How to Use an Asthma Inhaler Even Better

Asthma inhalers are an essential tool for anyone looking to manage their asthma, helping to prevent symptoms from occurring as well as acting as a life-saving medication in the event of an asthma attack. As such an important treatment for asthma, it may surprise you to learn that in a review of asthma device errors, 87% of people studied made at least one mistake when using their metered-dose inhaler (such as the Ventolin Evohaler).^[1] In this Health Centre article, we’ll highlight the common mistakes made when using inhalers and outline the best techniques for taking the medication as intended.

Why Does it Matter?

When taken correctly, you’re giving yourself the best chance of the medication travelling down your airways to where it can be properly utilised by your body, more effectively reducing asthma symptoms in the shortest time. The benefits of correct inhaler technique include:

• Reducing the risk of an asthma attack.
• Being able to cope better with asthma triggers.
• Improving the quality of your sleep.
• Disrupting your day less, such as reducing your time off work.
• The capability to exercise more regularly.

The Most Common Inhaler Technique Mistakes

No matter how good the medication is for your symptoms, if it can’t reach the targeted airways sufficiently then you won’t be receiving the proper dose of the treatment. Here are the top errors that people make when self-administering their metered-dose inhalers:^[2]

• Not shaking the inhaler first
• Holding it in the mouth incorrectly
• Not fully breathing out before taking the medication
• Failing to correctly time the inhale with the puff
• Breathing the medication in too slow or not deeply enough
• Not holding in the breath containing the medication for long enough

How to Properly Use a Reliever Inhaler

Make sure that you follow these step-by-step instructions when using your inhaler to ensure the medication is administered as intended. This way you can be the most confident that you’ve had the full dose from your reliever inhaler.

1. Remove the mouthpiece cap from the inhaler, and shake your inhaler for 5 whole seconds before use, ensuring the contents of the inhaler are evenly mixed and there are no loose objects in the mouthpiece.
2. If you have not used the inhaler in the past 5 days, point the mouthpiece away from you and pump the canister before using it to prime the inhaler. This is to ensure that the next dose will have the correct amount of the medication.
3. Sit up straight and tilt your head slightly backwards.
4. Holding the inhaler upright with your thumb on the base and forefinger on the canister, exhale fully.
5. Put the mouthpiece in your mouth between your teeth, seal your lips around the mouthpiece, but do not bite down.
6. Start to breathe in through your mouth, and just after starting to breathe in, press down on the canister with your forefinger to release the medicine. Breathe in steadily and deeply.
7. Take the inhaler out of your mouth whilst holding your breath, for at least a few seconds, but ideally as long as comfortable.
8. Once the time has elapsed, breathe out through your mouth.
9. If your doctor has instructed you to take 2 puffs, make sure you wait at least 30 seconds before repeating steps 2-9.
10. Remember to replace the lid on your inhaler to prevent dirt, lint and fluff entering it.
11. To clean your inhaler, remove the metal canister and mouthpiece cover, rinse the plastic casing under warm running water, and ensure it is fully dried out before reassembling.

You must not exceed the maximum dose of 8 puffs in 24 hours.

If you have a steroid inhaler, remember to rinse out your mouth after all the puffs to throat irritation or infection in the mouth, and make sure you spit out the water. Since Ventolin is not a steroid-based medication, there is no need to rinse out your mouth if you are using one of these inhalers.

In an emergency such as a severe asthma attack, try to keep calm and don’t lie down. Sit up straight and take single puffs 30-60 seconds apart. If you do not feel better after 10 puffs, call 999. If the emergency services are taking more than 15 minutes, take another few puffs about 30 seconds apart.^[3]

How to Use an Inhaler with a Spacer

For ensuring the full dose of the medication reaches the airways, and to help reduce the uncomfortable side effect of the medication hitting the back of the throat, you can use a spacer with your inhaler. Asthma spacers create a valved holding chamber between your lips and your inhaler, which not only makes it easier to coordinate your breath and the pressing of the inhaler, but also helps better deliver the full dose of the medication to your airways. With the Aerochamber Plus, the technique for use is largely the same as using your ventolin inhaler directly, but with the Aerochamber Flow-Vu there is an added indicator that helps identify if an inhalation is performed correctly. One advantage of these spacers, however, is that the valve system allows you to breathe out into the device if needed, and breathe in any medication that you weren’t able to fully breathe in the first time. You can also buy both versions with a mask attachment which covers the nose which further helps the medication to be fully breathed in. Visit the Aerochamber Spacer page to find out more about assembling, cleaning and storing your spacer.

Asthma doesn’t always manifest itself in the same way for everyone - different triggers might prompt your symptoms, so it’s important to understand what makes your asthma better or worse. Read our Health Centre article on the 7 Types of Asthma to learn more about the different forms asthma takes and how best to manage them.