When and How to Use an Inhaler

There are different types of inhalers that serve different purposes and require different techniques.

Every Day: Control Inhaler

These inhalers help prevent flares and keep symptoms from getting worse. They're called control inhalers because they have medicine that controls inflammation.

Use yours as often as your doctor tells you to, usually once or twice a day:

  • Whether or not you're having symptoms
  • Even if you feel like you're doing better

If you're supposed to use it two times a day, aim for 12 hours apart.

When you begin using this kind of inhaler, it may be 2 to 4 weeks before you notice the drugs start to work.

Quick Relief: Rescue Inhaler

Rescue or relief inhalers quickly bring back normal breathing when you are:

You should keep a rescue inhaler with you all the time. Use it:

  • When you have a flare of symptoms
  • Before you're going to be around your asthma triggers
  • When you run into unexpected triggers

A rescue inhaler is for short-term symptom relief, not to control your asthma in the long term. If you're using yours 2 or more days a week, or more than 2 nights a month, talk to your doctor about a daily control inhaler.

Make Activity Easier

When you have asthma triggered by exercise, short-acting inhalers can make activities that need extra lung power more doable. This includes things such as sports, yard work, and even singing.

  • To help prevent symptoms, use your rescue inhaler 15 to 30 minutes before you start.
  • Keep it on hand in case you have symptoms while you're working.

If lively movement often brings on a flare, don't give up on exercise. Regular exercise can help you control your asthma. It can strengthen lung muscles, make it easier to manage your weight, and boost your immune system. Instead:

  • Try different kinds of activities that are less challenging.
  • Avoid weather conditions that might trigger symptoms.

How to Use a Metered Dose Inhaler (MDI)

Inhalers are different, so check your instructions.

Prime the inhaler first. You need to do this when you use an inhaler for the first time, or if you haven’t used it for 2 weeks or more. Shake it for 5 seconds, turn the inhaler away from you, and press down to spray it. Wait a few seconds and do it again. Then do this two more times for a total of four.

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MDI Without a Spacer

Take off the mouthpiece cover, then:

  • Shake it for 5 seconds.
  • Hold the inhaler up with your index finger on top and your thumb underneath to support it. Use the other hand to hold the spacer if you need to.
  • Breathe out.
  • Put the mouthpiece between your teeth, and close your lips tightly around it. (Make sure your tongue doesn’t block the opening.)
  • You can also hold the mouthpiece about the width of two fingers away from your mouth.
  • Press the top down, and breathe in until your lungs fill completely -- about 4-6 seconds.
  • Hold the medicine in your lungs as long as you can (5-10 seconds is good), then breathe out.
  • If you don’t get enough air in the first breath, wait 15-30 seconds and try again. Shake the canister again before the next puff.
  • Recap the mouthpiece.
  • If your medicine has a steroid in it, rinse your mouth and gargle with water after you use the inhaler. Spit out the water.

MDI With a Spacer

  • Put the inhaler into the spacer.
  • Shake it for 5 seconds.
  • Hold the inhaler up with your index finger on top and your thumb underneath to support it. Use the other hand to hold the spacer if you need to.
  • Breathe out.
  • Put the mouthpiece between your teeth, and close your lips tightly around the spacer. (Make sure your tongue doesn’t block the opening.)
  • Press the top down and breathe in until your lungs fill completely -- about 3-5 seconds.
  • Hold the medicine in your lungs as long as you can (5-10 seconds is good), then breathe out.
  • If you don’t get enough air in the first breath, wait 15-30 seconds and try again. Shake the inhaler again before the second puff. Don’t fill the chamber with two puffs of medicine at once.
  • Recap the mouthpiece.
  • If your medicine has a steroid in it, rinse your mouth and gargle with water after you use the inhaler. Spit out the water.

How to Use a Dry Powder Inhaler

  • Remove the cap.
  • For a single-use device, load a capsule.
  • Breathe out slowly (not into the mouthpiece).
  • Put the mouthpiece between your front teeth and close your lips around it.
  • Breathe in through your mouth deeply for 2-3 seconds.
  • Remove the inhaler. Hold your breath for as long as you can. (Between 4 and 10 seconds is good.)
  • Breathe out slowly.

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How to Clean Inhalers

You have to clean them about once a week so the medication doesn’t build up and block the mouthpiece.

MDI:

  • Remove the canister and cap from the mouthpiece.
  • Don’t wash the canister or put it in water.
  • Run warm tap water through the top and bottom of the mouthpiece for 30-60 seconds.
  • Use a soft cloth to remove any medication buildup.
  • Shake off the water.
  • Let the mouthpiece dry completely. Overnight is best.
  • If you need to use the inhaler before the mouthpiece dries, shake off the extra water, replace the canister, point it away from your face, and test-spray it twice before you use it.

DPI: Don’t wash it with soap and water. Clean the mouthpiece with a dry cloth. Check the instructions for more information.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on May 12, 2019

Sources

SOURCES:

Allergy and Asthma Network: “Asthma Inhalers."

American Academy of Allergy Asthma and Immunology: “Inhaled Asthma Medications: Tips to Remember.”

Asthma Society of Canada: “Controllers: Inhaled Steroids.”

American Thoracic Society Patient Information Series: “Asthma and Exercise for Children and Adults.” 

Canadian Lung Association: “Exercise and Asthma.”

University of Pittsburgh Asthma Institute: “Asthma Fact Sheet.”

Cathy Vitari, RN, BSN, AE-C, clinical research nurse and certified asthma educator, University of Pittsburgh Asthma Institute, University of Pittsburgh Medical Center.

UpToDate: “Patient education: Asthma inhaler techniques in adults (Beyond the Basics).”

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