Bronchodilator reversibility test

Spirometry before and after an inhaled bronchodilator

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A bronchodilator reversibility test, also called bronchodilator responsiveness testing, compares spirometry measurements before and after an inhaled medicine that opens the airways. It shows whether, and by how much, airflow improves after the medicine.

At Tartaczna 2 Medical Centre in Gdańsk, we perform spirometry with bronchodilator testing for adults and young people aged 16 and over.

Why is a bronchodilator reversibility test performed?

The test is used when investigating asthma, COPD and symptoms such as breathlessness, wheezing or persistent cough. It helps assess the airway response to medication, but does not establish a diagnosis on its own.

Bronchodilator testing is performed when medically indicated. It is different from a bronchial challenge test, which is a separate investigation.

What happens during the test?

The staff review your health, medicines and preparation.
You perform baseline spirometry, repeating the breathing manoeuvres to obtain reliable measurements.
An inhaled bronchodilator is given according to the test protocol and medical indication.
After allowing time for the medicine to work, usually around 10–20 minutes, spirometry is repeated.
The measurements before and after the medicine are compared.

Allow more time than for baseline spirometry alone. The breathing manoeuvres are also described on our separate spirometry page.

How to prepare for bronchodilator testing

Follow the same preparation as for spirometry: avoid smoking and vaping for at least 4 hours, alcohol for at least 8 hours, a large meal for 2 hours and strenuous exercise for at least 30 minutes. Wear loose clothing and bring a list of medicines and any previous results.

Should I stop using inhalers before the test?

Your doctor decides whether a particular medicine needs to be withheld. The interval depends on the medicine, how long it acts and the purpose of the test. There is no single interval suitable for every inhaler, and combination inhalers contain more than one active ingredient.

Do not stop anti-inflammatory treatment or all asthma or COPD medicines on your own. Check which doses, if any, should be omitted before testing. If you need your prescribed reliever for breathlessness, use it according to your treatment plan and tell the staff what you took and when. Your safety takes priority over completing the test at the originally planned time.

What does a positive or negative result mean?

The doctor assesses changes in FEV1 and FVC, measurement quality and the criteria used in the report. A significant improvement can support a diagnosis of asthma, but a bronchodilator response can also occur in some people with COPD.

A negative test does not rule out asthma. Symptoms, current treatment and variation in the condition all matter. If asthma is still suspected, your doctor may recommend repeat measurements at another time or further investigations.

Precautions and possible side effects

Before the test, report any current infection, recent surgery, heart attack or stroke, unstable heart condition, pneumothorax or previous adverse reaction to inhaled medicines. Medical assessment determines whether testing is appropriate.

Forceful breathing may cause coughing or dizziness. Temporary hand tremor or palpitations can occur after the bronchodilator. Tell the staff about any significant symptoms.