Metered-Dose Inhaler Use (No Spacer)

Image of a woman inhaling using an inhaler.

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 and 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 instructions below for best results or see the instructions that came with your MDI.

  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 proper dose of medicine. It often includes spraying the inhaler a few times in the air before using it. Follow the manufacturer’s instructions. 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 and tilting your head back slightly and blowing air out.

  4. Your healthcare provider will tell you whether to use the open-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 2 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 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. 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 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 proper dose of medication. It usually involves spraying the inhaler a few times in the air before using it. Follow the manufacturer's instructions. Prime the inhaler in the air away from your face.

    The inhaler is now ready to use.

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

  4. Attach the spacer to the inhaler.

    Remove the cap from the spacer mouthpiece.

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

  6. 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.

  7. If you are using a spacer with a mask, make sure the mask covers your nose and mouth. There should be no space between your skin and the mask. Depending on your age, your healthcare provider may tell you to breathe in and out 5 to 10 times after each dose before removing your spacer

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

  9. Press down on the canister 1 time to release the medicine. Then breathe in slowly and deeply 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.

  10. 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.

  11. 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.

  12. 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.

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 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.

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.

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 provider

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

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

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

  • New symptoms develop

Call 911

Call 911if 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

  • Unable or hard to talk

  • Feeling lightheaded or dizzy

  • Feeling of doom

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