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Metered-dose inhaler (MDI) administration - no spacer

Using a metered-dose inhaler (MDI) seems simple, but many people do not use them the right way. If you use your MDI the wrong way, less medicine gets to your lungs.

(Note: The instructions below are not for dry powder inhalers. They have different instructions.)

Getting Ready

• Take off the cap and shake the inhaler hard.
• If you have not used the inhaler in a while, you may need to prime it. See the instructions that your inhaler came with for how to do this.
• Breathe out all the way.
• Hold the inhaler 1 to 2 inches in front of your mouth (about the width of 2 fingers).

Breathe in Slowly

• Start breathing in slowly through your mouth, and then press down on the inhaler 1 time. (If you use a spacer, press down on the inhaler before you breathe in. Within 5 seconds, begin to breathe in slowly.)
• Keep breathing in slowly, as deeply as you can.

Hold Your Breath

• Hold your breath as you count to 10 slowly, if you can. This lets the medicine reach deep into your lungs.
• If you are using inhaled quick-relief medicine (beta-agonists), wait about 1 minute before you take your next puff. You do not need to wait a minute between puffs for other medicines.
• After using your inhaler, rinse your mouth with water, gargle, and spit out. This will help reduce unwanted side effects from your medicine.

Keep Your Inhaler Clean

Look at the hole where the medicine sprays out of your inhaler. If you see powder in or around the hole, clean the inhaler. First, remove the metal canister from the L-shaped plastic mouthpiece. Rinse only the mouthpiece and cap in warm water. Let them air dry overnight. In the morning, put the canister back inside. Put the cap on. Do not rinse any other parts.

Replacing Your Inhaler

For control medicines you take each day, write the date you need to replace it on the canister.

To figure out this date, use the number of puffs you take each day and the number of puffs your canister contains. For example, say your new canister has 200 puffs (number of puffs is listed on canister) and your doctor tells you to take 8 puffs each day. This canister will last 25 days. If you started using this inhaler on May 1, replace it on or before May 25. Write May 25 on your canister.

Do NOT put your canister in water to see if it is empty. This does not work.

Bring your inhaler to your clinic appointments. Your doctor can make sure you are using it the right way.

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.