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Does the colour of a reliever inhaler really matter?

Johnathan Laird

day. Monday.


Wife calls: our son is struggling to breathe. Can you come home quickly?

Phone down. Run.

In the door, noisy breathing, crying, upset. Wheeze. His face is so white.

Dad is thinking: don’t panic, that’s probably the most unhelpful thing to do right now. Don’t panic. Shit, will he be ok?

Ok think. What do we do? Inhaler. Multidose. Spacer.

What colour? Is it the black, or the green, or the yellow?


Damn which one?

Ambulance. Blue light.

In the situation above, time is clearly of the essence, and choosing the correct inhaler to relieve these potentially life threatening symptoms is potentially critically important. Reliever inhalers need to be blue, and more than that as professionals my view is that we need to promote and embed this convention.

A research paper [1] looked at the idea of colour convention for inhalers. Interestingly, the study found that the blue inhaler convention is more important in asthma than in COPD, but does have a common purpose to encourage compliance in both conditions.

Toby Capstick and colleagues recently also helped to challenge the colour choice of the Relvar Ellipta device. It was later changed from blue to yellow (see the original blue Relvar below, and the newly branded yellow Relvar device to the right). The concern was that the blue Relvar may have been used as a reliever inhaler, and the same concern exists if we alter the outer casing of a Ventolin Evohaler. It has emerged that some online companies have started to do this.


If we see a red traffic light your first thought is to stop. Red usually means danger, green usually means ‘go’.

I could go on, but the point is that to potentially reduce the risk of death, and also to aid compliance in respiratory diseases, all professionals need to be on the same page when promoting colour convention in inhalers. The respiratory field has been flooded recently with new inhalers devices, drugs and combinations of drugs.

In this time of complexity I think the area of colour convention should provide some much-needed simplicity to improve the outcomes for patients with respiratory disease.

[1] Fletcher et al. Is the ‘blue’ colour convention for inhaled reliever medications important? A UK-based survey of healthcare professionals and patients with airways disease. npj Primary Care Respiratory Medicine 26. Article number: 16081 (2016). doi:10.1038/npjpcrm.2016.81.

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