What? You Take Your Inhaler Every Day?!

By Andrea M. Jensen CHES AE-C

2 min read

When I first heard a doctor wonder about taking an inhaler every day at the Association of Asthma Educator's conference, I had to laugh out loud! Then quickly scribble it down in my notebook. I'm one of those pens and paper kind of gals, I prefer that to laptops or tablets.

The actual quote was, "If a patient tells you they use their inhaler every day, they are probably abnormal and need a psychological workup."

I didn't realize that I am abnormal!

How often should you use your inhaler?

I take my controller inhaler every morning and every night - it's just part of my routine. Even when I travel. Daughter is also very careful about making sure she doesn't miss a day. We take it because we know that it will keep the swelling down in our lungs, which means less asthma attacks for us.

This doctor was speaking about how hard it is for people to remember to take their inhalers. It's generally hard for people to remember to take ANY medicine every day. He said most people only take their medicine half of the time. He also said patients will tell their doctors that they take their medicine every day because they don't want their doctor to get mad at them or be disappointed.

So, instead of asking patients if they take their medicine every day (because everyone will answer yes), he'll say something like, "Most patients take their inhaler 2 or 3 days a week." And his patients will say, "Well I take mine 4 days a week!"

That helps him get a better story of what's going on with someone when their asthma is acting up. He knows they aren't taking it every day, but not sure how much of the medicine they are actually getting.

Each person's asthma is different

The NAEPP EPR 3 guidelines (national guidelines for diagnosing and managing asthma) suggest moving patients up and down a "set of stairs." It's called the stepwise approach. The doctor decides whether to move you up and down the "stairs" depending on your symptoms.¹

Your doctor may ask if your asthma wakes you up during the night and - if so - how often. He may also ask how often you are using your rescue inhaler (albuterol), or if your asthma interferes with your daily activities.¹ You can see how you are doing by taking the Asthma Control Test™.²

What's the point of testing asthma control?

Well, there's no reason to move you up to the "next stair" - a higher dose inhaler - to help your asthma symptoms if you aren't using the inhaler you already have. Your doctor may think you need more medicine, but your asthma could be worse because you aren't taking your medicine every day.¹

I know it's hard to remember to use your inhaler every day. Life is busy with kids, work, school, and traveling. Throw in an unexpected twist like forgetting to set your alarm, staying up late to finish a project, etc. and you may be thrown off your schedule and forget your inhaler.

If you do, be truthful and let your doctor know. He or she won't be mad, they are just trying to figure out the best medicine for you.

If you have a tough time remembering to take your inhaler every day, is there anything that helps you remember?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Asthma.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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John Bottrell, RRT Moderator & Contributor
Great article, Andrea. Since most controllers are once or twice daily, I keep them by my toothbrush. This is something I tell my patients too.. mainly because that's what I do and it works for me. But, unlike you, I'm normal -- at least according to the doctor you referenced. I wish I was abnormal then. John. Site Moderator.
1. Andrea M. Jensen CHES AE-C Contributor
 I think because we know exactly what will happen biologically with our lungs if we don't use our controller. So, we are not taking a chance! I also tell the families that I work with to pair it with another daily activity, such as put it near their toothbrush, vitamins, or by their coffee maker.
wheezyme Member
Funny! 😀 I take it regularly. At my first follow up visit with my current doctor (several years ago) he used a similar technique: He said "most people use it occasionally, or every other day. How often do you use it?" I didn't understand at first, and said "what do you mean? You told me to do it every day!" And he smiled and answered, "you know, most people don't do what I tell them". John, taking it before brushing my teeth is a useful routine for me also. Plus, it washes the ICS that might remain in my mouth!
1. Leon Lebowitz, RRT Moderator & Contributor
 Hi WheezyMe and thanks so much for your post AND for sharing your anecdotal experiences with your inhalers and your physician. It sounds like you have this all under control, too! Keep up the good work! Leon (site moderator)
emmejm Member
As a kid, I rarely took my controller or was using an empty inhaler (this was pre-dosage counter and my parents weren’t proactive caretakers). I had no schedule in life so I just took it when I remembered. It wasn’t until I started college that I improved. I reached “near perfect” when I was 21 or 22 and now take about 95% of my doses (every now and then I miss a Friday or Saturday night because I’m just TOO tired). I still haven’t managed to take my doses at 12-hour intervals, because the only way I manage to take them at all is by making it part of my bedtime routine
1. Andrea M. Jensen CHES AE-C Contributor
 Good for you! It's interesting to see how far inhalers have come. It's so nice to have counters on them now. And to understand how much better we feel if we keep taking them every morning and every night. I also will forget to take mine occasionally. But really feel better when I remember to take it on schedule!
norty Member
Which inhaler are you talking about? Rescue?, I hope.
1. Andrea M. Jensen CHES AE-C Contributor
 This article is about the importance of taking your controller (or maintenance) inhaler every day. That's the inhaler that will help you keep the swelling down in your lungs, not your rescue inhaler. Rescue inhalers should not be taken every day. The NAEPP guidlines say that if you use your rescue inhaler more than 2 times per week, your asthma is not controlled (because you have swelling in your lungs). If you are using your rescue every day, check back with your doctor! 😀
tootmed Member
This! A few months ago, I discovered I was missing one or two doses of my 2 puffs twice a day Dulera, and occasionally missing a dose of Spiriva. I stumbled onto the Propeller device. It looks like a little white cap that you stick on the end of the canister. You get an app on your smart phone or tablet. The device communicates with the app and your doses are recorded. If you are late or miss a dose, you can get notifications. It tracks trends and goals, you can enter symptoms and triggers that prompted use of rescue meds. I have one for Dulera, Spiriva, and Pro Air. There is not a device for nebulizers yet, but you can make manual entries very easily to track the DuoNeb treatments. The best part of all...totally free of charge for me. You provide your name, email address, shipping address, and list your asthma meds for which sensors are needed. No credit card or insurance information required. My sensors arrived in about 5 days. I love my Propeller system and have not missed a single dose of anything since I started using it, including my other routine meds, as it helps me to remember my whole morning and evening medication routine as a force of habit. You can even have reports sent to your doctor if you wish, and the dashboard of the app includes the asthma weather and air quality forecast for your location. Pretty cool system!