How to Use a Metered-Dose Inhaler the Right Way

Using a metered-dose inhaler is a good way to take asthma medicines. There are few side effects because the medicine goes right to the airways inside the lungs. A spacer or valved-holding chamber attached to the inhaler can help make your inhaler easier to use and more effective. For patients taking inhaled steroids, a valved-holding chamber or spacer may help prevent irritation to the mouth. Inhalers have changed propellants – learn more about this change from CFC to HFA inhalers.

STEPS FOR USING AN INHALER

Get ready

1. Take off the cap and shake the inhaler.
2. Breathe out all the way.
3. Hold the inhaler in one of these two ways, as your doctor or asthma counselor said:

• Use a spacer/valved-holding chamber (the best way, useful for all patients)

• Hold inhaler 1 to 2 inches (or two finger widths) in front of your mouth

Breathe in slowly

4. As you start breathing in slowly through your mouth, press down on the inhaler one time. If you are using a spacer or valved-holding chamber, first press down on the inhaler. Within 5 seconds, begin to breathe in slowly.

5. Keep on breathing in slowly, as deeply as you can.

Hold your breath

6. Hold your breath as you count to 10 slowly, if you can.
7. For inhaled quick-relief medicine (like albuterol), wait about 1 minute between puffs. There is no need to wait between puffs for other medicines.

Dry Powder Inhalers
Dry powder inhalers are used differently. To use a dry powder inhaler, close your mouth tightly around the mouthpiece and inhale very fast. Click here for more information on how to use dry powder inhalers.

Cleaning
The inhaler should be cleaned often to prevent buildup that will clog the inhaler.

• Once a day, clean the inhaler and cap by rinsing them in warm running water. Let them dry before you use it again.
• Twice a week wash the plastic mouthpiece with mild dishwashing soap and warm water. Rinse and dry it well before putting it back.

Knowing When To Replace Your Inhaler
Some inhalers now include counters so you always know how many puffs are remaining in the device. For those that do not have counters, there are a variety of methods to determine how many puffs (i.e., how much medicine) is left.

If the canister is new, it is full. The number of puffs a canister contains is listed on the label. Do NOT put your canister in water to see if it is empty. This does not work.

• For a medicine you take each day: Take the number of puffs in the canister when it is full, and divide it by the number of puffs you take every day. This will tell you how many days your inhaler will last. For example:

Your inhaler canister has 200 puffs in it, you are told to take 8 puffs total every day.

                                                      25 days          
                8 puffs per day   ) 200 puffs in container 

This canister of medicine will last 25 days, so if you started using it on January 1, you should replace it on or before January 25.

• For quick-relief medicine, take as needed and count each puff. To keep track of this, use a check off sheet
• Click here for a pdf, printer-friendly version of this page. You may need to download Adobe Acrobat Reader to view it.

Adapted from How to Use Your Metered-Dose Inhaler the Right Way, Practical Guide for the Diagnosis and Management of Asthma, NIH Publication No. 97-4053, October 1997, National Institutes of Health, National Heart, Lung and Blood Institute