Drug Class Guide
LABA and LAMA Inhalers (Long-Acting Bronchodilators)
Daily maintenance inhalers that keep the airways open around the clock in COPD, and in asthma when combined with an inhaled steroid.
How LABA & LAMA Inhalers Work
LABAs (long-acting beta-agonists) relax the muscle around the airways by stimulating beta-2 receptors, the same target as a rescue albuterol inhaler, but for 12 to 24 hours. LAMAs (long-acting muscarinic antagonists) block acetylcholine, a nerve signal that tightens the airways. Using both opens the airways more than either alone, which is why they are often combined in a single inhaler. They are maintenance medicines taken every day, not rescue inhalers.
What LABA & LAMA Inhalers Treat
LABA & LAMA Inhalers in Our Medication Guide
- SalmeterolSereventLABA taken twice daily; also combined with fluticasone in Advair.
- FormoterolForadil, PerforomistFast-starting LABA taken twice daily; part of Symbicort, Dulera, Bevespi and Breztri.
- VilanterolBreo Ellipta (with fluticasone), Anoro Ellipta (with umeclidinium)Once-daily LABA available only in combination inhalers: Breo, Anoro and Trelegy.
- TiotropiumSpirivaOnce-daily LAMA; the soft-mist form is also approved for asthma.
- UmeclidiniumIncruse ElliptaOnce-daily LAMA for COPD; also part of Anoro and Trelegy.
- Glycopyrrolate-InhaledSeebri Neohaler, Lonhala MagnairLAMA in the Bevespi and Breztri inhalers; also made as a nebulizer solution.
Common Side Effects
LABAs can cause tremor, a fast or pounding heartbeat, nervousness and muscle cramps. LAMAs commonly cause dry mouth and occasionally constipation or difficulty urinating. Hoarseness and mouth thrush come from the steroid part of combination inhalers, so rinse and spit after using those.
Important Cautions
- In asthma, a LABA is never used without an inhaled corticosteroid; on its own it raises the risk of severe attacks.
- Keep a rescue inhaler for sudden symptoms. Most of these inhalers are too slow or not meant for that purpose.
- Tell your doctor about narrow-angle glaucoma, an enlarged prostate or trouble urinating before starting a LAMA, and keep the spray or powder out of your eyes.
- Get emergency care if breathing worsens right after a dose or your rescue inhaler is not helping.
Common Questions About LABA & LAMA Inhalers
What is the difference between a LABA and a LAMA?
Both are long-acting bronchodilators, but they open the airways through different pathways: LABAs stimulate beta-2 receptors that relax airway muscle, while LAMAs block the acetylcholine signal that tightens it. For COPD a LAMA, a LABA or the two together are the usual first-line maintenance treatment.
Can a LABA inhaler be used alone for asthma?
No. When LABAs were used alone in asthma, severe attacks were more common. Combined with an inhaled corticosteroid in the same inhaler, large FDA-required safety trials found no added risk. In COPD, a LABA can be used without a steroid.
What is a triple-therapy inhaler?
Trelegy and Breztri combine an inhaled steroid, a LAMA and a LABA in one device. They are used for COPD with repeated flare-ups despite dual therapy, and Trelegy is also approved for asthma in adults. Having all three in one inhaler means fewer devices to manage.
This guide is general information, not a substitute for advice about your own medicines. Do not start, stop or switch a medication without talking with your doctor. Questions about a prescription? Our internal medicine team can help.
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