The three main types of inhalers include:
- Metered dose inhalers: These inhalers spray medication in a quick burst via the propellant hydrofluoroalkane (HFA). Examples include Proair HFA, Atrovent HFA, and Ventolin HFA.
- Soft mist inhalers: These inhalers release medication in a mist. Examples include Spiriva Respimat and Combivent Respimat.
- Dry powder inhalers (DPIs): These inhalers contain a dry powder that breaks apart into an aerosol when you breathe through the mouthpiece.
Examples of DPIs include:
- Diskus (Advair, Flovent, and Serevent)
- Turbohaler or Turbuhaler (Symbicort)
- Pulmojet (Lifsar)
- Novolizer (Budelin and Ventolin HFA)
Many people find DPIs the easiest kind to use. With a DPI, you don’t have to sync your breathing with any buttons or switches. You can simply open the device and inhale. As an added bonus, they’re also more environmentally friendly.
Read on to learn how DPIs work and how to use yours correctly.
All DPIs work via the same basic mechanism. You open the device, put your mouth on the opening, and suck up the powdered medication inside.
The force of your breath cracks the powder, which is chemically designed to dissolve into tiny, breathable particles. Some DPIs have spirals or ridges inside to help break up the powder further. The pieces
Bronchodilators relax the muscles in your throat, opening them up so you can breathe more easily. Corticosteroids help reduce swelling and mucus production inside your airways.
The specific medication you take will depend on your age and condition and the severity of your symptoms.
While most people find DPIs very simple to use, you might skip essential steps if you don’t realize their importance. Using your inhaler incorrectly may prevent you from getting the full amount of medication you need, which can have serious health consequences.
- Before receiving training, 0% to 37.5% of participants used DPIs correctly — in one group, not a single participant used the inhaler correctly without instruction.
- After reading the patient instruction leaflet, 58.3% to 93.3% used DPIs correctly.
- After getting instruction from a healthcare professional, as many as 99.2% of participants used DPIs correctly.
As a general rule, you’ll want to review your instruction manual when you first receive your inhaler. To put it another way, you don’t want to wait until you feel the first symptoms of an asthma or COPD episode coming on.
Every DPI will come with its own unique manual, but the process of using your inhaler follows the same general steps:
- Remove the cap and load your device: Some DPIs come preloaded with medication. If yours doesn’t, you’ll need to load a capsule before each use — your manual will explain how.
- Hold your inhaler steady in one hand: Keep it level so nothing spills out. Never shake the inhaler, as this will break up the powder before you can breathe it in.
- Sit up straight and breathe out: This empties your lungs so you can take the biggest breath possible. Make sure to breathe away from the inhaler so you don’t accidentally scatter the powder.
- Close your lips around the mouthpiece: Create a tight seal so no air can escape. Avoid biting or licking the mouthpiece.
- Inhale through your mouth: Try to take as deep and fast a breath as possible, as if sucking the powder through a straw.
- Hold your breath for 10 seconds: Don’t worry if you can’t taste or feel the medication — it’s still working.
- Breathe out slowly: Again, avoid breathing into the inhaler, since the moisture from your breath can stick to the inside of the device. Saliva or water might cause additional doses of powder to clump.
- Repeat steps 1 to 7 if needed: If your treatment calls for multiple doses, wait
1 minutebefore repeating the previous steps.
- Do a post-treatment rinse and spit: If your medication is a corticosteroid, you’ll need to rinse your mouth out with water. This helps prevent oral thrush since corticosteroids can weaken the immune system inside your mouth.
Following these steps exactly can help your body consistently take in as much medication as possible.
It may help to take extra care with steps 3, 6, and 7, as
How to maintain your inhaler
Taking care of your DPI keeps it in good working condition.
These tips can help make your inhaler last as long as possible:
- Wipe down the mouthpiece with a dry cloth after each use.
- Never use water to clean your device. The inside must stay dry.
- Keep your inhaler closed when you’re not using it.
- Store your inhaler in a cool, dry place. If you typically store medications in your bathroom, you may want to find a different place for your inhaler and avoid storing it near your shower or sink.
Wondering how a DPI compares with other kinds of inhalers?
The benefits include:
- Ease of use: You don’t have to time your breath with a spray as you do with other inhalers. All you need to do is breathe in sharply through the mouthpiece — kids as young as 5 years old can master the technique.
- No propellants: Since DPIs contain no propellants, they pose less risk of environmental consequences.
- Resistance to contamination: So long as you take good care of your DPI, the device will be
exceptionally resistantto bacteria, viruses, and fungi.
Of course, no medical device is perfect. Some drawbacks of DPIs include:
- Moisture sensitivity: Water or saliva can interfere with the medication dispersal process, causing powder to stick inside the device.
- It may not work well in emergencies: If your airways have closed up, you might not be able to inhale deeply enough to suck out the powder.
- It may not work well for older adults: Some older adults may have trouble breathing quickly or deeply. According to 2017 research, up to 75% of older adults may find it difficult to inhale forcefully enough to activate the Turbohaler.
DPIs are generally safe to use, but some people may experience side effects or allergic reactions to the medication inside.
While each medication is different, some side effects remain pretty consistent across brands. Common side effects (meaning they occur in up to 1 in 10 people) include:
- oral thrush
- fluttering heart rate
- increased coughing
- change in mucus color or more mucus in general
These side effects are generally mild and often go away as treatment continues. But in some rare instances, you could experience more serious side effects, including:
If you experience any of the following issues, connect with a doctor or healthcare professional. They can offer guidance on how to minimize side effects while still controlling your asthma. They may, for instance, recommend switching to another kind of medication.
If you’re lactose intolerant
Most DPIs use lactose particles to keep the powdered medication from clumping. A standard dose usually doesn’t contain enough lactose to cause problems for people with lactose intolerance, but some people may have a higher sensitivity.
If you have any concerns, you may want to ask a doctor for a DPI that uses another kind of carrier particle.
DPIs contain powdered medication that you breathe in to treat asthma or COPD symptoms.
Many people find them fairly simple to use, but it’s important to learn the correct process and complete all the steps in order so you get the maximum benefit from your inhaler.
If you think this inhaler may work well for your needs, ask a doctor or other healthcare professional about giving it a try.
Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.