Spacers and Valved-Holding Chambers

If you don't use your inhaler the right way, much of the medicine may end up on your tongue, on the back of your throat, or in the air. A spacer or valved-holding chamber can help keep this from happening. A spacer or valved-holding chamber attaches to the inhaler. It holds the medicine in the chamber long enough for you to inhale the medicine in one or two slow, deep breaths. A spacer will help keep you from coughing when using an inhaler. A spacer will also help prevent you from getting a yeast infection in your mouth (known as thrush) when taking inhaled steroid medicines.

To use a spacer or valved-holding chamber, first read the instructions that came with it, since there are many types available. Use the general instructions below to help you get the most from your MDI.

1) Remove cap from metered dose inhaler (MDI).	2) Holding MDI upright, place in end of holding chamber.
3) Shake the MDI and chamber three to five times.	4) Tilt your head back slightly and breathe out.
5) Put your mouth around the holding chamber mouthpiece.	6) Squeeze down on the MDI to send the medicine into the holding chamber. 7) Breathe in slowly and completely, for three to five seconds.
8) Hold your breath for about ten seconds. 9) Repeat as your doctor or asthma educator tells you to do. Wait one minute between puffs.

Adapted from How to Use Your Metered-Dose Inhaler the Right Way, found in the 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. Pictures courtesy of Institute for Health Studies, Michigan State University.