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Pharmacists are being reminded of the risk of severe asthma attacks and increased mortality associated with overuse of short-acting beta 2 agonists (SABA) (salbutamol and terbutaline) with or without anti-inflammatory maintenance therapy in patients with asthma.

The latest MHRA Drug Safety Update also reminds healthcare professionals to be aware of the change in guidance that no longer recommends prescribing SABA without an inhaled corticosteroid.

Excessive use of SABA to relieve acute asthma symptoms may mask progression of the underlying disease and contribute to an increased risk of severe and potentially life-threatening asthma exacerbations.

SABA should not be prescribed to people of any age with asthma without a concomitant prescription of an inhaled corticosteroid, according to NICE guidelines (NG245 Asthma: diagnosis, monitoring and chronic asthma management).

Health professionals are advised to review and adjust asthma treatment in patients who take more than twice weekly “as needed” SABA, and urgently review those where there has either been an increase in the number of prescriptions requested for SABA reliever inhalers or a failure to collect prescribed anti-inflammatory maintenance treatment.

Asthma patients should be advised that if a blue inhaler is prescribed as the asthma reliever medication to be used during an asthma attack, a separate asthma preventer therapy will always be prescribed for regular daily use as well.