Metered-dose inhalers (MDIs) usually have 3 parts:
- A mouthpiece
- A cap that goes over the mouthpiece
- A canister full of medicine
If you use your inhaler the wrong way, less medicine gets to your lungs. A spacer device will help. The spacer connects to the mouthpiece. The inhaled medicine goes into the spacer tube first. Then you take two deep breaths to get the medicine into your lungs. Using a spacer wastes a lot less medicine than spraying the medicine into your mouth.
Spacers come in different shapes and sizes. Ask your doctor which spacer is best for you or your child. Almost all children can use a spacer. You do not need a spacer for dry powder inhalers.
The steps below tell you how to take your medicine with a spacer.
- Take the cap off the inhaler and spacer.
- Shake the inhaler hard.
- Attach the spacer to the inhaler.
- If you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for how to do this.
- Breathe out gently to empty your lungs
Breathe in slowly
- Put the spacer between your teeth and close your lips tightly around it.
- Keep your chin up.
- Start breathing in slowly through your mouth.
- Spray 1 puff into the spacer by pressing down on the inhaler.
- Keep breathing in slowly. Breathe as deeply as you can.
Hold your breath
- Take the spacer out of your mouth.
- Hold your breath as you count to 10, if you can.
- Pucker your lips and slowly breathe out through your mouth.
- After using your inhaler, rinse your mouth with water, gargle, and spit. This helps reduce side effects from your medicine.
Keep your inhaler clean
Look at the hole where the medicine sprays out of your inhaler. If you see powder in or around the hole, clean your inhaler. First, remove the metal canister from the L-shaped plastic mouthpiece. Rinse only the mouthpiece and cap in warm water. Let them air dry overnight. In the morning, put the canister back inside. Put the cap on. Do not rinse any other parts.
Replacing your inhaler
For control medicines you take each day, write on the canister the date you need to replace it.
To figure out this date, divide the number of puffs your canister contains by the number of puffs you take each day. For example, if your new canister has 200 puffs (the number of puffs is listed on canister), and your doctor tells you to take 8 puffs each day, this canister should last 25 days. If you started using this inhaler on May 1, replace it on or before May 25. Write May 25 on your canister.
Some inhalers come with counters on the canister. Keep an eye on the counter and replace the inhaler before you run out of medicine.
Puff counters can also be bought at a drugstore or online.
Do not put your canister in water to see if it is empty. This does not work.
Storing your inhaler
Store your inhaler at room temperature. It may not work well if it is too cold. The medicine in the canister is under pressure. So make sure not to get it too hot or puncture it.
Metered-dose inhaler (MDI) administration - with spacer
National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.
National Asthma Education and Prevention Program. How to use a metered-dose inhaler. http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf.Accessed May 8, 2014.National Asthma Education and Prevention Program. How to use a metered-dose inhaler. http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf. Accessed May 8, 2014.
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Update Date 4/26/2014
Updated by: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.