with NHS England, NHS Scotland, NHS Wales and Department of Health (Northern Ireland) to support you to make changes so you can live better with your lung condition and help the environment at the same time.

This project has been supported through a funded partnership with NHS England. 

What is a lower-carbon inhaler?

Dry powder inhalers (DPIs) and soft mist inhalers (SMIs) have a lower carbon footprint than pressurised metred dose inhalers (pMDIs). This is because they do not contain propellants that produce powerful greenhouse gases.

There are different types of DPIs and SMIs.

Some common examples of DPIs and SMIs include Accuhaler, Aerolizer, Easyhaler, Ellipta, Forspiro, NEXThaler, Novolizer, Respimat, Spiromax, Turbohaler and Twisthaler. 

You can find out how to use most of these lower-carbon inhalers by watching our short inhaler technique videos.

You can find out more about the environmental impact of inhalers here.

Are lower-carbon inhalers safe and easy to use?

Changing to a lower-carbon inhaler works well for most people and can improve condition management. In other European countries, most people who need inhalers use lower-carbon inhalers. In Sweden, for example, 13% of inhalers sales are for pMDIs, compared to 70% in the UK.

Many adults find dry powder inhalers (DPIs) easier to use than pressurised metered dose inhalers (pMDIs) because it’s easier to get the technique right. Dry powder inhalers are breath-actuated. This means that you need to be able to breathe in strongly to inhale the powder.

Some older people, some children (particularly under 12) or people with more severe lung conditions may find it hard to do this, especially when symptoms are bad.

Another benefit of dry powder inhalers is that you don’t need to use a spacer, which makes these inhalers easier to carry around.

Changing to a lower-carbon inhaler is not linked to symptoms getting worse or an increased risk of asthma attacks or COPD flare-ups.

The decision to change inhalers should always be made together with your GP, respiratory nurse or pharmacist. They should show you how to use your new inhaler and you should both be confident that you can use it well.

Getting your inhaler technique right is quick and easy. If you want to find out the right technique for your inhaler, take a watch of our short inhaler technique videos.

If you’re asked to try out a new lower-carbon inhaler, it’s worth giving it a go. The inhaler technique will change, but your medicine will continue to work in the same way. But if it doesn’t suit you, talk to your GP, respiratory nurse or pharmacist about trying another inhaler, or changing back to the one you were using before.

How will this impact my prescriptions and cost?

Changing the type of inhaler you use won’t make your prescriptions more expensive. But we know it can be difficult to manage the cost of regular prescriptions, especially if you pay for other medicines as well. It’s really important that you keep taking your medicines as prescribed, to help you stay well.

The NHS Low Income Scheme (LIS) and buying a pre-payment certificate could help you cover the cost of your medicines.

Read more on the financial support you could be eligible for.

This NICE patient decision aid has information on the different types of inhalers available and can help you, with the support of your healthcare team, to decide which inhalers are best for you.

If your symptoms get worse

If your symptoms get worse or you have an asthma attack or flare-up of your symptoms, your GP, respiratory nurse or pharmacist may recommend that you still use a pMDI reliever inhaler with a spacer. This should be added into your asthma action plan or your self-management plan. 

Keeping track of your doses

Many people tell us that not having a dose counter on their inhaler is annoying, as it can mean you end up using an inhaler that no longer contains any medicine. An extra positive about lower-carbon inhalers is that most come with a dose counter.

This also makes it easier to plan ahead, as you can always tell how much medicine you have left.

Most DPIs and SMIs come with a built-in dose counter. SMIs turn red when they are almost empty and lock themselves after all the medicine has been used.

Most pMDIs don’t have a dose counter, so it can be difficult to know when your medicine has run out. Keeping track of how many puffs you’ve taken from your pMDI inhaler means that you won’t end up using an empty inhaler.

You can read more about keeping track of your pMDI inhaler doses on our common concerns about medicines pages.

Want to find out some other quick and simple ways to improve your lung health and help the environment at the same time? Take a look at our Inhaler choices page.

Get support

Call our Helpline for support with your condition. Get advice on your medicines, symptoms or travelling with a lung condition, or just call us to say hello.

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