Bronchodilators

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Bronchodilators are a type of medication that make breathing easier. They relax the muscles in the lungs and widen the airways (bronchi).

What are bronchodilators used for?

Bronchodilators are often used to treat conditions where the airways become narrow and inflamed. For example asthma or chronic obstructive pulmonary disease (COPD).

Bronchodilators and corticosteroids

Inhaled corticosteroids are the main treatment for asthma. They reduce inflammation and prevent flare-ups. But some people may also benefit from taking bronchodilators too. These help to keep the airways open and enhance the effects of corticosteroids.

In people with asthma, long-acting bronchodilators should never be taken without corticosteroids.

In COPD, short or long-acting bronchodilators are given first. Corticosteroids are then added in some severe cases.

You may need separate inhalers if you’re being treated with corticosteroids and bronchodilators. These medications are often provided together in a single inhaler.

Types of bronchodilator

Bronchodilators may be either:

  • short-acting – used as short-term relief from sudden, unexpected attacks of breathlessness
  • long-acting – used regularly to help control breathlessness in asthma and COPD

The 3 most widely used bronchodilators are:

  • beta-2 agonists – like salbutamol, salmeterol, formoterol and vilanterol
  • anticholinergics – like ipratropium, tiotropium, aclidinium and glycopyrronium
  • theophylline

Beta-2 agonists and anticholinergics are available in both short-acting and long-acting forms. Theophylline is only available as an oral tablet in a long-acting form.

Possible side effects

Bronchodilators can sometimes cause side effects. These are usually mild or short-lived.

The side effects of bronchodilators can vary depending on the medication you’re taking. Make sure you read the leaflet that comes with your medication to check what the specific side effects are.

Beta-2 agonists

The main side effects of beta-2 agonists include:

  • trembling, particularly in the hands
  • nervous tension
  • headaches
  • suddenly noticeable heartbeats (palpitations)
  • muscle cramps

These often get better after you’ve been using beta-2 agonists for a few days or weeks. Contact your GP if your side effects persist, as your dose may need to be adjusted.

More serious side effects are rare.

Anticholinergics

The main side effects of anticholinergics include:

Less common side effects include:

  • nausea
  • heartburn
  • difficulty swallowing (dysphagia)
  • palpitations
  • throat irritation
  • difficulty urinating (peeing)
Theophylline

Theophylline can cause serious side effects if too much of it builds up in your body. You may need blood level tests during treatment. This will ensure that the levels of theophylline in your body are safe.

Older people are more at risk of developing side effects from theophylline. This is because their livers may not be able to remove it from their body.

The main side effects of theophylline include:

  • nausea and vomiting
  • diarrhoea
  • palpitations
  • a rapid heartbeat (tachycardia)
  • an irregular heartbeat (arrhythmia)
  • headaches
  • problems sleeping (insomnia)

Contact your GP if you have any of these side effects, as your dose may need to be reviewed.

Other medicines and bronchodilators

Bronchodilators may interact with other medicines. This could affect the way they work or increase your risk of side effects.

Some of the medicines that can interact with bronchodilators (particularly theophylline) include:

This isn’t all the medications that can interact with bronchodilators. Not all of these interactions apply to each type of bronchodilator.

If you want to check that bronchodilators are safe to take with your medication, ask your pharmacist or GP.

Pregnancy and breastfeeding

In most cases, bronchodilators should be taken as normal while pregnant or breastfeeding.

Speak to your GP if you regularly use bronchodilators and are considering having a baby or think you might be pregnant.

Pregnancy may affect your asthma. You should continue taking your medication and have it monitored regularly. This will ensure that the condition is controlled.

Last updated:
19 March 2024