How to Use Asthma Inhalers and Devices Correctly

Using an asthma inhaler wrong is more common than you think. Even people who’ve had asthma for years might be getting less medicine than they need-because of how they’re holding the inhaler, when they breathe in, or whether they’re using a spacer. This isn’t just about forgetting a step. It’s about making sure your inhaler actually works. If you’re still wheezing after using your inhaler, the problem might not be your asthma-it’s how you’re using the tool meant to help you.

Why Proper Inhaler Technique Matters

Studies show that up to 90% of people with asthma don’t use their inhalers correctly. That means most people are getting only a fraction of the medicine they’re paying for. A metered-dose inhaler (MDI) releases medicine in a puff, but if you don’t time your breath right, most of that puff flies out of your mouth or hits your throat instead of your lungs. That’s why you still feel tightness, cough, or shortness of breath-even after using your rescue inhaler.

The medicine needs to reach deep into your airways to open them up. If it sticks in your mouth or throat, you’re not just wasting medication-you’re increasing your risk of side effects like thrush or hoarseness. Correct technique isn’t optional. It’s the difference between feeling in control and being stuck in a cycle of flare-ups.

Types of Asthma Devices

There are three main types of asthma devices you might be prescribed:

• Metered-dose inhalers (MDIs): The classic canister you shake and spray. Most common for rescue inhalers like albuterol.
• Dry powder inhalers (DPIs): These don’t use a propellant. You breathe in fast and deep to pull the powder into your lungs. Examples: Advair Diskus, Symbicort Turbohaler.
• Spacers or valved holding chambers: Not inhalers themselves, but accessories that attach to MDIs. They hold the puff of medicine so you can breathe it in slowly.

Each one works differently. You can’t use the same technique for all. If your doctor gave you a DPI but you’re shaking it like an MDI, you’re not getting the full dose. Always check which type you have and follow the right steps.

How to Use a Metered-Dose Inhaler (MDI) Correctly

Here’s the exact sequence for an MDI-no shortcuts:

1. Remove the cap and shake the inhaler well for 5 seconds.
2. Hold the inhaler upright, with the mouthpiece at the bottom.
3. Breathe out fully-away from the inhaler. Don’t blow into it.
4. Place the mouthpiece between your lips and seal your lips tightly around it.
5. Start breathing in slowly through your mouth, and at the same time, press down on the inhaler to release one puff.
6. Keep breathing in slowly for 3 to 5 seconds until your lungs feel full.
7. Hold your breath for 10 seconds. This lets the medicine settle in your airways.
8. Breathe out slowly through your nose.
9. If you need a second puff, wait at least 30 seconds, then repeat.

Many people press the inhaler first, then try to breathe in. That’s the #1 mistake. The medicine is already gone before your lungs get a chance to catch it. Timing matters: inhale as you press.

Why You Should Use a Spacer

If you’re using an MDI, especially for children or older adults, a spacer is a game-changer. It’s a plastic tube with a mouthpiece on one end and a place to attach the inhaler on the other.

Here’s how it helps:

• Slows down the medicine puff so your lungs can catch it.
• Reduces throat deposition-less risk of hoarseness or oral thrush.
• Means you don’t have to coordinate breathing and pressing perfectly.

Using a spacer with your MDI is like adding a bridge between your inhaler and your lungs. It’s not optional for kids under 6. But even adults get better results with one. If your inhaler came with a spacer, use it. If not, ask your doctor for one-they’re usually covered by insurance.

How to Use a Dry Powder Inhaler (DPI)

DPIs work differently. You don’t press a button-you breathe in hard and fast. That’s the key.

1. Load the dose according to the device instructions (some twist, some slide, some click).
2. Hold the inhaler away from your mouth and breathe out fully.
3. Put the mouthpiece in your mouth and seal your lips.
4. Breathe in quickly and deeply-like you’re trying to suck through a thick straw.
5. Hold your breath for 10 seconds.
6. Breathe out slowly.

Don’t breathe out into the DPI. Don’t shake it. Don’t press anything. If you breathe too slowly, the powder won’t lift off the inside. If you breathe too gently, it won’t reach your lungs. You need force-but not a cough.

Common DPIs like Advair, Symbicort, and Breo use different loading systems. Always read the instructions that come with your specific device. If you’re unsure, ask your pharmacist to show you how to load it.

Common Mistakes and How to Fix Them

Here are the most frequent errors-and how to avoid them:

• Mistake: Not shaking the inhaler before use. Fix: Shake it for 5 seconds every time-even if you just used it 10 minutes ago.
• Mistake: Holding the inhaler at an angle or upside down. Fix: Always hold it upright. The medicine settles at the bottom.
• Mistake: Breathing in through the nose. Fix: Always inhale through your mouth. Nasal breathing doesn’t deliver medicine to your lungs.
• Mistake: Not holding your breath. Fix: Hold for 10 seconds. If you can’t, count to 5. It’s better than nothing.
• Mistake: Using the inhaler without a spacer and then rinsing your mouth. Fix: Rinsing helps, but using a spacer reduces the need for rinsing.

One big red flag: If you’re using your rescue inhaler more than twice a week (not counting exercise), your asthma isn’t controlled. That’s not normal. Talk to your doctor. You might need a daily controller medication.

When to Clean Your Inhaler

MDIs can get clogged with medicine residue. Clean your inhaler at least once a week:

1. Remove the metal canister from the plastic mouthpiece.
2. Rinse the plastic mouthpiece and cap under warm running water for 30 seconds.
3. Let it air-dry overnight-don’t wipe it with a towel.
4. Reassemble the next day.

Never rinse the metal canister. Water can damage the medicine inside. And never poke anything inside the nozzle to clear a blockage-that can break it.

DPIs don’t need cleaning. Just keep them dry. Don’t store them in the bathroom where steam can ruin the powder.

How to Tell If Your Inhaler Is Empty

Most inhalers have a counter that shows how many doses are left. If yours doesn’t, here’s how to estimate:

• Check the label. A standard albuterol inhaler has 200 puffs.
• If you use 2 puffs twice a day, that’s 4 puffs per day.
• 200 divided by 4 = 50 days.

Mark your calendar: when you start the inhaler, write down the date you’ll run out. Don’t wait until it feels light or you can’t hear the spray. You might be out of medicine without realizing it.

Some newer inhalers have built-in electronic counters. If yours does, trust it. If not, keep track manually.

What to Do If You’re Still Having Symptoms

Even with perfect technique, asthma can flare up. If you’re using your inhaler correctly but still wheezing, coughing, or feeling tightness:

• Use your rescue inhaler as directed-no more than 8 puffs in 24 hours.
• Wait 15 minutes. If you don’t feel better, call your doctor or go to urgent care.
• Don’t keep using it more often. Overuse can make symptoms worse.
• Keep a symptom journal: note when you used your inhaler, what you were doing, and how you felt.

Your doctor might need to adjust your controller medication. That’s not a failure-it’s just how asthma management works. Regular check-ins are part of staying in control.

Teaching Kids to Use Their Inhalers

Children often can’t coordinate breathing and pressing. That’s why spacers with masks are essential for kids under 6.

Steps for a child using a spacer with mask:

1. Attach the inhaler to the spacer.
2. Place the mask snugly over the child’s nose and mouth.
3. Press the inhaler once.
4. Let the child breathe in and out slowly through the mask for 6 breaths.
5. If a second puff is needed, wait 30 seconds and repeat.

Make it fun. Use a stuffed animal to demonstrate. Praise them after each try. Practice without medicine first. Consistency beats perfection.

Final Tip: Practice With Your Doctor

Don’t assume you know how to use your inhaler. Even if you’ve had asthma for years, technique can slip. Ask your doctor or pharmacist to watch you use it during your next visit. Many clinics have demonstration inhalers you can practice with.

There’s no shame in asking. In fact, the best asthma patients are the ones who double-check. Because when you use your inhaler right, you don’t just avoid emergency rooms-you live better. Full breaths. Fewer coughs. More days without limits.

Asthma inhaler use isn’t about memorizing steps-it’s about building habits that keep your lungs open. The right technique turns a simple device into a lifeline. Don’t guess. Don’t assume. Practice. Ask. Check. Your next breath depends on it.