What Is a Long-Acting Bronchodilator?

A long-acting bronchodilator is a type of medicine used to help people with asthma or chronic obstructive pulmonary disease (COPD) breathe more easily. It works by relaxing the muscles around the airways, keeping them open for a long time, usually 12 hours or more. This makes it easier to breathe and helps prevent symptoms like coughing, wheezing, and breathlessness.

How does a long-acting bronchodilator work?

It works by targeting the muscles in your lungs that tighten up and make breathing difficult. By relaxing these muscles, the medicine helps keep your airways open, making it easier for air to move in and out of your lungs [1]. Unlike quick-relief inhalers, long-acting bronchodilators are not used for emergencies – they’re taken regularly to keep symptoms under control.

Who uses long-acting bronchodilators?

These medicines are usually prescribed to people with:

Asthma (especially when it’s not well controlled with a preventer inhaler alone)
COPD (chronic obstructive pulmonary disease)

They are often used alongside inhaled corticosteroids or as part of a combination inhaler.

What are the types of long-acting bronchodilators?

There are two main types:

1. Long-acting beta-agonists (LABAs)

Examples: Salmeterol, Formoterol
Work for around 12 hours or more
Often used with an inhaled steroid for asthma

2. Long-acting muscarinic antagonists (LAMAs)

Examples: Tiotropium, Aclidinium
Mainly used for COPD
Work by blocking signals that tighten the airway muscles

How are long-acting bronchodilators taken?

They are usually taken through an inhaler once or twice a day, depending on the medicine. Some are also available in nebuliser form for people who need higher doses. It’s important to use the inhaler properly so the medicine reaches your lungs effectively.

Do they replace your reliever inhaler?

No. Long-acting bronchodilators are not used to treat sudden symptoms or asthma attacks. You should still keep your reliever inhaler (usually a blue one) with you for quick relief when needed.

Are there any side effects?

Side effects are usually mild, but can include [2]:

Dry mouth
Headache
Shaky hands (with LABAs)
Fast heart rate

Always tell your GP or asthma nurse if you notice any problems or feel unwell after using your inhaler.

Why is it important to use a long-acting bronchodilator every day?

To keep your symptoms under control, the medicine needs to be in your system continuously. Skipping doses can lead to flare-ups or increased breathlessness, especially in people with COPD. Using it every day helps prevent long-term damage to your lungs.

Key Takeaways

Long-acting bronchodilators help relax the airway muscles and make breathing easier over many hours.
They are used daily for asthma and COPD and help reduce the risk of flare-ups.
They do not replace your reliever inhaler and are not used in emergencies.
There are two types: LABAs and LAMAs, often taken through an inhaler.
Always use them as prescribed and keep your technique checked by a healthcare professional.

Reminder: If you have asthma or COPD and need help understanding your inhalers or treatment plan, speak to your GP, asthma nurse, or pharmacist. The right daily treatment can make a big difference to your breathing and quality of life.

Sources

[1] Di Marco, F., Sotgiu, G., Santus, P. et al. Long-acting bronchodilators improve exercise capacity in COPD patients: a systematic review and meta-analysis. Respir Res 19, 18 (2018). https://doi.org/10.1186/s12931-018-0721-3

[2] Suissa S, Dell'Aniello S, Ernst P. Long-Acting Bronchodilator Initiation in COPD and the Risk of Adverse Cardiopulmonary Events: A Population-Based Comparative Safety Study. Chest. 2017 Jan;151(1):60-67. doi: 10.1016/j.chest.2016.08.001. Epub 2016 Aug 20. PMID: 27554300.