Asthma inhalers and colour coding: universal dots.

The importance of colour-coded asthma treatment in patient education is well accepted. Traditionally, reliever medication inhalers are blue in colour and preventer inhalers brown. This custom is not always followed and the inconsistencies in the colour of inhalers create a lot of confusion. Marketing of the same medication in different colour inhalers and introduction of new drugs and combinations contributed to this predicament. The confusion created by the introduction of generic salbutamol in UK in orangecoloured inhalers has been previously discussed. Salbutamol in some countries comes in white inhalers with a blue cap. The colour coding of caps is never reliable as patients can easily change these stoppers. Across the world, inhaled corticosteroids (ICS) are available as brown, white, magenta, blue, orange brown, and red inhalers. Long-acting betaagonists (LABA) are now marketed in green, blue, white, and greenish blue containers. The new hydrofluoroalkane propellant-based salbutamol is marketed in red or yellow jackets. Interestingly, their advertisement in a journal asks patients to reach for the ‘red’ in case of need. Inhaled steroids and LABA combinations were introduced in violet, red, and brown inhalers. So at any point of time a patient can be exposed to a collection of coloured inhalers with total uncertainty of its contents. Ideally, to have certain colours universally accepted would be most order of colours reserved universally. Following the same principle, an alternative identification, colour bands, can also be considered; these could be called ‘universal bands’ or ‘U bands’ (Figure 1B). Partridge, narrates his unsuccessful efforts to get responsible bodies interested in the problems created by the introduction of a generic salbutamol inhaler. He is not alone in raising the same concerns. Nevertheless, we hope to revive discussion around the convenience of having uniform colours for inhalers. We call upon all manufacturers to consider this concept and adopt the suggested colours for each class of medications.