Correct Use of a Metered-Dose Inhaler

A metered-dose inhaler (a.k.a., inhaler) is a small portable canister, encased in a plastic device, which holds medication and delivers it in aerosol form, in exact doses, so that it can be inhaled directly into the lungs. Inhalers are the most efficient and effective way of relieving symptoms of asthma and bronchospasm and of rapidly improving airflow to the lungs.

Proper use of an inhaler is important in order to receive the entire metered dose of medication and ensure adequate alleviation of symptoms. Below are some tips to help you use your inhaler correctly:

First, check to see if the canister contains enough medication.
If your inhaler has been used often, it might be low on medication or even empty. An easy way to check the amount of medication remaining in your inhaler is to place the canister (without the plastic device) in a container of water. If the canister floats sideways on the surface, it is empty. If it tips up, it is partly full. If it sinks to the bottom of the container, it is full.

Administer the medication.

1. Reassemble the inhaler and remove the cap from the mouthpiece.

2. Vigorously shake the inhaler (failure to do this can result in unreliable delivery of the medication).

3. Hold the inhaler upright with your index finger on top and your thumb on the bottom. Position the mouthpiece about 1½ - 2 inches away from your mouth. Tilt your head back slightly and breathe out through your mouth.

4. Opening your mouth wide, simultaneously press down on the top of the canister while you slowly and deeply breathe in the medicine (3-5 seconds).

5. Close your mouth and hold your breath for 10 seconds, or as long as you comfortably can, to allow the medicine to travel deeply into your lungs. Resume normal breathing after exhaling.

6. Repeat steps 3-5 as many times as directed by the health care provider. Allow 1 minute between puffs to permit deeper penetration of the medicine with each remaining puff.

Note: Dry powder capsule inhalers are used differently. To use a dry powder inhaler, insert the mouthpiece into your mouth and seal your lips tightly around it. To receive the medicine, inhale rapidly.

Using a spacer.
Some people find it easier to use a spacer or holding chamber when administering their medication. A spacer or holding chamber is a device that attaches to a metered dose inhaler and holds the medicine in its chamber long enough for you to inhale it in one or two slow breaths. Use of a spacer or holding chamber has several advantages: 1) it eliminates the need to precisely time your inhale with release of the medicine, 2) it reduces the problem of medicine ending up on your tongue or the back of your throat or in the air rather than in your lungs, and 3) it helps to prevent some of the side effects generally associated with inhaled steroid medicines, such as thrush (yeast infection of the mouth) and hoarseness.

To use a spacer or holding chamber:

1. Attach the inhaler to the spacer or holding chamber as directed.
2. Vigorously shake the device.
3. Press down on the top of the inhaler canister to release one dose of medicine into the holding chamber.
4. Put the mouthpiece of the spacer or holding chamber in your mouth and inhale slowly. Hold your breath for a few seconds and then exhale.
5. Repeat step 4 two more times.
6. Repeat steps 3-5 as many times as directed by the health care provider.

Additional Tips:

Take only the recommended number of puffs prescribed by your health care provider.
If your chest feels tight, use a bronchodilator before using your inhaler – this will help open your airways and allow more medicine to enter deeper into your lungs.
Once a day clean the inhaler and cap by removing the canister and rinsing the plastic container under warm running water. Dry thoroughly before reassembling.
Twice a week remove the canister and wash the plastic mouthpiece with mild dish soap and warm water. Rinse and dry well before reassembling.

Should any of these occur, notify your health care provider:

You are not experiencing any relief from your metered-dose inhaler, or the relief is short-lived (only 1-2 hours).
Your peak flow keeps dropping after treatment or falls below 50% of your personal best.
You are experiencing weakness, increased heart rate, shakiness, insomnia, nervousness, headaches, and nausea or vomiting.
You are low on your medication supply.
You have any other concerns or questions about your condition and/or your medication.

The information provided above is for educational purposes only. Please do not use this information to diagnose yourself. If you have further questions or concerns about this topic or any others, please contact a Campus Health Service provider, 621-9202.