Patient education: How to use your metered dose inhaler (adults) (The Basics)

How do metered dose inhalers work? — Metered dose inhalers, or "MDIs," release medicine when you press down on the top of the canister (figure 1).

This article has instructions for how to use an MDI. The instructions are different for other types of inhalers, such as soft mist inhalers or dry powder inhalers.

How do I get the inhaler ready? — The first time you use your inhaler, you need to get it ready. This is called "priming." To do this, you:

●Take the cap off of the mouthpiece.

●Shake the inhaler for 5 seconds.

●Press down on the canister to spray the medicine into the air (away from your face).

●Repeat these steps 3 more times.

If you don't use your inhaler every day, check when it needs to be primed again. Most inhalers need to be primed if you haven't used them for more than 2 weeks. This means following the steps above before you use the inhaler again. Some inhalers need to be primed after 1 week of not using them.

After your inhaler is ready, you can use it as prescribed.

How do I use the inhaler? — Each inhaler comes with its own directions. Your doctor or nurse will show you how to use yours. In general, to use a metered dose inhaler, you:

●Take the cap off of the mouthpiece.

●Shake the inhaler for 5 seconds.

●Hold the inhaler upright with your finger on the top of the canister and your thumb holding the bottom of the inhaler (figure 2).

●Breathe out a normal breath.

●Close your lips around the mouthpiece, or hold the mouthpiece 1 to 2 inches (4 cm) in front of your mouth.

●As you start to inhale the next breath, press down on the canister.

●Keep inhaling deeply and slowly through your mouth.

●When your lungs are full, hold your breath for 5 to 10 seconds to keep the medicine in your lungs.

●Let your breath out.

●If you are supposed to take 2 puffs of your inhaler, wait 15 to 30 seconds before you take the second puff. Shake the inhaler again before the second puff.

●Put the cap back on the mouthpiece.

●If you use a "glucocorticoid" (steroid) inhaler, rinse your mouth out with water, gargle, and spit out the water.

What if I have trouble pressing on the canister and breathing in? — If you have trouble pressing down on the canister and breathing in at the same time, let your doctor or nurse know. They can prescribe:

●A spacer – A spacer is a device that attaches to the inhaler's mouthpiece. When you press down on the canister, the medicine sprays into the spacer and sits there until you breathe it in.

●A different type of inhaler – Dry powder inhalers work in a different way. They deliver the medicine when you take a deep breath from the inhaler, instead of when you press down on the canister.

How do I use an inhaler with a spacer? — Follow the directions above to get the inhaler ready (figure 2). Then:

●Put the inhaler into the spacer, and shake for 5 seconds.

●Breathe out a normal breath.

●Close your lips around the spacer's mouthpiece (figure 2).

●Press down on the canister.

●Breathe in deeply and slowly, and hold your breath for 5 to 10 seconds. Breathe out away from the spacer.

●If you are supposed to take 2 puffs of your inhaler, wait 15 to 30 seconds before you take the second puff. Shake the inhaler again before the second puff.

Some spacers let you know if you breathe in too fast by making a whistle noise. If you hear a whistle noise when you breathe in, breathe in more slowly.

How do I clean the inhaler? — If you use your inhaler every day, clean it at least once a week. If you don't use your inhaler every day, you can clean it less often.

To know when you need to clean it, look inside the mouthpiece. Clean your inhaler when you see powder in or around the hole.

To clean an inhaler:

●Remove the canister and cap from the mouthpiece. Do not wash the metal canister or put the canister under water.

●Run warm water through the mouthpiece for 30 to 60 seconds.

●Shake the water off of the mouthpiece. Let air dry overnight.

●Put the canister back in the mouthpiece. Replace the cover.

How do I clean the spacer? — If you use a plastic spacer every day, it will come with instructions on how often to clean it. This might be every 1 to 2 weeks.

Wash the spacer with warm water and dishwashing soap. Rinse it, and let air dry. Some hard plastic spacers can go in the dishwasher.

If you use a cardboard chamber every day, replace it every week or if it gets wet or damaged. Do not wash the bag.

How do I know when the inhaler is empty? — Some inhalers come with a built-in dose counter (picture 1). The counter keeps track of how many doses are left in the inhaler.

When the counter reads 0 (zero), it has no more medicine in it. Throw out the inhaler. Make sure to get another inhaler before the counter reads 0 on the old one.

If your inhaler doesn't have a built-in counter, you need to keep track of the number of doses left. Based on how often you use the inhaler, you can figure out when you will need a refill. Write this date down.

More on this topic

Patient education: Asthma in adults (The Basics)
Patient education: Asthma in children (The Basics)
Patient education: Medicines for asthma (The Basics)
Patient education: How to use your dry powder inhaler (adults) (The Basics)
Patient education: How to use your soft mist inhaler (adults) (The Basics)
Patient education: Inhaled corticosteroid medicines (The Basics)
Patient education: Asthma action plan for adults (The Basics)
Patient education: Asthma action plan for children (The Basics)
Patient education: COPD exacerbation (The Basics)

Patient education: Inhaler techniques in adults (Beyond the Basics)
Patient education: Asthma inhaler techniques in children (Beyond the Basics)
Patient education: Asthma treatment in adolescents and adults (Beyond the Basics)
Patient education: Asthma treatment in children (Beyond the Basics)