An international clinical trial in 3,132 patients 12 years or older has shown that use of blue inhaler alone is associated with a 26% higher risk of severe asthma than when the salbutamol is given in combination with a steroid.

For older children and adults it is now suggested that even for mild asthma, salbutamol is not administered alone but with a steroid to reduce the potential for exacerbations.

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