If you have asthma you may well have been prescribed a Ventolin blue reliever inhaler to help reduce symptoms of asthma attacks. I’ve certainly been using one for years, since childhood. Look out for this old faithful drug to be replaced soon, as Ventolin seems to be on the way out as an asthma medication.

Your GP rejected your medication request!
A while ago the asthma nurse told me they were bad for your lungs and caused damage over prolonged use. This sounded like just a nonsense to me because she didn’t explain how or why and also didn’t recall my old Ventolin inhalers or prescribe a safer drug. Could this be the reason I can no longer get Ventolin for my asthma?
Because this month, when I requested a replacement for my expired Ventolin reliever inhaler I was given a new inhaler with no explanation or discussion… just this notification that I only found when I logged into my Patient Access portal.

No respect for my fears about steroids
It felt like she was using this ‘it damages your lungs’ argument to get me using a preventative inhaler again, despite my crippling fears of steroids now, with good reason. I’m now just over 4 years topical steroid free and really don’t feel suppressing things is the way forward. If steroids damaged my skin so much what could they be doing to my lungs? Check out the TSW section for more details.
Does Ventolin blue inhaler damage your lungs?
I’m currently trying to find out of this is true. So far I’ve only found vague mentions of this in forums but no firm evidence or advice thus far. What should you do if you are using a ventolin blue inhaler? I’d say for the time being don’t panic! Keep taking your medication as prescribed. Check out the Fighting for Breathe / Asthma and Lung UK forum – Is Ventolin being stopped?
I asked my GP why my prescription had changed
When I logged into my patient access portal there was a notice saying my request for Ventolin had been rejected. So I asked why this was and why I’d been given Salamol instead and the told me this:
We have been directed by NHS England to change all people who use Ventolin Evohaler to Salamol Inhaler, as the latter has a significantly reduced carbon footprint compared to Ventolin. This policy is in line with the NHS Greener Agenda (https://www.england.nhs.uk/greenernhs/)
Raj Bhamra (Clinical Pharmacist)
This link doesn’t really explain things to me, it’s just a link to a page about how the NHS wants to be greener. Explain to me how my CFC Ventolin is worse for the environment for my CFC free Salamol, which doesn’t work. I needed to find out what was happening and whether there might be safer and more palatable alternatives that could request.
Changing medication should be a shared decision
No medication should be changed without discussion with the patient. To find that my prescription had been declined and replaced with a new drug with no consultation or explanation was not great, particularly as when I came to use, it didn’t even work that well.
It’s taken me hours of internet research to get to the bottom of why this change is required but I’m still confused about why the replacement appears so similar and is also ineffective and unpleasant to use.
Salamol is apparently better for the environment
The reason given above, that the NHS is moving to greener alternatives is all well and good, but from my research, it would appear that ‘mister’ and ‘powder’ inhalers are far better than inhalers that use a propellant, even one that is CFC free, as Ventolin has been for years.
The Green Inhaler report (linked below) explains that, “Salamol pMDI inhaler although a pMDI contains half as much propellant as Ventolin pMDI inhaler for equivalent dosage.” So this is the reason for the medication swap.

Salamol isn’t even working for my asthma
This new drug may be better for the environment, however I’ve not had a great experience. It tastes like glue and doesn’t seem to even work when I use it and needs cleaning after use. If we need safer drugs for the planet we also need to find drugs that work. What if you forget to clean your inhaler at home each week, something that is required with the Salamol inhaler as it gets easily and quickly blocked. You could easily be left with no relief during an asthma attack.
I’ve only had to use this new inhaler once and thankfully I had an old Ventolin with me because I don’t think Salamol helped. I think it might even have felt worse. I took two puffs and still felt wheezy. Grabbed the old one (thank goodness) and received instant relief.
I’ve read other comments on the Health Unlocked forum, it seems I’m not alone in my worries about this new drug. Check out Salamol doesn’t work for me.
What is the difference between Ventolin and Salamol?
According to my GP, They are the same drug, just with a different propellant and I think less propellant. This may explain why it feels like it’s not working, if less propellant is used perhaps we need to use more puffs to get to the same result and relief?
Thanks to Rachel on Instagram, I found this great source: What is the difference between Ventolin and Salamol.
Apparently this only difference is the cost, according to this article. ‘Ventolin and Salbutamol inhalers contain Salbutamol, which is the same medication. Both are beta-2 selective short-acting bronchodilators that relax the smooth muscles in the airways. The only difference between Ventolin and Salbutamol is their cost. While the former is branded as Ventolin Evohaler resulting in a higher cost, the latter is a more generic name for the asthma inhaler.’
Salamol needs more doses to be effective
It would seem that using Salamol needs different technique, and more puffs to get the same effect. So surely if patients are being swapped to a new drug that works differently they need to be given this vital information. Everyone I’ve spoken to says they need to use way more Salamol to find any relief and many say it makes them worse.
The cost difference between Ventolin and Salamol

This is infuriating… that this swap is purely cost related. Salamol is 38% cheaper than Ventolin, which could net the NHS big savings. Yet my GP told me it was due to environmental concerns. So what is the real reason? And why do these inhalers, which should work the same, seem so different in performance.
This table above needs a final line – effectiveness = Salamol – AWFUL!
The Green inhaler Guide – safer asthma inhaler alternatives
So what are the alternatives to inhalers that use propellants? I found the East Sussex Green Inhaler Guide and finally we have some answers.
The most commonly prescribed inhaler in the UK, Ventolin Evohaler has a carbon footprint equivalent to 28kg of CO2 (per whole inhaler). That is the same carbon footprint as the greenhouse gas emissions of driving 175miles from London to Sheffield in a small car. Dry powder inhalers on the other hand typically have a carbon footprint of less than 1kg.
Green inhaler guide – east sussex CCG
These stats are staggering! How can these tiny inhalers have such an incredible effect on our environment, and what are they doing to the human body if the greenhouse gas emissions are so high? You’re literally breathing in this stuff, and for years!
Safer inhaler alternatives for asthma
- Tablet salbutamol
- Powdered salbutamol
- Mister inhalers
And more… For a detailed explanation of all the asthma medication alternatives, their cost and co2 emissions check out the Green Asthma Inhaler report above. I’ve requested an appointment at my local surgery to discuss alternatives and will keep you all posted!
What inhaler do you use and how do you feel about this?
I’d love to hear your thoughts. What inhaler are you using. Were you consulted about the medication change? Let’s have a heated debate…
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