Asthma Experts vs. Reality: The Truth About Rescue Inhaler Refills

It can be frustrating when asthma specialists without asthma lecture us on how to manage our condition.

Take this comment from an asthma specialist, for example: "At some point, beta agonist overuse (let’s say more than 3–5 annual refills) is a risk factor for expensive urgent care visits, hospitalizations, or fatal outcomes, especially if the overuse approaches 12 or more units per year."

But where is the evidence to support this? While I agree that 3–5 annual refills might indicate poor asthma control for some, it’s not a universal rule. Many asthmatics, myself included, get an albuterol refill every month—not because of poor control, but because insurance limits us to one inhaler per month.

During severe asthma attacks, I might go through 1–3 inhalers in a single month. This makes it crucial to have more than one rescue inhaler on hand. If you wait until you need a refill, you might not have enough inhalers to get through a flare-up.

Additionally, some asthmatics—despite having well-controlled asthma—still require more than 3–5 albuterol inhalers per year, even if they’re not intentionally stocking up. For instance, I use Trelegy every day along with Singulair, and most days, my asthma is well controlled. However, I still experience mild shortness of breath on some days, requiring an extra puff or two (or three or four) of my rescue inhaler.

So, for asthma experts to assert that frequent rescue inhaler use automatically indicates poor control or increased risk of urgent care visits, hospitalizations, or fatal outcomes is misleading. While this might apply to some, it’s certainly not true for everyone—something I can personally attest to.