How to Use an Asthma Inhaler Correctly: Step by Step Guide

Using an asthma inhaler may seem straightforward, but many people do not use their inhaler correctly. Even a small mistake in technique can mean that less medicine reaches your lungs, making it harder to control asthma symptoms. Studies have shown that poor inhaler technique is common among both adults and children, often leading to reduced treatment effectiveness and an increased risk of asthma attacks.

Whether you have recently been diagnosed with asthma or have been using an inhaler for years, reviewing your technique can help you get the maximum benefit from your medication.

In this guide, you’ll learn how to use different types of asthma inhalers correctly, common mistakes to avoid, and simple tips to ensure your treatment works as intended.

Why Using an Asthma Inhaler Correctly Is Important

Asthma inhalers deliver medication directly into your airways, where it is needed most. When used correctly, the medicine reaches deep into your lungs to reduce inflammation, relax the airway muscles, or both.

Incorrect technique can prevent enough medication from reaching your lungs. Instead, much of it may remain in your mouth or throat, reducing its effectiveness.

Using your inhaler correctly can help you:

• Improve asthma symptom control
• Reduce wheezing, coughing and breathlessness
• Lower the risk of asthma attacks
• Reduce the need for emergency treatment
• Improve daily activities and exercise tolerance
• Get the full benefit from every prescribed dose

If you regularly find yourself needing your reliever inhaler more often than usual, it may be worth checking your inhaler technique before assuming your medication needs changing.

Know Which Type of Asthma Inhaler You Have

Not all asthma inhalers work the same way. The correct technique depends on the type of inhaler prescribed.

Pressurised Metered Dose Inhaler (pMDI)

This is the most commonly prescribed asthma inhaler in the UK.

It uses a pressurised canister to release a measured dose of medication when the canister is pressed. Correct timing between pressing the inhaler and breathing in is essential for effective treatment. Examples include many blue reliever inhalers and several preventer inhalers.

Dry Powder Inhaler (DPI)

Dry powder inhalers deliver medication as a fine powder rather than a spray.

Instead of pressing the inhaler, you inhale quickly and deeply to draw the medicine into your lungs. Different brands have slightly different loading mechanisms, so it’s important to follow the instructions for your specific inhaler.

Soft Mist Inhaler (SMI)

Soft mist inhalers produce a slow-moving mist that lasts longer than a standard aerosol spray. Because the mist is slower, it can be easier for some people to inhale the medication correctly.

Breath-Actuated Inhaler

These inhalers automatically release medication when you breathe in.

They remove the need to coordinate pressing the inhaler while inhaling, making them a good option for people who struggle with standard metered dose inhalers.

Step-by-Step Guide to Using a Pressurised Metered Dose Inhaler

The following technique applies to most standard metered dose inhalers. Always read the patient information leaflet supplied with your medication, as some inhalers may have specific instructions.

Step 1: Remove the Cap and Check the Mouthpiece

Remove the protective cap.

Inspect the mouthpiece to make sure it is clean and free from dust, dirt or any foreign objects that could block the medication. If the inhaler has not been used for several days or is new, it may need priming according to the manufacturer’s instructions.

Step 2: Shake the Inhaler Well

Shake the inhaler firmly for around five seconds.
Shaking mixes the medication properly inside the canister, helping to ensure each puff delivers the correct dose.

Skipping this step may result in inconsistent dosing.

Step 3: Breathe Out Fully

Before placing the inhaler in your mouth, breathe out gently until your lungs feel comfortably empty.
Avoid breathing out into the mouthpiece, as moisture can affect some inhalers.

Step 4: Position the Inhaler Correctly

Place the mouthpiece between your teeth without biting it. Seal your lips tightly around the mouthpiece to prevent medication from escaping.

Keep the inhaler upright.

Step 5: Press the Inhaler and Breathe In Slowly

Begin breathing in slowly through your mouth.

As you start inhaling, press the canister once to release one puff of medication. Continue breathing in slowly and steadily for around three to five seconds.

This is one of the most important steps. Breathing in too quickly may cause the medicine to hit the back of your throat instead of reaching your lungs.

Step 6: Hold Your Breath

Remove the inhaler from your mouth.

Hold your breath for approximately ten seconds, or for as long as is comfortable.
This gives the medication time to settle deep within your airways.

Then breathe out slowly.

Step 7: Wait Before Taking Another Puff

If your prescribed dose requires two puffs, wait around 30 to 60 seconds before repeating the process.
Shake the inhaler again before taking the second puff.

Step 8: Replace the Cap

Replace the protective cap securely after use.
Store the inhaler in a cool, dry place away from direct sunlight or excessive heat.

Common Asthma Inhaler Mistakes to Avoid

Even people who have used inhalers for years can develop poor habits. Avoiding these common mistakes can improve the effectiveness of your treatment.

Not Shaking a Metered Dose Inhaler

Failing to shake the inhaler before use can result in an uneven dose of medication.

Breathing In Too Quickly or Too Slowly

• For metered dose inhalers, breathe in slowly and steadily.
• For dry powder inhalers, breathe in quickly and deeply.

Using the wrong breathing technique reduces the amount of medicine reaching your lungs.

Poor Coordination

Pressing the inhaler before or after breathing in instead of during inhalation means much of the medicine may end up in your mouth rather than your airways. If coordination is difficult, speak to your healthcare professional about using a spacer or a different type of inhaler.

Forgetting to Hold Your Breath

Holding your breath for a few seconds allows the medication to settle in your lungs before you breathe out.

Not Rinsing Your Mouth After Steroid Inhalers

Preventer inhalers containing corticosteroids can leave small amounts of medicine in your mouth. Rinsing your mouth and spitting out the water after each dose helps reduce the risk of oral thrush and hoarseness.

Using an Empty Inhaler

Some inhalers include dose counters, while others do not. Keep track of how many doses remain and order a replacement before your inhaler runs out.

Poor Storage

Store your inhaler away from excessive heat, moisture and direct sunlight. Always replace the cap after use to keep the mouthpiece clean.

How to Know If Your Inhaler Technique Is Correct

Using the correct technique should help improve asthma control over time.

Signs that your inhaler is working effectively include:

• Fewer asthma symptoms during the day
• Reduced night-time coughing or wheezing
• Less reliance on your reliever inhaler
• Improved ability to exercise and carry out daily activities
• Better peak flow readings if you monitor them

If your symptoms remain poorly controlled despite taking your medication as prescribed, your inhaler technique should be reviewed before changing treatment.

Many GP practices, asthma clinics and pharmacies can assess your inhaler technique during a routine review.

Conclusion

Correct inhaler technique is one of the simplest ways to improve asthma control. Even the most effective medication may not work as intended if it is not used properly.

Take time to learn the correct technique for your specific inhaler, follow your prescribed treatment plan and attend regular asthma reviews. If you are ever unsure about your inhaler technique, ask your GP, pharmacist or asthma nurse to demonstrate the correct method.

Using your inhaler correctly can help reduce symptoms, improve your quality of life and lower the risk of asthma attacks.