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How to use an inhaler - no spacer

Metered-dose inhaler (MDI) administration - no spacer; Bronchial nebulizer; Wheezing - nebulizer; Reactive airway - nebulizer; COPD - nebulizer; Chronic bronchitis - nebulizer; Emphysema - nebulizer

Using a metered-dose inhaler (MDI) seems simple. But many people do not use them the right way. If you use your MDI the wrong way, less medicine gets to your lungs, and most remains in the back of your mouth. If you have a spacer, use it. It helps get more medicine into your airways.

(The instructions below are not for dry powder inhalers. They have different instructions.)

Getting Ready

  • 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 when and how to do this.
  • Take the cap off.
  • Look inside the mouthpiece and make sure there is nothing in it.
  • Shake the inhaler hard 10 to 15 times before each use.
  • Breathe out all the way. Try to push out as much air as you can.

Breathe in Slowly

  • Hold the inhaler with the mouthpiece down. Place your lips around the mouthpiece so that you form a tight seal.
  • As you start to slowly breathe in through your mouth, press down on the inhaler one time.
  • Keep breathing in slowly, as deeply as you can.

Hold Your Breath

  • Take the inhaler out of your mouth. If you can, hold your breath as you slowly count to 10. This lets the medicine reach deep into your lungs.
  • Pucker your lips and breathe out slowly through your mouth.
  • If you are using inhaled, quick-relief medicine (beta-agonists), wait about 1 minute before you take your next puff. You do not need to wait a minute between puffs for other medicines.
  • Put the cap back on the mouthpiece and make sure it is firmly closed.
  • After using your inhaler, rinse your mouth with water, gargle, and spit. Do not swallow the water. 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.

  • 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

Most inhalers come with counters on the canister. Keep an eye on the counter and replace the inhaler before you run out of medicine.

DO NOT put your canister in water to see if it is empty. This does not work.

Bring your inhaler to your clinic appointments. Your provider can make sure you are using it the right way.

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 you do not get it too hot or puncture it.

References

Laube BL, Dolovich MB. Aerosols and aerosol drug delivery systems. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 63.

Waller DG, Sampson AP. Asthma and chronic obstructive pulmonary disease. In: Waller DG, Sampson AP, eds. Medical Pharmacology and Therapeutics. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 12.

  • Inhaler with no spacer - adults

    Animation

  •  

    Inhaler with no spacer - adults - Animation

    If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, 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 when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

  • Inhaler with no spacer - child

    Animation

  •  

    Inhaler with no spacer - child - Animation

    If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, 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 when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

  • Inhaler medication administration

    Inhaler medication administration - illustration

    An inhaler is a quick way of administering medicine directly into the bronchial passageways to promote clearer breathing.

    Inhaler medication administration

    illustration

  • Inhaler with no spacer - adults

    Animation

  •  

    Inhaler with no spacer - adults - Animation

    If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, 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 when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

  • Inhaler with no spacer - child

    Animation

  •  

    Inhaler with no spacer - child - Animation

    If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, 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 when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

  • Inhaler medication administration

    Inhaler medication administration - illustration

    An inhaler is a quick way of administering medicine directly into the bronchial passageways to promote clearer breathing.

    Inhaler medication administration

    illustration

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Review Date: 1/13/2020

Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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