The recommended treatment for people with asthma aged 12 years and over is a 2-in-1 combination inhaler that contains the preventer medication budesonide and the reliever medication formoterol. This medication both reduces the risk of a severe attack, and provides immediate relief of asthma symptoms and ongoing relief of symptoms for up to 12 hours. The brand names for this medication are Symbicort® and DuoResp Spiromax®.


For people with mild asthma, this 2-in-1 combination inhaler can be used on its own as a reliever, and only taken as needed for asthma symptoms. Each time you use this inhaler you get the immediate relief from the reliever medicine, plus a dose of the preventer medicine which reduces the risk of an asthma flare-up (attack). This treatment is sometimes called ‘Anti-inflammatory Reliever’ (AIR) therapy by healthcare practitioners. You do not need a separate preventer inhaler if you are using this treatment.

For people with moderate to severe asthma, this 2-in-1 inhaler can be used as both a reliever and a preventer. This means you use this inhaler once or twice daily (as you would with other regular scheduled maintenance preventer inhalers) and as needed to treat asthma symptoms (as you would a reliever). This treatment is called ‘Single Maintenance And Reliever Therapy’ (SMART) by healthcare practitioners. You do not need a separate reliever inhaler when using this treatment.

Extensive international research has shown the 2-in-1 combination reliever inhaler containing budesonide and formoterol is far more effective in reducing the risk of severe asthma attacks than the traditional single reliever inhaler. This is because it offers a regular top-up of preventer medication to treat the underlying inflammation, as well as relieving short-term symptoms.