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Bronchodilators are a type of medication that make breathing easier by relaxing the muscles in the lungs and widening the airways (bronchi).
They're often used to treat long-term conditions where the airways may become narrow and inflamed, such as:
Bronchodilators may be either:
Inhaled corticosteroids are the main treatment to reduce inflammation and prevent flare-ups in asthma.
But some people may also benefit from taking bronchodilators to keep the airways open and enhance the effects of corticosteroids.
Long-acting bronchodilators should never be taken without corticosteroids.
In COPD initial treatment is with short- or long-acting bronchodilators, with corticosteroids added in some severe cases.
Treatment with corticosteroids and bronchodilators may require the use of separate inhalers, but increasingly these medications are provided together in single inhalers.
The 3 most widely used bronchodilators are:
Beta-2 agonists and anticholinergics are available in both short-acting and long-acting forms, whereas theophylline is only available in a long-acting form.
Beta-2 agonists are used for both asthma and COPD, although some types are only available for COPD.
They're usually inhaled using a small handheld inhaler, but may also be available as tablets or syrup.
For sudden, severe symptoms, they can also be injected or nebulised.
A nebuliser is a compressor that turns liquid medication into a fine mist, allowing a large dose of the medicine to be inhaled through a mouthpiece or face mask.
Beta-2 agonists work by stimulating receptors called beta-2 receptors in the muscles that line the airways, which causes them to relax and allows the airways to widen (dilate).
They should be used with caution in people with:
In rare cases, beta-2 agonists can make some of the symptoms and possible complications of these conditions worse.
Anticholinergics (also known as antimuscarinics) are mainly used to treat COPD, but a few can also be used for asthma.
They're usually taken using an inhaler, but may be nebulised to treat sudden and severe symptoms.
Anticholinergics cause the airways to widen by blocking the cholinergic nerves.
These nerves release chemicals that can cause the muscles lining the airways to tighten.
They should be used with caution in people with:
If you have benign prostate enlargement or a bladder outflow obstruction, anticholinergics can cause problems, such as difficulty peeing and not being able to empty your bladder fully.
Glaucoma can get worse if anticholinergic medication unintentionally gets into the eyes.
Theophylline is usually taken in tablet or capsule form, but a different version called aminophylline can be given directly into a vein (intravenously) if your symptoms are severe.
It's unclear exactly how theophylline works, but it seems to reduce any inflammation (swelling) in the airways, in addition to relaxing the muscles lining them.
The effect of theophylline is weaker than other bronchodilators and corticosteroids.
It's also more likely to cause side effects, so is often only used alongside these medicines if they're not effective enough.
Theophylline should be used with caution in people with:
Theophylline may make these conditions worse. In people with liver problems, it can sometimes lead to a dangerous build-up of medication in the body.
Other medicines can also cause an abnormal build-up of theophylline in the body. This should always be checked by your doctor.
Older people may also need additional monitoring while taking theophylline.
The side effects of bronchodilators can vary, depending on the specific medication you're taking.
Make sure you read the leaflet that comes with your medication to see what the specific side effects are.
General side effects of bronchodilators include:
In most cases bronchodilators should be taken as normal while pregnant or breastfeeding.
But speak to your GP if you regularly use bronchodilators and you're considering having a baby or think you might be pregnant.
Pregnancy may affect your asthma, so it's important to continue taking your medication and have it monitored regularly to make sure the condition is controlled.
Bronchodilators may interact with other medicines, which 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 is not a complete list of all the medications that can interact with bronchodilators, and not all of these interactions apply to each type of bronchodilator.
Always carefully read the patient information leaflet that comes with your medication.
You may be able to find a specific leaflet on the medicines A to Z on the MHRA website.
If in doubt, speak to a pharmacist or GP.
