Authorship & review
Dr Sean James Ledger, BSc Physio (Hons) MSc PhD FHEA
Director and Principal Physiotherapist
Ahpra registration PHY0002298174
Ahpra registration PHY0002298174
Version
1.1
Last updated
16 August 2026
Next review
16 August 2027
Every guide on this site is reviewed at least once a year, and sooner when the evidence changes.
How these guides are written and reviewed →
How these guides are written and reviewed →
The colour system — three ingredients, everything else is a mixture
Blue — β2-agonist
Smooth muscle relaxation via β2 receptors. Pale blue = short-acting (SABA), full blue = long-acting (LABA).
Amber — Muscarinic antagonist
Blocks vagal bronchoconstriction. Pale amber = short-acting (SAMA), full amber = long-acting (LAMA).
Red — Inhaled corticosteroid
Airway inflammation. No short-acting form exists, so red has one shade only.
Green — LAMA/LABA
Blue + amber. Dual bronchodilator, no steroid.
Purple — ICS/LABA
Blue + red. Steroid plus long-acting β2.
Charcoal — Triple therapy
All three segments filled. One device, three ingredients.
Grey — segment absent
Fingerprint order is always fixed: β2 · muscarinic · steroid.
Why the fingerprint earns its space. Lay two of a patient's inhalers side by side. A segment that lights up twice is a duplicated ingredient class.
Spiolto Respimat — LAMA/LABA
Symbicort Turbuhaler — ICS/LABA
Blue appears in both → two long-acting β2-agonists. Flag it. Either move to a single triple device, or query the combination with the prescriber.
Device codes — how the drug actually leaves the device
Two products can share every ingredient and still need completely different coaching. The code on each row below refers to the delivery mechanism, not the brand.
MDI
Pressurised metered dose inhaler
Propellant fires the dose regardless of the patient. Needs press–breathe coordination, a slow, deep inhalation and a 5–10 second hold. Shake before use, prime when new or unused. Use a spacer wherever possible.
Inhaler · Aerosol · Rapihaler · Aerosphere
MDI-BA
Breath-actuated pMDI
Still propellant-driven, but the patient's inspiration trips the dose — removes the coordination problem. Requires the lever to be raised each dose. Cannot be used with a spacer. Slow deep breath, as for a pMDI.
Autohaler
DPI-R
Dry powder — reservoir
Dose metered from a bulk powder store by twisting, clicking or opening. Needs a quick, deep, forceful inhalation — the opposite instruction to a pMDI. Must be held upright while loading. Never exhale into it; keep away from humidity.
Turbuhaler · Easyhaler · Spiromax · Genuair · Ciphaler
DPI-B
Dry powder — pre-metered blister
Each dose sealed in its own blister or strip; opening the cover loads it. Same quick, deep, forceful inhalation. More humidity-tolerant than a reservoir. Dose counter is reliable.
Accuhaler · Ellipta
DPI-C
Dry powder — single-dose capsule
A capsule must be loaded and pierced for every dose, then the capsule checked as empty — often a second inhalation is needed. Audible rattle gives feedback. Highest dexterity and inspiratory-flow demand; capsules are never swallowed.
Handihaler · Breezhaler · Zonda · Aerolizer
SMI
Soft mist inhaler
Mechanical spring generates a slow-moving mist with no propellant and no flow requirement. Base is twisted half a turn per dose; a cartridge must be inserted and the device primed on first use. Slow, deep inhalation. Best option when inspiratory flow is poor.
Respimat
The instruction that most often gets crossed over
If a patient uses both a pMDI and a dry powder device, they are being asked to breathe in two opposite ways: slow and steady for MDI, MDI-BA and SMI; quick and forceful for every DPI. Check which technique they are applying to which device before concluding a drug has stopped working. Assess technique at least six-monthly, and after every exacerbation or change of device.
SABA
Short-acting β2-agonist Reliever · as needed| Brand | Drug | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Ventolinalso Asmol, Zempreon | salbutamol | 100 mcg | Inhaler | MDI | |
| Airomir Autohaler | salbutamol | 100 mcg | Autohaler | MDI-BA | |
| Bricanyl Turbuhaler | terbutaline | 500 mcg | Turbuhaler | DPI-R |
SAMA
Short-acting muscarinic antagonist Reliever · as needed| Brand | Drug | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Atrovent | ipratropium | 21 mcg | Metered Aerosol | MDI |
LAMA
Long-acting muscarinic antagonist Maintenance · regular| Brand | Drug | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Spiriva Respimat | tiotropium | 2.5 mcg | Respimat | SMI | |
| Spiriva Handihaler | tiotropium | 18 mcg | Handihaler | DPI-C | |
| Tiotropium Lupin | tiotropium | 18 mcg | capsule inhaler | DPI-C | |
| Braltus Zonda | tiotropium | 13 mcg | Zonda | DPI-C | |
| Seebri Breezhaler | glycopyrronium | 50 mcg | Breezhaler | DPI-C | |
| Bretaris Genuair | aclidinium | 322 mcg | Genuair | DPI-R | |
| Incruse Ellipta | umeclidinium | 62.5 mcg | Ellipta | DPI-B |
LABA
Long-acting β2-agonist Maintenance · regular| Brand | Drug | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Serevent Accuhaler | salmeterol | 50 mcg | Accuhaler | DPI-B | |
| Oxis Turbuhaler | formoterol | 6 · 12 mcg | Turbuhaler | DPI-R | |
| Foradile Aerolizer | formoterol | 12 mcg | Aerolizer | DPI-C | |
| Onbrez Breezhaler | indacaterol | 150 · 300 mcg | Breezhaler | DPI-C |
ICS
Inhaled corticosteroid — preventer Monotherapy not for COPD without coexisting asthma| Brand | Drug | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Flixotide Inhaleralso Axotide, Fluticasone Cipla | fluticasone propionate | 50 · 125 · 250 mcg | Inhaler | MDI | |
| Flixotide Accuhaleralso Axotide Accuhaler | fluticasone propionate | 100 · 250 · 500 mcg | Accuhaler | DPI-B | |
| Arnuity Ellipta | fluticasone furoate | 100 · 200 mcg | Ellipta | DPI-B | |
| QVAR Inhaler | beclometasone | 50 · 100 mcg | Inhaler | MDI | |
| QVAR Autohaler | beclometasone | 50 · 100 mcg | Autohaler | MDI-BA | |
| Alvesco Inhaler | ciclesonide | 80 · 160 mcg | Inhaler | MDI | |
| Pulmicort Turbuhaler | budesonide | 100 · 200 · 400 mcg | Turbuhaler | DPI-R |
LAMA/LABA
Dual long-acting bronchodilator Maintenance · no steroid| Brand | Drugs | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Spiolto Respimat | tiotropium / olodaterol | 2.5/2.5 | Respimat | SMI | |
| Ultibro Breezhaler | indacaterol / glycopyrronium | 110/50 | Breezhaler | DPI-C | |
| Brimica Genuair | aclidinium / formoterol | 340/12 | Genuair | DPI-R | |
| Anoro Ellipta | umeclidinium / vilanterol | 62.5/25 | Ellipta | DPI-B |
ICS/LABA
Corticosteroid + long-acting β2-agonist Some are also the patient's reliever — check| Brand | Drugs | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Symbicort Turbuhaleralso Rilast Turbuhaler | budesonide / formoterol | 100/6 · 200/6 · 400/12 | Turbuhaler | DPI-R | |
| Symbicort Rapihaleralso Rilast Rapihaler | budesonide / formoterol | 100/3 · 200/6 | Rapihaler | MDI | |
| DuoResp Spiromaxalso BiResp Spiromax | budesonide / formoterol | 200/6 · 400/12 | Spiromax | DPI-R | |
| Bufomix Easyhaler | budesonide / formoterol | 200/6 · 400/12 | Easyhaler | DPI-R | |
| Seretide Inhaleralso Pavtide, SalplusF, Evocair, Fluticasone + Salmeterol Cipla | fluticasone propionate / salmeterol | 50/25 · 125/25 · 250/25 | Inhaler | MDI | |
| Seretide Accuhaleralso Pavtide, Fluticasone + Salmeterol Cipla | fluticasone propionate / salmeterol | 100/50 · 250/50 · 500/50 | Accuhaler | DPI-B | |
| Salflumix Easyhaler | fluticasone propionate / salmeterol | 250/50 · 500/50 | Easyhaler | DPI-R | |
| Fluticasone Salmeterol Ciphaler | fluticasone propionate / salmeterol | — | Ciphaler | DPI-R | |
| Flutiform Inhaler | fluticasone propionate / formoterol | 50/5 · 125/5 · 250/10 | Inhaler | MDI | |
| Fostair Inhaler | beclometasone / formoterol | 100/6 · 200/6 | Inhaler | MDI | |
| Breo Ellipta | fluticasone furoate / vilanterol | 100/25 · 200/25 | Ellipta | DPI-B | |
| Atectura Breezhaler | mometasone / indacaterol | 62.5/125 · 127.5/125 · 260/125 | Breezhaler | DPI-C |
ICS/LAMA/LABA
Triple therapy in a single device Maintenance only — never a reliever| Brand | Drugs | Strengths | Device | Code | |
|---|---|---|---|---|---|
| Trelegy Ellipta | fluticasone furoate / umeclidinium / vilanterol | 100/62.5/25 · 200/62.5/25 | Ellipta | DPI-B | |
| Enerzair Breezhaler | mometasone / glycopyrronium / indacaterol | 68/46/114 · 136/46/114 | Breezhaler | DPI-C | |
| Trimbow Inhaler | beclometasone / glycopyrronium / formoterol | 100/10/6 · 200/10/6 | Inhaler | MDI | |
| Breztri Aerosphere | budesonide / glycopyrronium / formoterol | 160/7.2/5 | Aerosphere | MDI |
Not a puffer
Appears on the asthma chart, no device technique involved Reference only| Name | Drug | Strengths | Route | Code | |
|---|---|---|---|---|---|
| Montelukastmultiple generics | montelukast — non-steroidal preventer | 4 · 5 · 10 mg | Oral tablet | ORAL | |
| Fasenra | benralizumab | 30 mg/mL | Injection | INJ | |
| Dupixent | dupilumab | 200 mg/1.14 mL · 300 mg/2 mL | Injection | INJ | |
| Nucala | mepolizumab | 100 mg/mL | Injection | INJ | |
| Xolair | omalizumab | 75 · 150 mg | Injection | INJ |
Translating what the patient says
Device colours are set by manufacturers, change between strengths, and are not preserved across generic brands. Treat a colour as a prompt to check, never as an identification.
- “the blue one”
- Usually a salbutamol reliever, but Breo Ellipta and several DPIs are also blue-toned. Confirm it is the as-needed one.
- “the red one”
- Could be a Symbicort Turbuhaler or Rapihaler, a QVAR, an Alvesco, an Anoro Ellipta or a Trimbow. Ask what it is for and how often.
- “the purple one”
- Commonly a Seretide product, either the pMDI or the Accuhaler disc.
- “the orange one”
- Often a fluticasone propionate preventer.
- “the round one”
- A disc — Accuhaler or Genuair.
- “the one with the capsules”
- DPI-C. Ask whether they are loading, piercing and checking the capsule empties.
The question that resolves most of it: ask the patient to bring every device in, then sort them by the fingerprint above — not by colour, not by memory.
Where the two source charts differ
- The Lung Foundation poster is COPD-first and includes a grid of which classes may be combined, plus Foradile Aerolizer and Fluticasone Salmeterol Ciphaler.
- The National Asthma Council chart is asthma-first and adds Tiotropium Lupin, montelukast and the severe-asthma biologics, and carries full strength ranges including junior formulations.
- Both flag that ICS monotherapy is not indicated in COPD without coexisting asthma.
- Both flag that pMDIs should be used with a spacer wherever possible.
- The charts differ in vintage — the Lung Foundation listing reflects PBS as at April 2026, the NAC chart is the 2025 edition. Where they disagree, the later one wins.
- PBS restriction symbols have deliberately been left off this sheet. They change frequently, and they are a prescribing question — check the current PBS and TGA listings rather than this page.
Source and limits. Compiled from two primary sources: Lung Foundation Australia, Inhalers for Chronic Obstructive Pulmonary Disease device chart poster (products listed on the PBS as at April 2026; next review April 2027), and National Asthma Council Australia, Asthma & COPD Medications chart 2025. Every brand and strength on this page is taken from those charts. Brand availability, strengths and PBS criteria change — check the TGA eBS and current PBS before acting on it. The colour system is a teaching and cross-checking aid: it is not a dosing, prescribing or substitution guide, and it does not reflect the actual colour of any device. PBS restriction symbols are deliberately omitted — they change frequently and are a prescribing question; both source charts carry them. Devices requiring a capsule to be loaded (Handihaler, Breezhaler, Zonda, Aerolizer) and the Respimat cartridge are noted in the device codes above. ICS monotherapy is not indicated for COPD without coexisting asthma.
Corrections: If something on this page is wrong, out of date or unclear, we want to know. Email reception@inspireclinic.au with the page name and what you believe is incorrect. Substantive corrections are made promptly, and the guide’s version and last-updated date are changed to reflect it.