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The role of Ventolin inhalers (salbutamol) in asthma care today

The use of Ventolin on this page refers to Ventolin inhalers (Accuhaler - Evohaler) only.

Ventolin (Salbutamol) pMDI/DPIs are indicated in adults, adolescents and children aged 4 to 11 years for use in the management of bronchospasm and/or reversible airways obstruction and also used for the relief of asthma symptoms. Ventolin should be used to relieve symptoms when they occur, and to prevent them in those circumstances recognised by the patient to precipitate an asthma attack (e.g. before exercise or unavoidable allergen exposure).1,2

In asthma, short acting beta-2 agonists (SABAs) including Ventolin Accuhaler/Evohaler should not be the main or only treatment. It is encouraged that SABAs should be prescribed with concomitant inhaled corticosteroid (anti-inflammatory).1,2

For babies and children under 4 years of age, see sections 4.2 and 5.1 of Ventolin Evohaler SmPC.1

Please refer to the SmPCs for full indications, contra-indications and other details.

Discover the role of inhaled Ventolin in asthma management:

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Ventolin in asthma care

Understand the appropriate use of Ventolin when implementing the 2024 BTS/NICE/SIGN Asthma Guidelines

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Assessing asthma control

As well as symptoms, check for other signs of asthma control to identify when an existing treatment (such as Ventolin) remains an appropriate option for patients

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Why prescribe Ventolin by brand

How branded prescribing may support consistent asthma control and treatment adherence

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Ventolin in asthma care

When is Ventolin an appropriate reliever option for people with asthma?
Ventolin remains an established reliever option when prescribed with concomitant inhaled corticosteroid (ICS) for appropriate patients in the following groups:3

  • Children under 12 years who may be unable to activate a dry powder inhaler during an acute asthma attack.
    Consider providing these patients with an additional metered dose SABA inhaler plus spacer for emergency use
  • Children aged 5 to 11 years with newly diagnosed asthma. Offer a twice-daily paediatric low-dose ICS, with a SABA as needed, as initial treatment. The guideline provides MART and conventional pathways for escalation if the child's asthma remains uncontrolled on paediatric low-dose ICS plus SABA or ICS/LABA
  • Children under 5 years with newly diagnosed or uncontrolled asthma. Consider an 8 to 12-week trial of twice-daily paediatric low-dose ICS, with a SABA as needed
  • Patients for whom AIR or MART regimens are unsuitable or not indicated

Please refer to the NICE/BTS/SIGN 2024 Guidelines (NG245) for details before prescribing.

How does the BTS/NICE/SIGN guideline support personalised care?
In November 2024, a collaborative guideline developed jointly by the BTS, NICE and SIGN was published, which updated and replaced previous guidance from these bodies on the diagnosis, treatment and monitoring of asthma.3

The combined BTS/NICE/SIGN asthma guideline NG245 emphasises personalised care, with age-specific recommendations for people aged 12 and over, children aged 5 to 11, and children under 5, as well as newly diagnosed patients.3

While the BTS/NICE/SIGN guideline recommends MART or AIR for the majority of asthma patients, there is still a need and recommendation for prescribing SABAs in certain patient groups (listed above).3

Patients of any age with an existing asthma diagnosis who are stable on an appropriate regimen (such as those comprising an ICS or ICS/long-acting beta agonist (LABA) plus Ventolin as needed) do not have to switch treatment.3

Assessing asthma control to identify when existing treatment (such as Ventolin) remains an appropriate option for patients

Monitor asthma control at every review to identify patients who can remain on an existing treatment regimen such as Ventolin, and those for whom alternative therapies should be considered.

Symptoms are important, but they may not provide a full picture of asthma control.

✔️ In addition to asking about symptoms, check for other signs to determine whether the patient's asthma is uncontrolled and may warrant a change in treatment:3

  • Time off work or school due to asthma
  • Overuse of reliever inhaler indicated by more than two SABA inhalers per year
  • Asthma exacerbations needing treatment with two or more courses of oral corticosteroids per year
  • Two or more asthma-related emergency department visits or hospital admissions

Use a validated symptom questionnaire, such as the Asthma Control Test (ACT) or Asthma Control Questionnaire (ACQ) to support your assessment.4,5

✔️ If a patient appears to have poorly controlled asthma, the guidelines emphasise assessment before adjusting medication.3

Review and address the possible reasons for uncontrolled asthma before changing an individual's asthma treatment.

Confirm the diagnosis, and review modifiable risk factors and triggers that may be impacting control, such as:3

  • Alternative diagnoses or comorbidities
  • Suboptimal adherence
  • Suboptimal inhaler technique
  • Smoking (active or passive), including vaping using e-cigarettes
  • Occupational exposures
  • Psychosocial factors such as anxiety, depression, relationships and social networks
  • Seasonal factors
  • Environmental factors (such as air pollution, indoor mould exposure).

Steps to review asthma control and treatment

STEP 1: IS ASTHAMA WELL CONTROLLED?

Consider using questionnaires, e.g., the Asthma Control test (ACT) or
Asthma Control Questionnaire (ACQ) to help quantify asthma control.

If not using ACT/ACQ, examples of questions that can help establish
whether the patient's asthma is controlled are:

  • Is asthma impacting the person's lifestyle, or restricting their normal activities, because of symptoms such as coughing, wheezing, shortness of breath and chest tightness?
  • Any asthma exacerbation needing treatment with oral corticosteroids in the past year?
  • Need to use a SABA reliever 3 or more days per week?
  • Having 1 or more nights per week when asthma causes night-time waking?
❌ ANY YES → STEP 2
✅ ALL NO = WELL CONTROLLED
→ NO ROUTINE SWITCH is mandated
→ Check technique/adherence/action plan
→ Prescribe by brand (familiar device)
→ Continue regular review

STEP 2: CHECK POSSIBLE CAUSES OF LACK OF CONTROL

Take into account and try to address the possible reasons for uncontrolled
asthma before starting or adjusting medicines for asthma:

  • Comorbidities/alternative diagnosis
  • Incorrect inhaler technique
  • Suboptimal adherence
  • Triggers (such as smoking or vaping, allergens, psychosocial or environmental factors)

Issues found? → Fix first → Reassess
Still uncontrolled? → STEP 3

STEP 3: CONSIDER TREATMENT CHANGE

Follow age-specific guideline algorithm to determine next step

  • Under 5 years → BTS/NICE/SIGN guideline NG245 Algorithm E, local paediatric guidance (trial low-dose ICS + SABA)
  • 5–11 → BTS/NICE/SIGN guideline NG245Algorithm D, local paediatric guidance
  • ≥12 → BTS/NICE/SIGN guideline NG245Algorithm C, local guidance → AIR/MART

In patients of any age, ensure:
Shared-decision-making, education on new inhaler, follow-up review

Prescribing Ventolin by brand may support consistent asthma management

Consistency of inhaler device is very important for people with asthma. Changing from a regular, familiar device, particularly without adequate patient training or consultation, may negatively impact asthma control and patient outcomes.6 In part, this is because using any inhaler incorrectly can substantially reduce the amount of dose delivered to the lung.7 Furthermore, adherence is negatively impacted by changing treatments without consultation.6

Prescribing of Ventolin by brand may support your patients by ensuring they receive the inhaler they know how to use and prefer.6,8,9,10

To help reduce confusion and anxiety and ensure patients receive the inhaler they have been given training for, the brand and inhaler device should be specified when prescribing.9 Generic prescribing of inhalers is not encouraged, as it risks people being given an unfamiliar device at the point of dispensing.10

Important: Ventolin must always be prescribed with a concomitant ICS.3,11

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Ventolin safety information

Please refer to the Ventolin Accuhaler and Ventolin Evohaler SmPCs for full prescribing information, including the list of adverse reactions.1,2
Common adverse reactions include tremor, headache and tachycardia. Contraindications include hypersensitivity to the active substance or any of the excipients listed in 6.1 of the SmPCs. Non-IV formulations of salbutamol must not be used to arrest uncomplicated premature labour or threatened abortion.1,2 Ventolin Accuhaler is also contraindicated in patients with severe milk-protein allergy.2

Abbreviations

ACQ, Asthma Control Questionnaire; ACT, Asthma Control Test; AIR, anti-inflammatory reliever; BTS, British Thoracic Society; DPI, dry powder inhaler; ICS, inhaled corticosteroid; LABA, long-acting beta agonist; MART, maintenance and reliever therapy; NICE, National Institute for Health and Care Excellence; SABA, short acting beta-agonist; SIGN, Scottish Intercollegiate Guidelines Network.

References

  1. GSK.Ventolin Evohaler SmPC October 2025
  2. GSK. Ventolin Accuhaler SmPC November 2025
  3. BTS, NICE, SIGN. 2024. Asthma: diagnosis, monitoring and chronic asthma management NICE guideline NG245. www.nice.org.uk/guidance/ng245. Accessed April 2026
  4. Asthma Control Test: https://www.asthmacontroltest.com/en-gb/welcome Accessed April 2026
  5. Asthma Control Questionnaire. www.qoltech.co.uk/acq.html. Accessed April 2026
  6. Lavorini F, et al. Expert Opin Drug Deliv 2013;10:1597-1602
  7. Chrystyn H, Price D. Prim Care Respir J 2009;18(4):243-249
  8. Capstick T, et al. Pharm J 2015;294;7845. https://pharmaceutical-journal.com/article/letters/generic-prescribing-is-not-appropriate-for-inhaled-drugs. Accessed April 2026
  9. NICE BNF. 2026. Respiratory system, inhaled drug delivery. https://bnf.nice.org.uk/treatment-summaries/respiratory-system-inhaled-drug-delivery. Accessed April 2026
  10. NHS Specialist Pharmacy Service. 2026. Example medicines to prescribe by brand name. https://www.sps.nhs.uk/articles/example-medicines-to-prescribe-by-brand-name. Accessed April 2026
  11. MHRA. 2025. Drug Safety Update. Short-acting beta 2 agonists (SABA) (salbutamol and terbutaline): reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines. https://assets.publishing.service.gov.uk/media/680a0f63382965132de1aa69/SABA_DSU_FINAL_PDF.pdf. Accessed April 2026

Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/ or search for MHRA Yellowcard in the Google Play or Apple App Store.
Adverse events should also be reported to GSK on 0800 221 441 or UKSafety@gsk.com.

July 2026 | PM-GB-SLB-WCNT-260001 (V2.0)