Monday, 13th February, 2017

Ventolin vs salbutamol: what’s the difference anyway?

Are you confused about the difference between ventolin and salbutamol? In terms of medicine, Ventolin and salbutamol are exactly the same.

They each contain the same concentration of medication and they each have a capacity of 200 sprays, with 100 micrograms of salbutamol in each spray.

Now, that might not have been the opening you were expecting from an article claiming to explain the differences between Ventolin and salbutamol, but acknowledging that these medicines are exactly the same in terms of their chemical makeup is precisely the place where this discussion needs to begin.

Many articles discussing the differences between different asthma medications fall into the trap of becoming as dry as the throats of the people with asthma who are reading them (I get to say that because I have asthma too), so I’ll keep the tone of this article as light as possible, while sharing with you the nitty-gritty details that differentiate Ventolin and salbutamol.

Who said asthma medication had to be boring, anyway?

Ventolin and salbutamol as brands

As I’ve said, Ventolin and salbutamol are exactly the same.

In reality, Ventolin is salbutamol.

But here’s the catch: Ventolin is what all pharmacists who know what they’re talking about will refer to as a ‘branded’ medicine. By contrast, salbutamol is a ‘generic’ medicine. The difference here is in the branding.

You can think of the difference between Ventolin and salbutamol in terms of the differences between paracetamol and Calpol. While the first (paracetamol) is the name of a medicine, the second (Calpol) is the brand name used to market that medicine.

If that example didn’t quite hit the mark for you, you can also think of the difference between Ventolin and salbutamol as comparable to the differences between supermarket-own brands of cola and more well-known brands like Coke and Pepsi. (Except that with Ventolin and salbutamol, there really is no difference in the taste, so there’s no need to decide between #PepsiForTheWin or #CokeEveryTime).

Ventolin and salbutamol as inhalers

Another notable difference between Ventolin and salbutamol is the size of each of the inhalers.

While a blue Ventolin inhaler measures around 9 cm, a blue salbutamol inhaler measures approximately 6.5 cm.

So the difference between the two inhalers is a matter of 2.5 cm (or 1 inch), which may leave you asking the age-old question: ‘what’s in an inch?’

The significance of these variations in pump size will only affect the effectiveness of your medication if you feel less comfortable using one inhaler over the other, and if you then go on to use the inhaler prescribed to you incorrectly.

So personal preference shouldn’t be dismissed as a mere whimsical fancy, because it actually plays a key role in determining your ability to successfully self-medicate and self-manage your asthma.


Asthma Medication and Adherence

NHS Fylde and Wyre GPs based in Blackpool have stated that:

“There are some circumstances in which continuity of the same brand is important for patient safety and brand-name prescribing [is] preferred.”

This acknowledgement, as taken from the ‘Statement on Brand-Name Prescribing of Inhalers’, is intended to alert health authorities to the need for more consistency in asthma inhaler prescriptions.

The ideal situation would run like this:

1) Your GP prescribes you an asthma medication (which just so happens to be branded Ventolin).

2) The next time you go to refill your asthma prescription, your GP prescribes the same type of asthma medication as before (i.e. the branded Ventolin).

3) You have no confusion about how to take your asthma medication, as you’ll be using the same inhaler you always have done in the past. Also, you won’t be tempted to stop using your inhaler at any point owing to the fact that you’re not sure it’ll work the same as the asthma inhaler you’re used to.

When it comes to medicine adherence, and specifically medicine compliance, (i.e. taking your medication as instructed), understanding your medicine and being fully aware of how it works is vital. NHS Fylde and Wyre state that “patient familiarity with one product is important” in maintaining the safety of people with asthma under NHS care.

With £300 million worth of medicine being wasted every year in the UK, and NHS Improvement reporting a national healthcare deficit of £461 million, making sure that we’re comfortable with our medications and that we take them as and when we should has never been more important.

The statement released by the NHS Fylde and Wyre Clinical Commissioning Group ultimately demonstrates that brand choice can affect how people take their medicine. It thereby suggests that sticking with whichever inhaler you are first prescribed (whether branded or generic), is advisable once your condition is stable and you require no changes to your treatment.


A study into the differences between Ventolin and salbutamol

Research into UK preferences for branded and generic asthma medications found that people with asthma in Scotland most commonly elected Ventolin as their asthma medication of choice.

Only 27% of people with asthma living in Scotland used generic salbutamol to treat their asthma, despite the fact that 45% were prescribed the generic version.

This means that between their doctor’s appointment and their trip to the pharmacy, 12.15% of Scottish people with asthma chose to pick up a branded Ventolin inhaler rather than the generic salbutamol originally prescribed to them.

Doctors who conducted this study into medication preferences noted that there was a prevalent belief amongst the participants, in addition to some GPs, that generic inhaled salbutamol is inferior to Ventolin.

At the close of the study, doctors found that there was no evidence to support this assumption.

Spending two weeks using Ventolin and another two weeks using salbutamol, the people with asthma who participated in this study never altered the amount of times that they used their inhaler and their base levels of peak flow (i.e. the amount and force of breath they could inhale and exhale) did not change with either medicine. This means that the two medicines had the same treatment effects as each other.   

These results, indicating no difference between Ventolin and salbutamol, came back from the clinical findings of this study in spite of the fact that 55% of people with asthma monitored said they were able to detect a difference between the inhalers they used.

Such a variation between clinical results and respondent feedback suggests that brand recognition alone may have been powerful enough to influence the preferences of the people with asthma who participated in the study; essentially producing a placebo effect.


Final thoughts

Based on the evidence currently available, it’s safe to say that there is very little difference between Ventolin and salbutamol.

The only difference between the two, aside from branding, is the size of the inhaler through which they are taken.

You should note that if you prefer the taste of Ventolin over salbutamol (or vice versa), it means you’re actually taking one or both of them in the wrong way. Any asthma medicine you breathe in using an inhaler should travel directly down your air passages and into your lungs, so speak to your doctor if you can taste your asthma medicine, so that he or she can help you correct your inhalation technique.

If you’re left with a bad taste in your mouth after using Ventolin or salbutamol, just know that it’s nothing to do with the medicine. Both work very well for treating asthma, which is why they continue to be commonly prescribed.

Further reading

Still confused by the difference between generic and brand-name medicines? This article explains all. For more information on asthma, check out the NHS website