If I rely on Ventolin nebules at home, what should I do right now?

Book a GP appointment specifically to review your asthma management. The key questions are: why you are using nebulised salbutamol rather than an inhaler and spacer; whether your preventer (inhaled corticosteroid) medication is adequate; and what your written Asthma Action Plan says for exacerbations. Your GP can refer you to a respiratory physician if your asthma is difficult to control. The National Asthma Council Australia also has updated resources at asthmacommunity.com.au.

Ventolin nebule shortage: what your asthma plan should look like right now

Q: Is a puffer with a spacer actually as effective as a nebuliser for asthma?

For most people managing mild to moderate asthma symptoms at home, yes. Evidence consistently shows that a pressurised metered-dose inhaler used with a spacer delivers salbutamol at least as effectively as a nebuliser, with the added benefit of portability. Nebulisers are slower (up to 10 minutes per treatment) and are not portable. For severe acute asthma in a monitored clinical setting, the picture is more complex — but for home management, a pMDI and spacer is the guideline-recommended approach.

What just happened

GlaxoSmithKline Australia has confirmed a shortage of Ventolin nebules that will run for the remainder of 2026. The 5 mg/2.5 mL ampoules are out of stock until 17 August. The 2.5 mg/2.5 mL ampoules are on limited availability through 21 December.

The cause is a combination of factors: depletion of non-GSK salbutamol supplies, de-registration of competitor products, increased demand for branded Ventolin, and manufacturing constraints. None of those factors are expected to resolve quickly.

For people whose asthma management includes regular nebuliser use at home, this is a practical problem — not a clinical crisis, but a supply gap that needs a plan. The RACGP is asking GPs to take this as a prompt to review whether the patients on their books who use nebulised salbutamol are on the right form of treatment in the first place.

That is a question worth sitting with — because the answer, for most of them, is that they are not.

Both-and

The clinical case for moving away from SABA-only treatment

The Australian Asthma Handbook is unambiguous on this point. Clinical Associate Professor Debbie Rigby, National Asthma Council: “No adult or adolescent should be using SABA-only treatment.” Dr Kerry Hancock, RACGP Respiratory Medicine Chair, is equally direct: “Most patients with asthma should not be using short-acting beta agonists — that’s salbutamol — for management.”

The evidence base for this position has firmed over the past decade. Regular salbutamol use without an inhaled corticosteroid (ICS) as a preventer increases the risk of fatal and near-fatal asthma attacks. It also suppresses the perception of worsening airway inflammation — the person feels temporarily better while the underlying inflammation continues unchecked. Relying on a reliever without a preventer treats the symptom while the condition producing the symptom goes unmanaged.

The revised Australian guideline position — which aligns with international consensus — is that ICS-containing therapy is first-line treatment for virtually all people with persistent asthma from adolescence onwards. If you are relying on salbutamol alone to manage your asthma, that is not aligned with current evidence, and this shortage is an opportunity to change that with your GP’s support.

The inhaler versus nebuliser question

If someone needs salbutamol during an exacerbation, is a puffer with a spacer actually as effective as a nebuliser?

For most people managing mild to moderate symptoms at home: yes. Evidence consistently shows that pressurised metered-dose inhalers used with a spacer deliver salbutamol at least as effectively as a nebuliser in this population, with the practical advantage of portability. A nebuliser requires a power source, takes up to 10 minutes per treatment, and is not something most people can use while driving themselves to an emergency department.

There are specific clinical contexts where a nebuliser is the appropriate choice — severe acute asthma requiring continuous administration in a monitored setting, or patients with very poor inhaler technique who cannot be retrained. But home nebuliser use for routine exacerbation management in people who have not had their preventer adequately optimised is not guideline-concordant practice for most adults.

The practical move for GPs reviewing their nebuliser-dependent patients is straightforward: assess inhaler technique, optimise the preventer regimen, provide a written Asthma Action Plan, and transition to a pMDI and spacer for home reliever use.

One piece of genuinely new clinical news in the same story

The RACGP story also noted TGA registration this month of depemokimab (Exdensur) — a new anti-interleukin-5 monoclonal antibody for severe eosinophilic asthma, administered every six months. If you have severe asthma that is not controlled on high-dose ICS plus add-on therapy, this is worth raising with your respiratory specialist. The six-monthly injection interval is a meaningful step forward in treatment burden compared with existing biologics that require monthly or fortnightly administration.

My two cents

A supply shortage of a reliever medication is not the time to panic. It is the time to review.

The practical question for anyone using nebulised salbutamol at home: when did you last have your asthma formally reviewed? If the answer is “more than 12 months ago” or “I’m not sure what my preventer medication is” — book an appointment now, before the shortage creates a situation where you need relief and cannot access it.

The clinical hierarchy for asthma management in adults in 2026 looks like this:

Preventer (ICS or ICS-combination) — taken daily, prevents the inflammation that causes exacerbations. This is the foundation.

Reliever (salbutamol pMDI and spacer) — used when symptoms break through; should be needed infrequently if preventer is adequate.

Nebulised salbutamol — for clinical settings and the small proportion of people who genuinely cannot use an inhaler and spacer effectively.

If you are sitting at the third level for home management, your asthma plan needs revisiting regardless of the shortage.

Verdict: yes — the Ventolin nebule shortage is a real supply problem, and the RACGP response is the right one: use the gap to review whether nebuliser-dependent patients are on evidence-aligned preventer therapy.

Sources cited

GPs urged to review asthma prescribing amid Ventolin nebule shortage. RACGP NewsGP, July 2026. https://www1.racgp.org.au/newsgp/clinical/gps-urged-to-review-asthma-prescribing-amid-ventol
Australian Asthma Handbook. National Asthma Council Australia. https://www.asthmahandbook.org.au