What Inhaler Is Stronger Than Trimbow

What Inhalers Are Stronger or Offer an Alternative to Trimbow?

There isn’t a single inhaler that’s stronger than Trimbow in terms of medication per dose, but there are alternative combinations and delivery methods that can be used when triple therapy in a single inhaler isn’t doing enough.

1. Separate Triple Therapy Inhalers

Instead of a combined inhaler like Trimbow, your doctor may prescribe:

• A LAMA/LABA inhaler such as Ultibro Breezhaler or Anoro Ellipta

• Alongside a separate ICS inhaler such as Clenil Modulite or Fostair

This allows greater control over individual doses and delivery, especially if stronger doses of one component are needed (e.g. a higher-dose steroid).

2. Nebulisers for Advanced COPD or Asthma

For those with very severe COPD or asthma that isn’t well controlled on inhalers, nebulised medication may be introduced. Nebulisers deliver medication in a mist that’s inhaled over time, and can include bronchodilators like Salbutamol or Ipratropium, as well as nebulised corticosteroids.

Nebulised therapy is often used in hospital settings or prescribed for home use in severe cases.

3. Biologic Therapies for Severe Asthma

If your diagnosis includes severe asthma, and symptoms persist despite high-dose triple therapy like Trimbow, your consultant may assess your suitability for biologic injections. These are targeted therapies that work on the immune system, such as:

• Fasenra (benralizumab)

• Xolair (omalizumab)

• Dupixent (dupilumab)

These are not inhalers, but they can significantly reduce asthma flare-ups and steroid dependence in patients with allergic or eosinophilic asthma.

Can the Dose of Trimbow Be Increased?

Trimbow comes in a few different strengths, such as:

• 87/5/9 micrograms

• 172/5/9 micrograms

If you’re on the lower strength, your doctor may increase the dosage before considering a new inhaler entirely. This decision usually depends on lung function tests, symptom diary reviews and exacerbation history.

Are There Side Effects with Stronger Inhalers?

Stronger or more complex inhaler regimens may increase the risk of side effects such as:

• Oral thrush (from higher steroid doses)

• Hoarseness

• Palpitations or tremors (from stronger bronchodilators)

• Dry mouth or urinary retention (from anticholinergics)

Your clinician will weigh these risks against potential benefits, especially if you're experiencing more flare-ups or needing oral steroids more often

What Should You Do Next?

If you feel Trimbow isn’t working as well as it used to, or your symptoms have changed—it’s important to speak to your GP or respiratory nurse. They may carry out a full asthma or COPD review, check inhaler technique and adherence, and decide whether to increase the dose, change the inhaler, or explore advanced options like nebulisers or biologics.

Never stop or change your inhaler without professional advice, as this can lead to worsening symptoms or even life-threatening exacerbations.

Final Thoughts: There Are Options Beyond Trimbow

Trimbow is a powerful inhaler designed for people who need full triple therapy, but it’s not the final step in respiratory treatment. Whether it’s moving to a split therapy regime, exploring nebulisers, or starting biologic treatment for severe asthma, there are stronger or more tailored options available if symptoms persist.

Talk to your respiratory team they’ll help you find the best combination to keep your symptoms under control and improve your quality of life.