Using your inhaler (puffer) properly is important when you have asthma or COPD (chronic obstructive pulmonary disease).
This short clip shows you how to use a standard metered dose inhaler (MDI), often called a puffer, with a spacer.
Medications
A standard puffer and spacer is used with many different medications. These include:
- Airomir (salbutamol)
- Alvesco (ciclesonide)
- APO-Salbutamol (salbutamol)
- Asmol (salbutamol)
- Atrovent (ipratropium)
- Flixotide and Flixotide Junior (fluticasone propionate)
- Flutiform (fluticasone propionate)
- Intal and Intal Forte (sodium cromoglycate)
- Qvar (beclomethasone)
- Seretide (fluticasone propionate plus salmeterol)
- Tilade (nedocromil sodium)
- Ventolin (salbutamol)
Checklist of steps
Multiple breath method
- Assemble spacer (if necessary)
- Remove inhaler cap
- Check dose counter (if device has one)
- Hold inhaler upright and shake well
- Insert inhaler upright into spacer
- Put mouthpiece between teeth (without biting) and close lips to form good seal
- Breathe out gently, into the spacer
- Keep spacer horizontal and press down firmly on inhaler canister once
- Breathe in and out normally for 3 or 4 breaths
- Remove spacer from mouth
- Breathe out gently
- Remove inhaler from spacer
- If more than one dose is needed, repeat all steps starting from step 4
- Replace inhaler cap
Single breath method
- Assemble spacer (if necessary)
- Remove inhaler cap
- Check dose counter (if device has one)
- Hold inhaler upright and shake well
- Insert inhaler upright into spacer
- Put mouthpiece between teeth (without biting) and close lips to form good seal
- Breathe out gently, into the spacer
- Keep spacer horizontal and press down firmly on inhaler canister once
- Breathe in slowly and deeply
- Hold breath for about 5 seconds or as long as comfortable
- While holding breath, remove spacer from mouth
- Breathe out gently
- Remove inhaler from spacer
- If more than one dose is needed, repeat all steps starting from step 4
- Replace inhaler cap
Your inhaler and spacer will come with instructions in the package. Always check the package insert for any specific instructions.
Common problems
- Not breathing in quickly enough after pressing the canister, so the medication falls to the bottom of the spacer
- Not breathing in deeply enough
- Not holding breath for long enough
- Taking several puffs without waiting or shaking the inhaler in between
Tips
- Looking after your spacer properly helps the medication get to your lungs better, as it doesn't stick to the sides or get clogged in the valve
- Using a spacer can help reduce the chance of side-effects like hoarse throat and thrush
- Ask your pharmacist about a facemask if your child can't seal their lips around the spacer mouthpiece properly
- If you are using this inhaler for a corticosteroid preventer medication, with or without a spacer, rinse your mouth with water and spit after inhaling the last dose to reduce the risk of side-effects
Spacer care
- Clean your spacer before you use it for the first time and then about once a month
- It's not unusual for your spacer to look a bit cloudy
- Wash your spacer in warm water with kitchen detergent and allow to air dry without rinsing
- Drying with a cloth or paper towel can result in electrostatic charge (‘static') on the inside of the spacer, which make the medication stick to the sides
- Wipe the mouthpiece clean of detergent before use
- Spacers should be checked by your doctor, pharmacist or nurse every 6-12 months to check the structure is intact (e.g. no cracks) and the valve is working.
Getting the most out of your inhaler
Ask your doctor, pharmacist or asthma & respiratory educator to:
- Explain how your inhaler should be used
- Check you are using your inhaler properly
- Tell you where to find the expiry date on your inhaler
- Show you how to check if your inhaler is empty or nearly empty
- Discuss any unwanted effects from your medication
- Explain how to clean your inhaler and spacer (if you have one).
Different brands of inhalers sometimes have slightly different instructions to each other for similar steps. The checklists in our How-To Video library have been simplified and standardised where possible to reduce confusion.
Your inhaler will come with instructions in the package. Always check the package insert for any specific instructions.
Other inhaler types
See our complete How-to video library for other inhaler types and how to use them.
Acknowledgement
Thanks to Ms Judi Wicking, asthma and respiratory educator, and the patient who participated in this film clip.
Development of this How-to video was supported by the Australian Government Department of Veterans' Affairs as part of the Prevent Puffer Problems campaign. The National Asthma Council Australia retained editorial control.
Disclaimer
Although all care has been taken, this video is a general guide only, which is not a substitute for assessment of appropriate courses of treatment on a case-by-case basis. The National Asthma Council Australia expressly disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained herein.
