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Can I get ventolin over the counter in the UK?

41 replies

SquirrelsAreGo · 20/06/2025 06:31

I'm coming back to the UK for a few weeks, and weighing up what to take with me. I very rarely need ventolin, usually only in the winter. I don't have any at the moment, but was wondering, if for some reason I need it when I'm there, can I just buy it? Cheers.

OP posts:
MrsKypp · 20/06/2025 18:23

@buffyajp The combination inhalers aren't actually new: the typical combo corticosteroid + long acting beta agonist (LABA) has been around for decades (with newer ones being added now and then). Examples include Fostair, Seretide and several others.

The combination inhalers don't contain Ventolin (Salbutamol) which is a short acting beta agonist. They contain the long acting version instead.

Ventolin (Salbutamol) also has a different use eg it's great for loosening tight breathing muscles very quickly. It's also good in an attack and can be prescribed eg take 10 puffs. It's also used in nebulisers in capsule form.

There are different types of asthma and different causes, so ideally a consultant would select the right medication for each individual patient. That didn't happen for me till I'd had massive problems on a combo inhaler for years. When I finally saw the consultant she changed my medications and things hugely improved. My asthma is allergy driven but like you, @buffyajp I am also prone to lung infections.

DemonsandMosquitoes · 20/06/2025 18:50

They contain formoterol. Works as quickly, lasts longer, plus includes a shot of inhaled steroid to treat the cause. It’s all about MART and AIR. Statistically safer.
Most asthma deaths (five a day) occur in those with ‘mild’ asthma or those just using a blue. Very risky.

MrsKypp · 20/06/2025 19:39

@DemonsandMosquitoes Not safer for me I nearly died on Seretide (a corticosteroid and LABA combo) due to side effects.

I really, really dislike medicine practised in it's the same for everybody approach. Our phenotypes differ.

I was never only "using a blue" not before and not now, but am doing really well on a specific Corticosteroid plus leukotriene receptor antagonist. No LABA or SABA except Salbutamol PRN and rarely needed.

Thank goodness I am under a consultant and not a nurse who just parrots what is supposedly safer for "everyone"

SquirrelsAreGo · 20/06/2025 20:22

@mrskypp - hey, that last line was uncalled for. I understand your situation, but it wasn't the fault of a nurse.

The whole point is that you clearly couldn't use what everyone else used, and so a consultant found you the right combination. You triaged up to a consultant's input.

If you were one of the 99 out of a hundred for whom it worked, you would be fine. Nurses don't "parrot", they use their education to provide support to the majority.

OP posts:
SquirrelsAreGo · 20/06/2025 20:35

@DemonsandMosquitoes - that is interesting, and very scary. I went to a respiratory guy a couple of times but he didn't think I had a problem my lung capacity was always so good.. in the end, my immunologist (for another issue) said he would treat the symptoms, not the test results, as I ended up getting pneumonia twice in one winter.

This month is the 1st time in 5 years that I've needed nebulising and then consistent puffers during a chest infection.

My gp gave me a combined puffer at the beginning, but I was really ill.. discovered it used lactose! I really think that should've been in large print!

So now I've got atrovent and busedonide until it's all calmed down.

On the back of this thread, I've made an appt to see the gp before I leave, to get a proper plan together, so thank you! Especially @Oneearringlost - much appreciated!

OP posts:
DemonsandMosquitoes · 20/06/2025 20:53

MrsKypp · 20/06/2025 19:39

@DemonsandMosquitoes Not safer for me I nearly died on Seretide (a corticosteroid and LABA combo) due to side effects.

I really, really dislike medicine practised in it's the same for everybody approach. Our phenotypes differ.

I was never only "using a blue" not before and not now, but am doing really well on a specific Corticosteroid plus leukotriene receptor antagonist. No LABA or SABA except Salbutamol PRN and rarely needed.

Thank goodness I am under a consultant and not a nurse who just parrots what is supposedly safer for "everyone"

That’s why I said ‘most’.

Oneearringlost · 20/06/2025 22:12

MrsKypp · 20/06/2025 19:39

@DemonsandMosquitoes Not safer for me I nearly died on Seretide (a corticosteroid and LABA combo) due to side effects.

I really, really dislike medicine practised in it's the same for everybody approach. Our phenotypes differ.

I was never only "using a blue" not before and not now, but am doing really well on a specific Corticosteroid plus leukotriene receptor antagonist. No LABA or SABA except Salbutamol PRN and rarely needed.

Thank goodness I am under a consultant and not a nurse who just parrots what is supposedly safer for "everyone"

I am delighted that you have a treatment that works well for you.

Just for clarity though, you say you are not on any SABA ( Short-acting broncho-dilator) but "Salbutamol PRN"( as required), is exactly that.

Montelukast is fab and works well for allergy-driven asthma, very much used in paediatrics where the infant is too wee to tolerate inhalers as well.

I absolutely agree with you that good prescribing and care should be individually-tailored. It should be based on a thorough history-taking, appropriate questioning, consideration of possible differential diagnoses, family history, allergies, appropriate tests, ie spirometry, peak flow testing, FENO testing...and REALLY listening to all that.
However, just as we now prescribe Montelukast for example, rather than ascribe asthma symptoms to hysteria and burn funny papers and candles for patients, as we did 100 years ago, so do we move to change our prescribing behaviour in line with current, up-to-date, evidence-based practice.

Single, short-acting broncho-dilator therapy, such as Ventolin and Salbutamol, is going out as it is associated with catastrophic asthma events. ( It CAN be life-saving, but only in some cases and it is far outweighed by the risks it can pose).
The combined therapy is vastly safer and more protective. Seretide, as you mentioned, is now pretty old and was associated with a significant risk in cases of Pneumonia; it is rarely prescribed now. But there are much better more up-to-date combinations of inhaled Corticosteroid and LABA ( Long-acting Broncho-dilator). As @DemonsandMosquitoes said, it's all about MART ( Maintenence And Reliever Therapy) and AIR now. Much, much safer.

I'm glad you are under consultant care for your asthma @MrsKypp . You are clearly not under my DH's consultant care though, as he would not be giving you a Salbutamol inhaler. He has been at the BTS (British Thoracic Society) Summer meeting for the last two days, in Manchester. He gave a talk there, this morning. Maybe your consultant was even there? I'm confident he is as about bang up-to-date as you can get. As a nurse practioner, specialising in Respiratory diseases, I make sure I am as bang up-to-date as I can be too. Anything less, and I would be ashamed to practise. Good care relies on curious, reflective, questioning and diligent practise and flexible thinking, but not at the cost of out-dated and risky, possibly lazy prescribing.

DuchessofReality · 20/06/2025 22:27

@Oneearringlostcan I ask a question? DS is on Symbicort and Montelukast (and under a consultant) and has Ventolin if needed, which he hasn’t for a few months. I know I can also use the Symbicort as a reliever for him, but I am not sure of the maximum dose. My two older children both had asthma, and with all of them there were occasional days where their Ventolin use was 8-10 puffs 4 hourly, usually followed by prednisolone as soon as we could get to a doctor.

I am just not sure exactly how to use Symbicort as a reliever in an acute asthma episode. Up to 8 extra puffs a day - how many at a time - how spaced out - and what do you do if it isn’t working and you can’t get to medical help quickly? I realise that the whole point is that the Symbicort should reduce/eliminate the acute episodes, but what happens on the odd time that you have one anyway? At the moment I have Ventolin so I can just move on to that but I am nervous about the phasing out.

MrsKypp · 20/06/2025 23:06

@SquirrelsAreGo Yes, you are correct and I apologise to @DemonsandMosquitoes for that. I have terrible experience of nurses but also wonderful experiences too. Not fair to say what I did, I am sorry @DemonsandMosquitoes . Also, apart from that, it's not a nurse's fault when the NHS dumps work on them that should be done by a consultant.

MrsKypp · 20/06/2025 23:17

Oneearringlost · 20/06/2025 22:12

I am delighted that you have a treatment that works well for you.

Just for clarity though, you say you are not on any SABA ( Short-acting broncho-dilator) but "Salbutamol PRN"( as required), is exactly that.

Montelukast is fab and works well for allergy-driven asthma, very much used in paediatrics where the infant is too wee to tolerate inhalers as well.

I absolutely agree with you that good prescribing and care should be individually-tailored. It should be based on a thorough history-taking, appropriate questioning, consideration of possible differential diagnoses, family history, allergies, appropriate tests, ie spirometry, peak flow testing, FENO testing...and REALLY listening to all that.
However, just as we now prescribe Montelukast for example, rather than ascribe asthma symptoms to hysteria and burn funny papers and candles for patients, as we did 100 years ago, so do we move to change our prescribing behaviour in line with current, up-to-date, evidence-based practice.

Single, short-acting broncho-dilator therapy, such as Ventolin and Salbutamol, is going out as it is associated with catastrophic asthma events. ( It CAN be life-saving, but only in some cases and it is far outweighed by the risks it can pose).
The combined therapy is vastly safer and more protective. Seretide, as you mentioned, is now pretty old and was associated with a significant risk in cases of Pneumonia; it is rarely prescribed now. But there are much better more up-to-date combinations of inhaled Corticosteroid and LABA ( Long-acting Broncho-dilator). As @DemonsandMosquitoes said, it's all about MART ( Maintenence And Reliever Therapy) and AIR now. Much, much safer.

I'm glad you are under consultant care for your asthma @MrsKypp . You are clearly not under my DH's consultant care though, as he would not be giving you a Salbutamol inhaler. He has been at the BTS (British Thoracic Society) Summer meeting for the last two days, in Manchester. He gave a talk there, this morning. Maybe your consultant was even there? I'm confident he is as about bang up-to-date as you can get. As a nurse practioner, specialising in Respiratory diseases, I make sure I am as bang up-to-date as I can be too. Anything less, and I would be ashamed to practise. Good care relies on curious, reflective, questioning and diligent practise and flexible thinking, but not at the cost of out-dated and risky, possibly lazy prescribing.

@Oneearringlost

Wow, just wow at your final para...

So you are implying I have a PRN Salbutamol inhaler due to my respiratory consultants' "out-dated and risky, possibly lazy prescribing."

My respiratory consultants have been fantastic, they have worked out which medications work for me and that I can take without catastrophic side effects. They actually know my medical history and other diagnoses which you don't. You are a random poster on the internet. It is highly unprofessional and unethical of you to tell someone what you said to me in your last paragraph.

I will continue to follow the advice of my consultants who know my medical diagnoses rather than a random poster online.

And am I supposed to be impressed that your DH gave a talk at a conference? Sorry to disappoint you, but I am not. In any case, my respiratory consultant is highly regarded and sought after in case you feel the need to hear that. No idea if any of the dept are currently in Manchester; I last saw the consultant in December for an annual check up.

MrsKypp · 20/06/2025 23:20

PS @Oneearringlost

Obviously, I know that Salbutamol is a SABA🙄You couldn't be more patronising if you tried. You are the sort of nurse I try to avoid.

Seeing as I take on average one puff a month I don't consider myself "on it". However, it is good to have for the rare occasion that eg someone smokes very near me and my chest tightens. I am extremely allergic to smoke.

MrsKypp · 20/06/2025 23:24

@DuchessofReality I would ask your DS' consultant, not a random online person who has no idea who your DS is or his precise diagnoses and medical history. @Oneearringlost isn't even a doctor let alone respiratory consultant.

DaveMinion · 20/06/2025 23:47

I am on fostair and have been for many years. They tried to change me to a mart regime last year and I had a real fight to change it back to salbutamol and the 200/6 fostair (they reduced it to 100/6 for mart). It just didn't work for me and I ended up with worse symptoms and still ended up needed to use salbutamol as it just wasn't relieving acute symptoms. Much better and using much less ventolin (barely any) on the higher dose.

Btw I also still get ventolin not salamol. No idea why but I always have. I'm prescribed salbutamol.

DemonsandMosquitoes · 21/06/2025 07:39

Retiring in 17 months. This just a nurse, like many thousands, has had enough. Relentless.
Threads like this demonstrate why.
Breathe easy everyone.

Oneearringlost · 21/06/2025 08:53

DuchessofReality · 20/06/2025 22:27

@Oneearringlostcan I ask a question? DS is on Symbicort and Montelukast (and under a consultant) and has Ventolin if needed, which he hasn’t for a few months. I know I can also use the Symbicort as a reliever for him, but I am not sure of the maximum dose. My two older children both had asthma, and with all of them there were occasional days where their Ventolin use was 8-10 puffs 4 hourly, usually followed by prednisolone as soon as we could get to a doctor.

I am just not sure exactly how to use Symbicort as a reliever in an acute asthma episode. Up to 8 extra puffs a day - how many at a time - how spaced out - and what do you do if it isn’t working and you can’t get to medical help quickly? I realise that the whole point is that the Symbicort should reduce/eliminate the acute episodes, but what happens on the odd time that you have one anyway? At the moment I have Ventolin so I can just move on to that but I am nervous about the phasing out.

@DuchessofReality
This is a really good question.
You don't mention how old your DS is?
Is he between 5- 11 or older than 12 years?

Salbutamol DOES still have a place in the management of some asthma, specifically acute, severe and "brittle" asthma, where there can be sudden, life-threatening, severe attacks that come from nowhere, with no triggers or precipitating factors. And it is still used in children under hospital care, it has a place, for sure. It can be life-saving, as I've mentioned in previous posts. It won't become unavailable, just prescribed an awful lot less, because of the risks of over-using it, and that it can "mask" severe, underlying inflammation.

As you say, your DS will hopefully, and probably, need his SABA, ( aka, Short-acting broncho-dilator, Salbutamol or Ventolin) a lot less as time goes on, as the protective anti-inflammatory effect of the inhaled steroid takes effect and dampens down his irritable, twitchy airways. However, I absolutely understand your nervousness about the prospect of not having Salbutamol to hand in an asthma crisis. Depending on how unpredictable your DS's asthma symptoms are, I would imagine his consultant would be recommending you keep it, and in the event of an emergency, 8-10 puffs, over 5 minutes, via a spacer is still what to do, while waiting for an ambulance. You really need to clarify this with his consultant. I would hope he/she has discussed a PAAP ( Personalised Asthma Action Plan)? This should cover everything from day-to-day management of his asthma with his prescribed medication and devices, to crisis management, and everything in between, ( for instance, how to deal with P.E at school or other activities). You should make lots of copies of this, ( a good one will have pictures of his asthma devices, ie, brown/red inhaler, what his particular spacer looks like) and make sure everyone has a copy, teachers, school, wrap-a-round care, after-school activities, Cubs/Beavers etc...

During this time, your DS's consultant will be vigilant as to how his asthma has been, ie, how many times as he needed extra maintenence doses ( Symbicort), what were the triggers, did he need a short course of oral steroids, any hospitalisations etc...?

With his Symbicort, this can be used for in-between doses, again, depending on his age?
But an extra 6-8 puffs daily, so for instance, if he were to get a hay-fever flare, on the back of a virus, if he is allergic to pet dander...You can fo this for a couple of days if he is "tight", wheezing or coughing more, especially at night.

But, and this is important! It isn't used for crisis management where, as I mentioned above, Salbutamol would be used. But, extra doses in the run- up to a potential crisis for a few days might well avert the crisis and need for this. Which is why diligent use of regular inhalers/medication is SO important...lack of symptoms indicate well-controlled asthma. But regular reviews are also important in whether it might be appropriate to "step down", asthma ebbs and flows over a lifetime, so its as important to step down, sometimes as to step up.

But you really need to speak to his consultant and get this all written down clearly, as it is highly personalised, for each individual, as to how to manage their asthma.

I do hope his symptoms reduce. Most people, with good asthma management, appropriate medication and clear explanation should be able to live life normally, including athletes and people doing high-performing activities. But, and I would urge you again, do speak to his paediatrician for written clarification.

All the best. It's horrible, having a child with asthma; I had one myself and one is constantly alert and vigilant. I completely understand your worry.

DuchessofReality · 29/06/2025 07:45

Thank you @Oneearringlostthat is very helpful. DS is 10 and obviously we will discuss all this with his consultant, however the latest appointment was cancelled and we don’t have a new one yet. After my message we had an asthma review with the GP who is happy with how he is doing and happy to prescribe the Ventolin for use in acute episodes.

I hope it was clear I wasn’t asking for advice on a specific medical situation, more as an intellectual exercise to help me discuss with the doctors. Over more than a decade of asthma management of 3 children, I know that they can deteriorate out of the blue very quickly. And in the past ventolin has bought us some valuable hours if we happen to be on holiday in the middle of nowhere, for example.

I can see that the Symbicort is working well, but until I have years rather than months of no episodes I am going to remain vigilant and prepared.

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