Australia has implemented major changes in asthma treatment, advising doctors to stop prescribing blue “reliever” puffers as the sole therapy for adults and adolescents over 12 due to increased risks of severe asthma attacks.
The National Asthma Council Australia (NAC) released the updated Australian Asthma Handbook, presented by Health Minister Mark Butler, marking a significant shift in how asthma is managed. The new guidelines encourage the use of inhalers combining anti-inflammatory medication with a reliever effect, rather than relying exclusively on short-acting beta2 agonists (SABA).
Statistics indicate that 474 Australians died from asthma in 2023. Overuse of blue puffers – more than three inhalers per year – is linked to a higher risk of severe attacks, while using twelve or more annually significantly raises the risk of death.
Clinical Associate Professor Debbie Rigby, pharmacist and Clinical Executive Lead at NAC, emphasized that inhaled corticosteroids (ICS) should now form part of every asthma treatment plan to reduce inflammation and prevent exacerbations. “SABA-only treatment is associated with higher risk of severe exacerbations compared with anti-inflammatory therapy or maintenance low-dose ICS,” she stated.
Minister Butler highlighted that the changes affect the 2.8 million Australians living with asthma, providing healthcare teams with updated clinical guidance to improve care and quality of life. NAC Guidelines Committee Chair Professor Nick Zwar stressed the importance of prescribing anti-inflammatory inhalers from day one rather than waiting for symptoms to worsen.
Dr Anita Muñoz from the RACGP Victoria noted that the guidelines also address the problem of self-medication, as many Australians were relying solely on over-the-counter blue puffers, increasing the risk of serious asthma episodes.
Despite the updated recommendations, blue puffers remain available for acute asthma management. The NAC now recommends that every patient carries a Written Asthma Action Plan and an anti-inflammatory reliever at all times. The 2025 edition of the Australian Asthma Handbook also includes updated guidance for diagnosing and managing asthma in infants and children.
