Bronchodilators: Uses, most common brand names, and safety information

Medically reviewed by  Jamie Winn, PharmD

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Therapeutic vapors and aerosols have been used to treat lung conditions such as asthma for thousands of years. The first known therapeutic aerosol use dates back to around 1550 BC in Egypt. Fast forward to the last half of the 19th century and the delivery techniques for inhaled medications started to advance with the introduction of nebulizers and dry powder inhalers (DPIs).

The first metered dose inhaler (MDI) was launched in 1956 and by the 1980s, they were the preferred delivery system of aerosolized medications to the lung. A metered dose inhaler (MDI) is a small, pressurized canister of medicine in a plastic holder with a mouthpiece. Two albuterol (salbutamol) MDIs were brought to the market in 1981 and are still used as quick-relief or rescue medications.

The list below includes the best bronchodilators available over-the-counter or by prescription and their pricing:

List of bronchodilators

Some other combination medications that contain bronchodilators include:

• Bevespi Aerosphere (glycopyrrolate/formoterol)
• DuoNeb (ipratropium bromide/albuterol)
• Stiolto Respimat (tiotropium/olodaterol)
• Advair Diskus (fluticasone/salmeterol)
• Advair HFA (fluticasone/salmeterol)
• Combivent Respimat (ipratropium bromide/albuterol)
• Dulera (mometasone inhaled/formoterol)
• Symbicort (formoterol/budesonide)
• Trelegy Ellipta (umeclidinium bromide/vilanterol inhaled/fluticasone furoate)

What are bronchodilators?

Bronchodilators are a type of medication used to manage symptoms of chronic obstructive pulmonary disease (COPD) and asthma. By helping open up your airways (bronchi), they can help relieve wheezing, shortness of breath, cough, and chest tightness.

The are 2 types of bronchodilators are:

• Short-acting bronchodilators. Short-acting beta-2 agonists (SABAs), such as Proventil HFA (albuterol sulfate), are used to quickly relieve acute asthma symptoms such as breathlessness. Their effects typically last 3 to 6 hours.
• Long-acting bronchodilators. Long-acting beta-2 agonists (LABAs) are used daily for the long-term prevention of asthma attacks or to reduce symptoms of COPD. These medications can last for up to 12 hours. LABAs are typically prescribed as a combination product that contains an inhaled corticosteroid. Your doctor will also frequently combine different types of bronchodilators to help manage your condition.

How do bronchodilators work?

There are 3 main mechanisms bronchodilators use to relieve or prevent symptoms:

• Beta 2-agonists. Beta-2 agonists open (dilate) by relaxing the smooth muscles in your airways. They work by activating the beta-2 receptors in these muscles, which opens up your airways. This allows increased airflow and reduction of symptoms. Regular use of these medications can cause a reduction in their effectiveness and may require higher doses to work.
• Anticholinergic bronchodilators. These medications target receptors in the parasympathetic nervous system to block the effects of acetylcholine in your airways. This helps open the airways and reduce bronchial secretions.
• Theophylline. Theophylline is classified as a methylxanthine. It works by relaxing the smooth muscles in your airways and suppressing the response of your airways to stimuli. Theophylline is typically used if you have failed other therapies.

What conditions are bronchodilators used to treat?

Bronchodilators are used to treat or prevent lung diseases and conditions such as:

• Asthma
• Exercise-induced asthma
• Chronic obstructive pulmonary disease (COPD)
• Bronchitis
• Emphysema

Are bronchodilators safe?

When taken as prescribed, bronchodilators are safe and effective. Make sure your healthcare provider is aware if you have any of the following:

• Heart disease
• Arrhythmias (irregular heartbeat)
• Hypokalemia (low potassium levels)
• Hyperthyroidism (overactive thyroid)
• Diabetes
• Hypertension (high blood pressure)
• Kidney impairment
• Glaucoma

Can you take bronchodilators while you are pregnant or breastfeeding?

According to the CDC, guidelines recommend that pregnant women with asthma should continue to use medication to manage their condition. Safety data on using these medications during pregnancy is very limited.

There is also limited data on the use of bronchodilators while breastfeeding but it is not thought to pass into breast milk in large amounts. Inhaled bronchodilators are thought to be generally acceptable for use during lactation.

You should discuss the need for any medication with your doctor if you are pregnant, plan on becoming pregnant, or are breastfeeding.

What are the common side effects of bronchodilators?

Some common adverse effects of bronchodilators include:

• Tremors
• Nervousness
• Heart palpitations
• Increased heart rate
• Muscle cramps
• Dry mouth
• Problems urinating
• Constipation

Bronchodilators can sometimes cause severe adverse events, including:

• Sudden constriction of the airways (paradoxical bronchospasms)
• Low potassium levels
• Heart attack
• Acute delirium in elderly patients
• Allergic reactions

This is not a complete list of side effects and we encourage you to consult with your healthcare professional for medical advice about any possible side effects.

How much do bronchodilators cost?

Bronchodilators are very expensive with an average cost of around $10,000 per year.

You can purchase bronchodilators for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.

Related resources for bronchodilators

• The history of therapeutic aerosols: a chronological review. National Library of Medicine
• What are bronchodilators? COPD.net
• Bronchodilators overview. NHS
• What is a bronchodilator? Cleveland Clinic
• Bronchodilators (rescue inhalers): Short-acting and long-acting types. WebMD
• Maternal asthma medication use and the risk of selected birth defects. Centers for Disease Control and Prevention