MHRA Alert – SABA Overuse in Asthma: Safety Reminder and Prescribing Guideline Changes

MHRA Safety Reminder: Short-Acting Beta 2 Agonist Overuse

Healthcare professionals and patients are reminded of the significant risks associated with overuse of short-acting beta 2 agonists (SABA) in asthma management. The MHRA has issued this alert to reinforce existing safety guidance and highlight recent changes to SABA prescribing recommendations.

Key Safety Points

• Overuse of SABA—with or without anti-inflammatory maintenance therapy—is associated with severe asthma attacks and increased mortality risk
• Frequent SABA use (more than twice weekly) is a marker of poor asthma control and indicates need for review
• SABA should be used as reliever therapy only; regular use suggests inadequate maintenance anti-inflammatory treatment
• Recent prescribing guidelines have been updated to reflect best practice in SABA use

Affected Medications

This alert applies to:

• Salbutamol (albuterol)
• Terbutaline

Recommended Actions

• Review asthma patients currently using SABA frequently or regularly
• Assess control and optimise maintenance anti-inflammatory therapy where needed
• Counsel patients on appropriate SABA use as reliever therapy only
• Familiarise yourself with the updated SABA prescribing guidelines
• Consider referral to specialist asthma services if control remains poor despite optimisation

Further Information

For the full MHRA drug safety update, visit the MHRA website.