Asthma
A Beginner's Guide to Fostair Inhalers for Asthma
Managing asthma effectively often involves using the right inhaler at the right time. Fostair is a commonly prescribed asthma treatment that combines two medicines in a single inhaler to help control symptoms and reduce the risk of asthma attacks.
This guide explains what Fostair is, how it works, the differences between available devices, how the Maintenance and Reliever Therapy (MART) approach works, potential side effects and how Mail My Meds can help patients manage their prescriptions.
Fostair is a dual-action combination inhaler that is a prescription-only medication used as part of a chronic asthma management treatment plan. It contains Beclometasone dipropionate (inhaled corticosteroid / ICS) and Formoterol fumarate dihydrate (long-acting bronchodilator / LABA) to support respiratory management by reducing airway inflammation and relaxing airway muscles.
Available as both a pMDI (Pressurised Metered Dose Inhaler) and NEXThaler, it may also be prescribed under the Maintenance and Reliever Therapy (MART) approach following assessment by a General Practitioner (GP) or asthma specialist.
At Mail My Meds, we help patients access their prescribed treatments conveniently through our online pharmacy service.
In One Sentence:
Yes, Fostair is primarily a preventer inhaler, but in certain treatment plans, it can also be used as a reliever inhaler through the MART approach.
Key Takeaways
What is Fostair?
Fostair is mainly a preventer inhaler, although some patients use it as both a preventer and reliever inhaler under the Maintenance and Reliever Therapy (MART) protocol.
What is the difference between pMDI and NEXThaler?
The Fostair pMDI delivers medication through an aerosol spray, while the Fostair NEXThaler is a breath-actuated dry powder device.
Which option is best?
Patients who struggle with hand-breath coordination may find the Fostair NEXThaler easier to use than the Fostair pMDI.
What are the most common side effects?
Common local side effects include oral thrush (oral candidiasis) and hoarse voice (dysphonia), which can often be reduced with proper mouth rinsing.
Is Fostair an emergency medication?
Fostair should not replace an emergency reliever unless it has specifically been prescribed as part of a MART protocol rather than standard therapy.
Is Fostair a preventer or a reliever?
Fostair is primarily a preventer inhaler, although some patients may use it as both a preventer and a reliever inhaler under a MART protocol.
The inhaled steroid component helps reduce inflammation over time, while the long-acting bronchodilator helps keep airways open. When prescribed under standard therapy, Fostair is taken regularly alongside a separate emergency reliever. Under a MART protocol, the same inhaler can also provide symptom relief when needed.
What is the difference between the two devices?
The main difference is how the medication is delivered into the lungs.
The Fostair pMDI uses an aerosol spray that requires coordination between pressing the inhaler and breathing in. The Fostair NEXThaler is a breath-actuated dry powder device that releases medication automatically when the user inhales forcefully enough.
Are there side effects?
Yes, Fostair can cause side effects, although many people use it without significant problems.
Local side effects may include oral thrush (oral candidiasis) and hoarse voice (dysphonia), while some patients may experience mild headaches, tremor or palpitations. Following correct inhaler technique and maintaining good oral hygiene can help reduce the risk of side effects.
What are the common side effects of Fostair?
Most side effects associated with Fostair are mild and manageable.
The corticosteroid component can contribute to oral thrush (oral candidiasis) and voice hoarseness (dysphonia). These occur because medication residue can remain in the mouth and throat, affecting local immune balance and encouraging natural yeast overgrowth.
The formoterol component may occasionally cause mild headaches, muscle tremors or temporary heart palpitations. These effects are often mild and improve as the body adjusts to treatment.
Patients should seek medical advice if side effects persist, become troublesome or worsen.
"A rare but important reaction is paradoxical bronchospasm. If a patient experiences sudden wheezing immediately after using their inhaler, they should stop using the device, use their emergency blue reliever if available and seek urgent medical care without delay."
What is Fostair and how does it work?
Fostair works through a dual mechanism of action that both reduces inflammation and opens the airways.
Fostair contains Beclometasone dipropionate and Formoterol fumarate dihydrate. Beclometasone dipropionate helps reduce baseline inflammation, airway swelling and mucus production within the lungs. This helps control the underlying disease process that contributes to asthma symptoms.
The second ingredient, formoterol fumarate dihydrate, acts as a bronchodilator by relaxing airway smooth muscle. This allows air to move more freely through the lungs and can help ease symptoms triggered by pollen, cold air, pet dander and other common asthma triggers.
Unlike a standard steroid inhaler, Fostair combines both treatments in a single device. Formoterol has a rapid onset of action and can begin improving airflow quickly. Research has shown that the extrafine beclometasone/formoterol formulation provided significant bronchodilation within five minutes of inhalation, supporting its role in both maintenance treatment and symptom relief when prescribed appropriately [1].
"Many patients are familiar with a traditional blue reliever such as Salbutamol. Fostair is different because it combines anti-inflammatory treatment with airway-relaxing effects. Formoterol works quickly, and its effects can last for around 12 hours, making it suitable for specific treatment strategies recommended by the National Institute for Health and Care Excellence (NICE)."
Fostair pMDI vs. Fostair NEXThaler: What's the difference?
Both devices deliver the same active ingredients, but they use different delivery mechanisms.
Research has found that the NEXThaler dry powder device is clinically non-inferior to the pMDI version in adults with controlled asthma, meaning both can provide comparable asthma control when used correctly [2].
The Fostair pMDI delivers an extra-fine solution using a pressurised aerosol canister and plastic actuator. Some patients benefit from using a spacer device such as the AeroChamber Plus, particularly if they struggle with inhaler coordination.
The Fostair NEXThaler is breath-actuated, meaning the medication is released automatically during inhalation. This can be helpful for patients with adequate lung capacity who find hand-breath coordination difficult.
Some NHS Clinical Commissioning Groups (CCGs) may also prescribe Luforbec pMDI, a licensed bioequivalent brand alternative to Fostair pMDI.
Feature | Fostair pMDI (Pressurised Metered Dose Inhaler) | Fostair NEXThaler |
| Form Factor | Aerosol canister inside a plastic actuator. | Dry powder breath-actuated device. |
| Inhalation Technique | Slow and steady deep breath. | Quick, sharp, and forceful deep breath. |
| Shaking Required? | No (Fostair is an extra-fine solution). | No. |
| Spacer Compatible? | Yes (e.g., AeroChamber Plus). | No (Dry powder only). |
| Dose Counter | Numeric wheel or color indicator on the side. | Numerical countdown window. |
Understanding the Fostair MART Regime
The MART approach allows Fostair to be used for both daily control and symptom relief.
Maintenance and Reliever Therapy (MART), sometimes referred to alongside Anti-inflammatory Reliever (AIR) therapy approaches, combines daily maintenance doses with additional doses for emergency relief when symptoms occur.
Under a fixed-dose regime, patients take their regular maintenance treatment and use a separate blue reliever inhaler (Salbutamol) when symptoms develop. Under MART, patients use the same Fostair inhaler for both purposes.
Clinical research involving more than 1,700 patients found that using beclometasone-formoterol for both maintenance and relief significantly delayed severe exacerbations and reduced the risk of severe asthma flare-ups compared with fixed-dose treatment plus Salbutamol [3].
Because Formoterol has a rapid onset of action, it can help relieve sudden symptoms such as shortness of breath (breathlessness), while anti-inflammatory steroids address the underlying inflammation contributing to an asthma attack.
"Patients should always follow their prescribed dosing instructions and Asthma Action Plan. Standard MART guidelines often include a maximum limit of eight inhalations in a 24-hour period, although individual instructions may vary. If symptoms continue despite treatment or a patient feels seriously unwell, emergency medical assistance should be sought immediately."
Protocol Feature | Traditional Fixed-Dose Regime | Fostair MART (Anti-inflammatory Reliever) Protocol |
How to Use Your Fostair Inhaler Safely: Step-by-Step
Correct inhaler technique helps maximise treatment effectiveness and reduce side effects.
Good inhaler technique allows more medication to reach the lungs and less medication to remain in the mouth and throat. Rinsing the mouth with water, gargling or brushing teeth after use can significantly reduce local side effects.
Steps for the Fostair pMDI
The pMDI requires coordinated breathing and inhaler activation.
Remove the mouthpiece cover. You do not need to shake the inhaler.
Breathe out as far as is comfortable.
Place the mouthpiece in your mouth and seal your lips around it.
Start to breathe in slowly and steadily, and immediately press down on the top of the canister to release an aerosol mist.
Continue breathing in deeply.
Remove the inhaler from your mouth.
Hold your breath for 5 to 10 seconds.
Breathe out gently.
Crucial Safety Rule: Rinse your mouth out with water, gargle and spit it out, or brush your teeth immediately after use.
Steps for the Fostair NEXThaler
The NEXThaler uses a breath-actuated mechanism that releases dry powder automatically.
Open the cover fully until you hear a click.
Breathe out as far as is comfortable, avoiding breathing into the inhaler.
Seal your lips around the mouthpiece.
Breathe in quickly and deeply using a sharp breath force.
Remove the inhaler from your mouth.
Hold your breath for 5 to 10 seconds.
Close the cover completely.
Crucial Safety Rule: Rinse your mouth with water or brush your teeth after every dose to help prevent local side effects.
Managing Your NHS Asthma Prescriptions Online with Mail My Meds
Managing repeat prescriptions consistently can help reduce the risk of asthma complications.
Mail My Meds is an Electronic Prescription Service (EPS) provider that helps patients manage repeat Fostair prescriptions through a discrete online pharmacy service with convenient home delivery.
Missing doses or running out of a preventer inhaler can contribute to medication non-adherence, which may increase the risk of poor asthma control and severe asthma attacks. Ordering repeat prescriptions on time helps ensure uninterrupted treatment.
As a pharmacy regulated by the General Pharmaceutical Council (GPhC), Mail My Meds follows professional standards designed to support patient safety. Medicines supplied within the UK are also regulated by the Medicines and Healthcare products Regulatory Agency (MHRA).
Patients can nominate Mail My Meds through the NHS app, making it easier to receive regular prescriptions without visiting a pharmacy in person.
Frequently Asked Questions
Can I use Fostair if I am pregnant?
Yes, many people continue using Fostair during pregnancy, but treatment decisions should always be made with healthcare professionals.
Uncontrolled asthma can pose risks to both mother and baby, so maintaining good asthma control is important. Patients who are pregnant or planning pregnancy should speak with their GP or asthma specialist before making any changes to their treatment.
Why do I need to keep Fostair in the fridge?
Fostair may be refrigerated before first use to help maintain chemical stability.
Once dispensed, patients should follow the storage instructions included with their inhaler. Depending on the product version, it can generally be stored at standard room temperature below 25°C after removal from refrigeration and may have a limited shelf life of approximately five months. Always check the patient information leaflet for product-specific guidance.
Can I suddenly stop taking Fostair if I feel better?
No, Fostair should not be stopped suddenly without medical advice.
Asthma is a chronic condition and symptoms may improve because the corticosteroid preventer is successfully suppressing underlying inflammation. Stopping treatment unexpectedly can increase the risk of worsening symptoms and severe asthma attacks. Any treatment changes should be discussed with your healthcare professional.
Final Thoughts From Our Superintendent Pharmacist
"Fostair is an important part of modern asthma management because it combines anti-inflammatory treatment with fast symptom relief in a single inhaler. Whether you use a MART protocol or a traditional treatment plan, correct inhalation technique and good oral hygiene through rinsing your mouth after use are essential. Choosing between a Fostair pMDI with a spacer or a breath-actuated NEXThaler depends on individual needs and technique. Ensuring effective drug deposition in the lungs rather than the throat can improve treatment outcomes, and patients should always seek guidance from their GP, asthma specialist or pharmacy team if they have any questions about their inhaler."
