How to use a metered dose inhaler with a spacer for adults
- Assemble spacer.
- Check the medication device dose counter and the expiry date – never use your medication after this date.
- Remove the mouthpiece cover.
- Hold inhaler upright and shake well.
- If this is the first time you are using your inhaler, or if you haven’t used it in a while, you will need to prime it before placing it into the spacer. Press down on the canister to release two “puffs” of medication (some medications require 4 puffs to prime – please read the instructions for your particular device).
- Insert inhaler upright into spacer.
- Sit upright.
- Breathe out gently to empty your lungs.
- Place the spacer mouthpiece between teeth (without biting) and above your tongue and close lips to form good seal.
- Hold spacer level and press down firmly on canister to release one puff of medication into the spacer.
- Breathe in slowly and deeply.
- Remove spacer from mouth, close lips and hold breath for at least 5 seconds or as long as comfortable.
- Breathe out gently away from mouthpiece.
- If more than one dose is needed, repeat all steps. You can leave the metered dose inhaler in the spacer to shake it before the next puff.
- After the required number of puffs have been given, remove inhaler from the spacer
- Replace the mouthpiece cover on the inhaler.
If using a steroid inhaler, remember to rinse your mouth after use.
Tips
- Not all metered dose inhalers need to be shaken, so please read the instructions for your particular device.
- The preferred technique for adults is one slow, deep breath. Hold breath for about 5-10 seconds or as long as comfortable.
- Alternatively breathe in and out normally for 4 breaths. This is known as the tidal technique and can be used if the person is unable to take a slow, deep breath.
- Ask your pharmacist about a facemask if you can't seal your lips around the spacer mouthpiece properly.
- 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 and 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.
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 Narelle Williamson, Asthma and Respiratory educator, and the patient who participated in this film clip.
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.
