Some inhalers contain steroids, but many do not. It depends entirely on which inhaler you’ve been prescribed. The two main categories of inhaler medication are corticosteroids (steroids) and bronchodilators (non-steroids), and they do very different things. If you have a rescue inhaler like albuterol, that is not a steroid. If you have a daily maintenance inhaler for asthma or COPD, there’s a good chance it contains one.
Which Inhalers Are Steroids
Inhaled corticosteroids (often abbreviated ICS) are the steroid-containing inhalers. They work by calming inflammation inside your airways, switching off the signals that cause swelling, excess mucus, and sensitivity to triggers. They’re prescribed as daily, long-term controllers for asthma and sometimes COPD. You won’t feel an immediate effect when you use one because they work gradually over days to weeks.
Common steroid-only inhalers include fluticasone (sold as Flovent, Arnuity Ellipta, and generics), budesonide (Pulmicort), mometasone (Asmanex), beclomethasone (Qvar Redihaler), and ciclesonide (Alvesco). If any of those names appear on your inhaler’s label, it contains a corticosteroid.
Which Inhalers Are Not Steroids
Bronchodilators contain zero steroids. Instead of reducing inflammation, they relax the muscles wrapped around your airways so air can flow more freely. They come in three main types:
- Short-acting bronchodilators (SABAs) like albuterol are the classic “rescue” inhalers. They work within minutes and are used for sudden symptoms like wheezing, coughing, or shortness of breath. Albuterol is not a steroid.
- Long-acting bronchodilators (LABAs) relax airway muscles over 12 to 24 hours and are taken on a schedule, not for emergencies.
- Long-acting muscarinic antagonists (LAMAs) also provide long-term airway opening and help reduce mucus production, mostly in COPD.
Combination Inhalers: Both in One Device
Many commonly prescribed inhalers contain a steroid combined with one or two bronchodilators in a single device. This is where the confusion often starts, because the inhaler does contain a steroid even though it also contains a non-steroid medication. Some well-known combination inhalers include Advair and Wixela (fluticasone plus salmeterol), Symbicort and Breyna (budesonide plus formoterol), Breo Ellipta (fluticasone furoate plus vilanterol), Dulera (mometasone plus formoterol), and Trelegy Ellipta, which combines a steroid with two different bronchodilators.
There’s also Airsupra, which pairs albuterol (a rescue bronchodilator) with budesonide (a steroid) in a single inhaler. So even some rescue-style inhalers now include a steroid component.
If you’re unsure about your specific inhaler, the drug name on the label is the fastest way to check. Any ingredient ending in “-sone,” “-sonide,” or “-nide” (fluticasone, budesonide, mometasone, beclomethasone, ciclesonide) is a corticosteroid.
How Inhaled Steroids Differ From Oral Steroids
When people hear “steroid,” they often think of prednisone pills or the anabolic steroids associated with bodybuilding. Inhaled corticosteroids are neither. They deliver a very small dose of anti-inflammatory medication directly to your lungs, so most of it stays local rather than circulating through your whole body. That’s why they carry far fewer systemic side effects than steroid pills.
That said, inhaled steroids are not side-effect-free. The most common problems are local: oral thrush (a yeast infection in the mouth) and hoarseness or voice changes. These happen because some of the medication lands in your throat and mouth instead of reaching your lungs.
At higher doses used over long periods, inhaled steroids can cause subtler systemic effects. These include reduced bone density, skin thinning and easy bruising, slightly slowed growth in children, and in some cases increased eye pressure. A large study in Quebec found that continuous use at high doses for three months or longer was linked to a higher risk of glaucoma. These risks are dose-dependent, meaning lower doses carry less risk.
Reducing Side Effects From Steroid Inhalers
Two simple habits make a significant difference. First, rinse your mouth with water and spit after every dose, then brush your teeth. This clears the steroid residue from your mouth and throat, substantially lowering your chance of developing thrush or hoarseness. Second, if your inhaler is a metered-dose type (the pressurized canister you press down), using a spacer attachment helps more medication reach your lungs and less settle in your mouth.
Skipping doses or stopping a steroid inhaler because of side-effect concerns often leads to worse outcomes than the side effects themselves. Uncontrolled airway inflammation causes its own damage over time. If you’re experiencing side effects, the dose or specific medication can usually be adjusted rather than stopped entirely.
How to Tell What’s in Your Inhaler
The color of an inhaler is not a reliable guide, since manufacturers use different colors for different products. Your best options are checking the generic drug name printed on the inhaler or its box, looking up the brand name on the prescribing information, or asking your pharmacist directly. If the label lists only albuterol, levalbuterol, ipratropium, tiotropium, or similar bronchodilator-only names, your inhaler does not contain a steroid. If it lists any corticosteroid ingredient, alone or in combination, it does.