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COPD: Using Inhalers 

Some COPD medicines are taken by using inhalers. Inhalers send measured doses of medicine into your lungs. Not all inhalers work the same way. Have your healthcare provider show you how to use your inhaler.

Woman exhaling.
Breathe out

Woman using metered-dose inhaler with spacer.
Breathe in

Using metered-dose inhalers (MDIs) with spacers

A metered-dose inhaler sends a measured amount of medicine to your lungs. The medicine must be breathed deeply into your lungs for it to work. Your inhaler has a spacer. The spacer increases the amount of medicine that goes to your lungs.

Here’s how to use an inhaler with a spacer.

  1. First, wash your hands. Then, check the expiration date and the counter on the inhaler. Make sure the inhaler still has doses left. Also check that the metal canister is put correctly into the plastic boot.

  2. Remove the cap from the inhaler. Shake the inhaler several times.

  3. If this is the first time you are using the inhaler, you need to prime it. That means making sure it is ready to use. Follow the manufacturer's instructions. Prime the inhaler in the air away from your face. The inhaler is now ready to use.

  4. Next, remove the cap and look into the mouthpiece of the spacer to make sure nothing is in it (the spacer).

  5. Attach the spacer to the inhaler. Remove the cap from the spacer mouthpiece.

  6. Empty your lungs completely by taking a deep breath in and tilting your head back slightly and blowing air out.

  7. Put the mouthpiece of the spacer in your mouth, past your teeth and above your tongue. Make sure your tongue doesn't block the opening of the spacer mouthpiece. Close your lips tightly around it to create a tight seal.

  8. If you are using a spacer with a mask, make sure the mask covers your nose and mouth. There should be no space between your skin and the mask.

  9. Make sure you are standing up or sitting up straight in a chair. Always keep your chin level.

  10. Press down on the canister 1 time to release the medicine. Then breathe in slowly and deeply until all of the medicine in the spacer is gone, or as directed by your healthcare provider. If your spacer has a whistle built in, hearing the whistle means you are breathing in too quickly.

  11. Remove the spacer mouthpiece from your mouth and close your lips.

  12. Hold your breath for up to 10 seconds, if you can. Then breathe out slowly through your mouth.

  13. Repeat these steps for each puff of medicine. Wait at least 15 seconds to 1 minute before taking the next puff, or as long as directed.

  14. If you’re using a steroid inhaler, rinse your mouth and gargle with water to prevent thrush, a fungal infection. Spit the water out. Don’t swallow the water. If a mask was used, wash your face, especially around your mouth and nose, with warm water to prevent a skin rash.

  15. Clean your inhaler and spacer after every use or at least once a week or as directed by the manufacturer of the device.

Using MDIs without spacers

A metered-dose inhaler sends a measured amount of medicine to your lungs. The medicine must be breathed deeply into your lungs for it to work.

If you don’t use a spacer, follow these steps:

  1. First, wash your hands. Then, check the expiration date and the counter on the inhaler. Make sure the inhaler still has doses left. Also check that the metal canister is put correctly into the plastic boot.

  2. Remove the cap from the inhaler mouthpiece. Shake the inhaler several times.

  3. If this is the first time you are using the inhaler, you need to prime it. That means making sure it is ready to use. Follow the manufacturer’s instructions. Prime the inhaler in the air away from your face.

  4. The inhaler is now ready to use.

  5. Your healthcare provider will tell you whether to use the closed-mouth or open-mouth method.

  6. Empty your lungs completely by taking a deep breath in and tilting your head back slightly and blowing air out.

  7. For the closed-mouth method, put the inhaler mouthpiece in your mouth, past your teeth and above your tongue. Close your lips tightly around the mouthpiece to create a tight seal so the medicine doesn’t spray in your eyes.

  8. Or, for the open-mouth method, hold the inhaler up to your mouth, with the mouthpiece 2 finger-widths away from your lips.

  9. Make sure you are standing up or sitting up straight in a chair. Always keep your inhaler at chin level.

  10. Press down on the canister 1 time to release the medicine. At the same time, breathe in deeply and slowly for 3 to 5 seconds.

  11. Remove the mouthpiece from your mouth if you are using the closed-mouth method. Or, move it away from your mouth if you are using the open-mouth method. Then, close your lips.

  12. Hold your breath for up to 10 seconds, if you can. Then breathe out slowly through your mouth.

  13. Repeat these steps for each puff of medicine. Wait at least 15 seconds to 1 minute before taking the next puff, or as long as directed by your healthcare provider.

  14. If you’re using a steroid inhaler, rinse your mouth and gargle with water to prevent thrush, a fungal infection. Spit the water out. Don’t swallow the water. Clean your inhaler after every use or at least once a week or as directed by the manufacturer of the device.

Using dry-powder inhalers (DPIs)

Man using a dry-power inhaler.

Man breathing out.

Some inhalers use tiny grains of powder to deliver medicine. These don’t need spacers. They often have counters that track how many doses you use. Dry-powder inhalers, such as diskus or twist, don’t all work the same way. Be sure you know how to use yours correctly.

Here's how to use your diskus or twist dry-powder inhaler (DPI)

  1. First, wash your hands and check the expiration date

  2. Remove the cap and hold the diskus DPI flat - like a flying saucer (If you are using a twist dry-powder inhaler (DPI), remove the cap and holding the DPI upright, like a rocket.)

  3. Load the DPI and prime the DPI as needed

  4. Do not shake the DPI

  5. Stand up straight or sit up straight in a chair

  6. Take a deep breath in; Your head should be slightly tilted back and blow the air out completely to empty your lungs; do not blow into the DPI

  7. Place the mouthpiece of the diskus DPI or the twist DPI in your mouth and closing your lips around it to form a tight seal

  8. Take a fast, deep, and forceful breathe in through your mouth

  9. Hold your breath for up to 10 seconds, if you can

  10. Take the DPI out of your mouth and breathe out or exhale slowly. Face away from the DPI.

  11. Rinse your mouth and gargle with warm water if inhaling a steroid medicine. Spit the water out of your mouth to prevent a mouth infection called thrush.

Online Medical Reviewer: Alan J Blaivas DO
Online Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer: John Hanrahan MD
Date Last Reviewed: 2/1/2019
© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.