How to Use an Asthma Inhaler Properly, Step by Step

Inhalers are the main medicine for people with asthma. But the medicine inside only helps when it is really breathed down into the lungs. With the wrong technique, much of it can stay in the mouth or throat. That is why how you use an inhaler matters as much as the medicine itself.

This article is about the pressurised metered dose inhaler, or pMDI, the most common type, where you press a canister to release a spray.

Steps for using a spray inhaler

From Asthma + Lung UK, the UK charity for asthma and lung health:

1. Hold the inhaler upright and take the cap off.
2. Check that there is nothing inside the mouthpiece.
3. Shake the inhaler well.
4. Sit or stand up straight and tilt your chin up slightly, which helps the medicine reach your lungs.
5. Breathe out gently and slowly, away from the inhaler, until your lungs feel empty.
6. Put your lips around the mouthpiece to make a tight seal.
7. Start to breathe in slowly and steadily, and at the same time press the canister once.
8. Keep breathing in slowly through your mouth until your lungs feel full.
9. Take the inhaler out of your mouth, close your lips, and hold your breath for up to ten seconds, or as long as is comfortable.
10. Breathe out gently through your mouth, away from the inhaler.
11. If you have been prescribed a second puff, wait 30 seconds to a minute, shake again, and repeat steps 4 to 10.
12. When you have finished, put the cap back on.

If the inhaler is new, or has not been used for five days or more, release one test puff into the air first, with the mouthpiece pointing away from you.

Use a spacer if advised

A spacer is a tube that fits between the inhaler and your mouth. Asthma + Lung UK says it helps the medicine get into the lungs and lowers the risk of side effects. The NHS recommends a spacer for people using high dose steroid inhalers, and always for children aged 15 and under.

Rinse after a steroid inhaler

Preventer inhalers usually contain a steroid. After using one, rinse your mouth with water and spit it out, or brush your teeth. The NHS says this helps prevent oral thrush, a dry throat, and a hoarse voice.

A preventer inhaler is used every day, even when you have no symptoms. Do not stop it on your own without talking to your doctor.

When to get help quickly

For a reliever inhaler such as salbutamol, the NHS gives this guide:

• During an asthma attack, a reliever can be used up to 10 puffs, with 30 to 60 seconds between each and a shake every time.
• If you do not feel better after 10 puffs, or you feel worse at any time, call emergency services straight away.
• See a doctor if you need your reliever more than 4 times in a day, on 3 or more days a week, or in the middle of the night at least once a week. This is a sign your asthma is not under control.

Have your technique checked

Inhaler technique is worth checking regularly. Bring your inhaler to the pharmacy, and a Coapotek pharmacist can watch how you use it and help you get it right.

Sources

1. Asthma + Lung UK. How to use a pMDI inhaler.
2. NHS. How and when to use salbutamol inhalers.
3. NHS. How and when to use beclometasone inhalers and Side effects of beclometasone inhalers.