Metered-dose inhaler (MDI) administration - no spacer
Using a metered-dose inhaler (MDI) seems simple. But many people do not use them the right way. If you use your MDI the wrong way, less medicine gets to your lungs and most remains in the back of your mouth. If you have a spacer, use it. It helps get more medicine into your airways.
(The instructions below are not for dry powder inhalers. They have different instructions.)
Take off the cap and shake the inhaler hard.
If you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for how to do this.
Breathe out all the way.
Hold the inhaler 1 to 2 inches in front of your mouth (about the width of 2 fingers).
Breathe in slowly
Start breathing in slowly through your mouth, then press down on the inhaler 1 time.
Keep breathing in slowly, as deeply as you can.
Hold your breath
If you can, hold your breath as you slowly count to 10. This lets the medicine reach deep into your lungs.
If you are using inhaled, quick-relief medicine (beta-agonists), wait about 1 minute before you take your next puff. You do not need to wait a minute between puffs for other medicines.
After using your inhaler, rinse your mouth with water, gargle, and spit. This helps reduce side effects from your medicine.
Keep your inhaler clean
Look at the hole where the medicine sprays out of your inhaler. If you see powder in or around the hole, clean your inhaler.
Remove the metal canister from the L-shaped plastic mouthpiece.
Rinse only the mouthpiece and cap in warm water.
Let them air dry overnight.
In the morning, put the canister back inside. Put the cap on.
Do not rinse any other parts.
Replacing your inhaler
For control medicines you take each day, write on the canister the date you need to replace it. To figure out this date, divide the number of puffs your canister contains by the number of puffs you take each day. For example, say your new canister has 200 puffs (the number of puffs is listed on each canister) and your doctor tells you to take 8 puffs each day. This canister will last 25 days. If you started using this inhaler on May 1, replace it on or before May 25. Write May 25 on your canister.
Some inhalers come with counters on the canister. Keep an eye on the counter and replace the inhaler before you run out of medicine.
Puff counters can also be bought at a drugstore or online.
Do not put your canister in water to see if it is empty. This does not work.
Bring your inhaler to your clinic appointments. Your doctor can make sure you are using it the right way.
Storing your inhaler
Store your inhaler at room temperature. It may not work well if it is too cold. The medicine in the canister is under pressure. So make sure you do not get it too hot or puncture it.
National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.
National Asthma Education and Prevention Program. How to use a metered-dose inhaler. http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf. Accessed May 8, 2014.
Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.