Breathing Problems: How to Use a Metered-Dose Inhaler

A metered-dose inhaler lets you breathe medicine into your lungs quickly. It can help you breathe during an emergency. Or you may use one with a longer-acting medicine to prevent breathing problems and be more active.

A metered-dose inhaler may work faster than the same medicine in a pill. It allows you to take less medicine than you would need if you took it as a pill.

Using a spacer with an inhaler is the best way to get the most medicine to your lungs.

Understanding metered-dose inhalers

A metered-dose inhaler provides a puff of medicine in a measured dose. You use it to inhale medicines directly into your lungs.

You can take different medicines through an inhaler. You may have several inhalers that you use for different reasons. You may use some of them daily to keep your symptoms under control. And you may have one for an emergency that you use when you have severe symptoms.

Using an inhaler

Talk with your doctor to be sure you are using your inhaler the right way. It might help if you practice using it in front of a mirror.

  • Use the inhaler exactly as prescribed.
  • Check that you have the correct medicine. If you use several inhalers, put a label on each one so that you know which one to use at the right time.
  • Keep track of how much medicine is in the inhaler. Check the label to see how many doses are in the container. If you know how many puffs you can take, you can replace the inhaler before you run out. Learn how to estimate how much medicine is left. Your doctor or pharmacist can help you with this.
  • A spacer is recommended for most inhalers. Always use a spacer with inhaled steroid medicines to avoid side effects.

What is a spacer?

A spacer is a chamber that you attach to the inhaler. The chamber has a one-way valve that holds the medicine in the chamber before you inhale it. That way you can inhale the medicine in one or more breaths, depending on your ability.

A spacer helps people who have trouble using an inhaler. It also keeps you from swallowing as much medicine, which reduces side effects.

Here is how to use an inhaler with a spacer:

  1. Shake the inhaler and remove the inhaler cap. Check the inhaler instructions to see if you need to prime your inhaler before you use it. If it needs priming, follow the instructions on how to prime your inhaler.
  2. Place the mouthpiece of the inhaler into the spacer.
  3. Remove the cap from the spacer.
  4. Hold the inhaler upright with the mouthpiece at the bottom.
  5. Tilt your head back slightly, and breathe out slowly and completely.
  6. Place the spacer's mouthpiece in your mouth.
  7. Press down on the inhaler to spray one puff of medicine into the spacer, and then start breathing in slowly (press, then inhale). Hold your breath for 10 seconds. This will let the medicine settle in your lungs.
  8. If you need to take a second dose, wait 30 to 60 seconds to allow the inhaler valve to refill. This will help the medicine get deep into your lungs.

Here is how to use an inhaler without a spacer:

  1. Shake the inhaler and remove the inhaler cap. Check the inhaler instructions to see if you need to prime your inhaler before you use it. If it needs priming, follow the instructions on how to prime your inhaler.
  2. Hold the inhaler upright with the mouthpiece at the bottom.
  3. Tilt your head back slightly, and breathe out slowly and completely.
  4. Position the inhaler in one of two ways:
    • Place the inhaler in your mouth. This method is easier for most people and lowers the risk that any of the medicine will get into your eyes.
    • Or you can place the inhaler 1 to 2 inches in front of your open mouth, without closing your lips over it. This may be better for getting the medicine into your lungs, but some people may find this method too hard to do.
  5. Start breathing in slowly, evenly, and deeply, and press down on the inhaler one time (inhale, then press).
  6. Hold your breath for 10 seconds. This will let the medicine settle in your lungs.
  7. If you need to take a second dose, wait 30 to 60 seconds to allow the inhaler valve to refill. This will help the medicine get deep into your lungs.

If you are using a steroid inhaler, your goal is to inhale the medicine, not swallow it. Gargle and rinse out your mouth with water after use. Do not swallow the water. Swallowing the water will increase the chance that the medicine will get into your bloodstream. This may increase the side effects of the medicine.