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Metered-Dose Inhaler Use (With or Without a spacer)

The metered-dose inhaler (MDI or inhaler) that you were prescribed should be used as directed. The medicine in your inhaler must be breathed deeply into your lungs for it to work. The inhaler sends the medicine directly into your lungs. Make sure you know how to use your inhaler. Always use the correct methods to make sure the medicine reaches the airway in your lungs. If you need help, ask your healthcare provider, nurse, or pharmacist.

Follow the directions below for best results or see the directions that came with your MDI.

How to use your metered-dose inhaler without a spacer

Image of a woman inhaling using an inhaler.

  1. First wash your hands. Then check the expiration date and the counter on the inhaler. Make sure the inhaler still has doses left. Also check that the metal canister is put correctly into the plastic boot.

  2. Remove the cap from the inhaler mouthpiece. Shake the inhaler several times.

    If this is the first time you are using the inhaler, you need to "prime" it. That means making sure it's ready to use and can deliver the correct dose of medicine. It often includes spraying the inhaler a few times in the air before using it. Follow the manufacturer’s directions. Prime the inhaler in the air away from your face.

    The inhaler is now ready to use.

  3. Empty your lungs completely by taking a deep breath in. Then tilt your head back slightly. And blow air out.

  4. Your healthcare provider will tell you whether to use the open-mouth method or closed-mouth method.

    • Closed-mouth method. Put the inhaler mouthpiece in your mouth, past your teeth and above your tongue. Close your lips tightly around the mouthpiece to create a tight seal so the medicine doesn’t spray in your eyes.

    • Open-mouth method. Hold the inhaler up to your mouth, with the mouthpiece two finger-widths away from your lips.

  5. Make sure you are standing up or sitting up straight in a chair. Always keep your inhaler at chin level.

  6. Press down on the medicine canister 1 time to release the medicine. At the same time, breathe in deeply and slowly through your mouth for 3 to 5 seconds.

  7. Remove the mouthpiece from your mouth and then close your lips right away if you are using the closed-mouth method. Or move it away from your mouth if you are using the open-mouth method. Then close your lips.

  8. Hold your breath for up to 10 seconds, if you can. Then breathe out slowly through your mouth.

  9. If your healthcare provider directs you to take more than 1 puff, repeat these steps for each puff of medicine. Wait at least 15 seconds to 1 minute before taking the next puff, or as long as directed by your healthcare provider.

  10. If you’re using a steroid inhaler, rinse your mouth and gargle with water to prevent thrush, a fungal infection. Spit the water out. Don’t swallow the water.

  11. Clean your inhaler after every use or at least once a week or as directed by the manufacturer of the device.

How to use your metered-dose inhaler with a spacer

You may also be prescribed a metered-dose inhaler (MDI or inhaler) with a spacer. This is a special chamber that attaches to your inhaler. It increases the amount of medicine that goes to your lungs. It can also improve how well each treatment works. Ask your healthcare provider about this if you didn't get one.

Remember: It's very important to use correct inhaler methods to make sure the medicine enters into the airway in your lungs.

  1. First wash your hands. Then check the expiration date and the counter on the inhaler. Make sure the inhaler still has doses left. Also check that the metal canister is put correctly into the plastic boot.

  2. Remove the cap from the inhaler. Shake the inhaler several times.

    If this is the first time you are using the inhaler, you need to prime it. That means making sure it's ready to use and can deliver the correct dose of medicine. It usually involves spraying the inhaler a few times in the air before using it. Follow the manufacturer's directions. Prime the inhaler in the air away from your face.

    The inhaler is now ready to use.

  3. Next remove the cap from the spacer and look into the mouthpiece of the spacer to make sure nothing is in it (the spacer).

  4. Attach the spacer to the inhaler.

  5. Empty your lungs completely by taking a deep breath in and tilting your head back slightly and blowing air out.

  6. Spacer with a mouthpiece: Put the mouthpiece of the spacer in your mouth, past your teeth and above your tongue. Make sure your tongue doesn't block the opening of the spacer mouthpiece. Close your lips tightly around it to create a tight seal. Spacer with a mask: Make sure the mask covers your nose and mouth. There should be no space between your skin and the mask.

  7. Make sure you are standing up or sitting up straight in a chair. Always keep your chin level.

  8. Press down on the canister 1 time to release the medicine. Then breathe in slowly and deeply through your mouth until all of the medicine in the spacer is gone or as directed by your healthcare provider. If your spacer has a whistle built in, hearing the whistle means you are breathing in too quickly.

  9. Remove the spacer mouthpiece from your mouth and close your lips.

    Hold your breath for up to 10 seconds, if you can. Then breathe out slowly through your mouth.

  10. If your healthcare provider directs you to take more than 1 puff, repeat these steps for each puff of medicine. Wait at least 15 seconds to 1 minute before taking the next puff, or as long as directed.

  11. If you’re using a steroid inhaler, swish, rinse, and gargle with water to prevent thrush, a fungal infection. Spit the water out. Don’t swallow the water. If a mask was used, wash your face, especially around your mouth and nose, with warm water to prevent a skin rash.

Clean your inhaler and spacer after every use or at least once a week or as directed by the manufacturer of the device. Always remember to remove the metal canister before cleaning the plastic boot.

Warning

If you've been diagnosed with asthma, always remember to follow your Asthma Action Plan. If you have been diagnosed with a lung condition or disease, it's important to follow the advice given to you by your healthcare provider. Follow up with our healthcare provider to develop an action plan or update your current Asthma Action Plan based on your health condition.

Keep your metered-dose inhaler clean

  1. First wash your hands and remove the metal medicine canister from the plastic mouthpiece. The metal cannister is never washed or immersed in water.

  2. Run warm tap water through the top of the mouthpiece for 30 seconds. Then run warm tap water through the bottom of the mouthpiece for 30 seconds.

  3. Use a soft cloth to remove any crusting of medicine around the pinhole in the plastic mouthpiece. Shake off excess water.

  4. Let the mouthpiece air dry fully. It's best to let it dry, but if you need to use the inhaler before the mouthpiece is dry, shake off excess water. Then replace the metal canister.

  5. Test spray the medicine twice, away from your face before use.

Keep your inhaler at room temperature or as directed by the package insert of the medicine.

Keep your spacer clean

Read the directions that come with your spacer on how to take the spacer apart.

Spacers should be washed in warm water and dishwashing soap once a week.

Let the spacer air-dry fully before using it again. The spacer should not be wiped with a towel.

When to get medical advice

Call your healthcare provider right away if any of the following occur:

  • Symptoms documented on your Asthma Action Plan by your healthcare provider

  • Need to use your inhaler more often than normal or as directed by your healthcare provider

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Coughing up lots of dark or bloody sputum (mucus)

  • New symptoms develop

Call 911

Call 911 if you are having:

  • Symptoms documented on your Asthma Action Plan by your healthcare provider

  • Wheezing, shortness of breath, or trouble breathing that doesn't improve with treatment (or your medicine is not working)

  • Blue or gray lips, fingernails, or skin

  • Peak flow reading less than 50% of your normal best or as directed by your healthcare provider

  • Chest pain or chest tightness

  • Trouble talking

  • Feeling lightheaded or dizzy

  • Feeling of doom

Online Medical Reviewer: Chris Southard RN
Online Medical Reviewer: Deborah Pedersen MD
Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Date Last Reviewed: 6/1/2023
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