Proper use of an inhaler depends on the type and whether you use a spacer. You also need to “prime” your inhaler before its first use.

Asthma inhalers are among the most frequently prescribed medications in the United States. They are small, portable, and fast-acting, making them incredibly useful.

But inhalers can be surprisingly complicated to use properly. Research repeatedly finds that improper inhaler technique is common in both children and adults, reducing treatment effectiveness.

There are several types of asthma inhalers. Correctly using and maintaining yours ensures the greatest possible benefit from your asthma medication.

Metered-dose inhalers (MDIs)

MDIs are the most common inhaler type. Many different asthma medications come in MDI form.

Often called “puffers,” MDIs consist of a medication canister inside a plastic case with a mouthpiece. Pressing down on the canister activates a propellant, delivering one “puff” of medication as an aerosolized mist.

People of all ages can use MDIs, including infants. But MDIs release medication quickly and forcefully with each puff, so experts recommend using a spacer for best effectiveness, especially in children.

Dry powder inhalers (DPIs)

DPI disks or cylinders store your medication as a fine, dry powder. They are twisted or clicked to prepare each dose.

There’s no propellant in a DPI and no spacer is needed. Instead, you inhale the powder into your lungs with a fast, deep breath. This technique can be a bit challenging, so doctors don’t usually recommend DPIs for young children.

Soft mist inhalers

These deliver a slow-moving fine mist of medication using mechanical power instead of a propellant. Soft mist inhalers come in two parts — an inhaler and a medication cartridge — so you need to assemble it before using it for the first time.

Only one specialized medication (Spiriva) is available in this form.

Asthma inhaler vs. nebulizer

Inhalers are portable, self-powered, handheld devices. They deliver medication quickly but may require coordination of breathing and spacer or mask use for best effectiveness.

Nebulizers are electrical machines you need to plug in. They require extra pieces, like tubing and a mouthpiece or face mask. No coordinated breathing method is needed, but it may take up to 15 minutes to deliver a medication dose.

Research has repeatedly shown that, with proper use, an inhaler and spacer can work as well or better than a nebulizer.

Was this helpful?

For many people, it’s best to use a spacer with your inhaler. If you’ve been instructed to use an MDI alone:

  1. Shake your inhaler for 10 seconds.
  2. Exhale completely (away from the inhaler) and hold your breath briefly.
  3. Place the plastic mouthpiece in your mouth.
  4. Press down on the inhaler canister once, and simultaneously begin to inhale.
  5. Inhale slowly and deeply for 3–5 seconds.
  6. Hold your breath for 10 seconds, then exhale slowly.
  7. Wait 1 minute before taking another puff (if prescribed).
  8. When finished, rinse your mouth with water or brush your teeth.

The Global Initiative for Asthma 2023 guidelines recommend using a spacer with MDIs.

Spacers or valved holding chambers are plastic tubes that attach to the mouthpiece of your inhaler. They help deliver medication past your mouth and throat into your smallest airways, where it works best. Spacers may also help minimize medication side effects.

For older children and adults using an inhaler and a spacer with a mouthpiece:

  1. Shake your inhaler for 10 seconds.
  2. Insert your inhaler into the correct end of the valved spacer or holding chamber.
  3. Exhale completely (away from the inhaler) and hold your breath briefly.
  4. Place the spacer mouthpiece in your mouth.
  5. Press down on the inhaler canister once and immediately take a steady, deep inhale.
  6. Hold your breath for 10 seconds, then exhale slowly.
  7. Wait 1 minute before taking another puff (if prescribed).

For infants and young children using an inhaler and a spacer with a mask:

  1. Shake the inhaler firmly for 10 seconds.
  2. Insert the inhaler into the correct end of the spacer or holding chamber.
  3. Place the mask end of the device over the child’s mouth and nose, making a tight seal.
  4. Press down on the inhaler canister once.
  5. Keep the mask sealed over the mouth and nose while they take six regular breaths.
  6. Remove the mask and wait 1 minute before taking more puffs (if prescribed).

Rinse your mouth or brush your teeth after using an inhaler and spacer or mask.

Priming your inhaler

You “prime” your MDI by depressing the canister a few times before first use. You need to re-prime after dropping your inhaler or if you don’t use it every day.

Talk with a pharmacist and check your package insert for specific instructions.

Cleaning your inhaler

Once a week, remove the canister and run warm, clean water through your plastic inhaler case for 30 seconds. Allow it to air dry completely before reassembling.

If you’re using a plastic spacer or mask, check the packaging for cleaning instructions.


Most inhalers have a dose counter. When it’s approaching “0,” it’s time for a refill.

DPIs and soft mist inhalers have different instructions for priming, cleaning, monitoring, and proper use. Be sure to check with a doctor or pharmacist, and read your package insert carefully.

How many puffs of an asthma inhaler should I take?

The correct number of puffs depends on the type of medication and the dose your doctor prescribed.

Check your prescription and asthma action plan for advice. If the correct number of puffs remains unclear, contact your doctor’s office.

Should I drink water before or after using an asthma inhaler?

It’s a good idea to rinse and spit or brush your teeth after using an inhaler. Experts especially advise this after using inhaled corticosteroid medications. It helps prevent mouth infections, like oral thrush.

What is the most commonly prescribed asthma inhaler?

Albuterol, usually in MDI form, is the most commonly prescribed asthma medication in the United States.

One of the most popular and preferred brands of albuterol, Proair HFA, was discontinued in 2022. However, albuterol is still available under several other brand names, such as Ventolin and Proventil.

Asthma inhalers come in many forms. They are commonly prescribed but often used incorrectly.

Talk with your doctor and pharmacist about inhaler use, and read your medication insert carefully. Bring your inhaler to appointments and ask any questions you have.

Maintaining and using your inhaler correctly can help better manage your asthma and reduce your risk of medication side effects.