Patients using blue Salbutamol inhalers for asthma are being urged to contact their GP practice if they experience side effects or need to use the inhaler regularly. NHS GP and TV medic Dr Amir Khan has issued guidance on potential side effects of common prescriptions, including the blue inhaler.
Blue inhalers: a sign of poor control
Dr Khan, known for appearances on ITV's This Morning and Lorraine, explained in an Instagram post that blue inhalers can make hands feel shaky or cause a racing heart for a short while after use. He stressed that needing the blue inhaler regularly is a sign that asthma may not be well controlled and warrants a review.
He advised: "If you're getting side effects from your medicine, don't suffer in silence and don't just suddenly stop taking them without speaking to your GP, nurse, or pharmacist. Very often, we can adjust the dose, change how you take it, or find an alternative that suits you better."
NICE guideline change
The National Institute for Health and Care Excellence (NICE) recently changed its guidelines, warning that long-term use of traditional blue inhalers can "make the condition worse". New anti-inflammatory reliever inhalers not only relieve symptoms but also treat underlying inflammation that causes asthma attacks.
Professor Ewan Maule from North East and North Cumbria Integrated Care Board said: "By upgrading to a combined treatment inhaler patients not only get the relief they need but also benefit from treatment that treats the root cause of their asthma."
NICE warns that overuse of blue inhalers is "linked to a higher risk of attacks, hospital admissions and death". Nearly half of all blue inhaler users in England were prescribed more than two in 2024-25, which specialists say is a warning sign.
GP Dr Amina Al-Yassin said blue inhalers "make people feel better, but only briefly" and that "over time, they are likely to make asthma worse".
Other common medications
Dr Khan also highlighted side effects of other frequently prescribed medicines. Metformin, used for type 2 diabetes, can cause diarrhoea, bloating, stomach cramps, and nausea, especially when first starting. These symptoms often settle after a few weeks.
Lansoprazole and omeprazole, proton pump inhibitors for acid reflux and ulcers, can reduce absorption of nutrients like vitamin B12 and magnesium if taken for months or years, so they should be reviewed periodically.
Ferrous sulfate (iron tablets) can cause constipation, tummy discomfort, and nausea, and turn stools black, which is expected. Liquid iron is available as an alternative.
Bisoprolol, used for high blood pressure and heart problems, may cause tiredness, dizziness on standing, or cold hands and feet.
Dr Khan advised that any concerns should be discussed with a GP, nurse, or pharmacist, rather than stopping medication abruptly.
