Using a MDI (“puffer”) inhaler

For information about why spacers should be used with puffer inhalers, how to get one, and how to care for your spacer, see section on ‘Spacers’.

How to use a metered dose inhaler with a spacer:

1. Take off the cap and hold the inhaler upright.
2. Shake the inhaler to mix the medication with the propellant.
3. Fit the puffer inhaler into the spacer opening (opposite the mouthpiece).
4. Sit upright, tilt your head back slightly (as if you are sniffing).
5. Hold the device upright, insert the mouthpiece into your mouth ensuring that your lips firmly seal around the mouthpiece of the spacer.
6. Press the puffer inhaler once only.
7. Take 4-6 normal breaths in and out through your mouth. (Do not remove the spacer from your mouth between breaths) OR take one slow deep breath in and hold this for 10 seconds.
8. Repeat steps 2 to 7 for further doses.
9. When finished, remove the inhaler from the spacer and place the cap back on the inhaler.
10. Rinse your mouth with water and spit out if you are using a corticosteroid-containing MDI. This reduces side effects such as a husky voice, sore throat, or fungal growth inside the mouth (oral thrush).

If you need to use your puffer inhaler without a spacer, follow these steps:

1. Take off the cap and hold the inhaler upright.
2. Shake the inhaler to mix the medication with the propellant.
3. Sit upright, tilt head back slightly (as if you are sniffing).
4. Hold the inhaler away from your mouth and breathe out fully.
5. Hold the device upright, insert the mouthpiece into your mouth ensuring that your lips firmly seal the mouthpiece.
6. At the beginning of a slow deep breath, breathe in through the inhaler and activate the aerosol once.
7. Breathe in fully, remove the MDI from the mouth and hold your breath for five seconds or as long as comfortable.
8. Breathe out gently, away from the inhaler.
9. Repeat steps 2 to 8 for further doses.
10. When finished, place cap back on inhaler.
11. Rinse your mouth with water and spit out if you are using a corticosteroid-containing MDI. This reduces side effects such as a husky voice, sore throat, or fungal growth inside the mouth (oral thrush).

Caring for your metered dose inhaler

Clean your MDIs weekly to ensure they do not block.

1. Remove the plastic mouthpiece cap.
2. Remove the metal canister (don’t put it in water).
3. Rinse the mouthpiece and cap under warm water for at least 30 seconds.
4. Shake off any excess water and leave the mouthpiece and cap to dry overnight.
5. Put the metal canister back in, and replace the cap.

When to start a new metered dose inhaler

As most MDIs don’t have a dose counter window, it is wise to have a back-up inhaler on hand well before the inhaler is nearly empty. For regularly scheduled inhalers taken every day, you can work out when your inhaler will be empty by calculating your daily dose from the date you first open each new inhaler. For example: two puffs twice a daily = 4 puffs per day; if the inhaler contains 120 doses in total, then you will finish your inhaler in 30 days – mark this date on your calendar.

For a useful ‘How to’ video visit the National Asthma Council Australia.