What is an inhaler device?

If you have asthma or chronic obstructive pulmonary disease (COPD), you may need to use one or more medicines to help you breathe better. Most of these medicines are inhaled into your lungs through your mouth using an inhaler device.

It is important that you use your inhaler correctly to get the full benefit of your medicine. However, many people do not use the correct technique.

Ask your doctor, pharmacist or nurse to show you how to use your inhaler device. It’s easier to use it correctly when someone shows you what to do.

Here are some tips that are helpful with all types of inhalers:

• Make sure your inhaler is not past its expiry date.
• Make sure your inhaler is not empty.
• Learn how to clean and care for your inhaler — and your spacer, if you use one.
• Lift your chin slightly while using your inhaler, as this helps the medicine reach your lungs.
• Wipe the mouthpiece of your inhaler with a dry cloth or tissue after every use.

Are all inhaler devices the same?

There are several types of inhalers and each one has its own technique for use. When choosing the right device for you, your doctor will consider:

• your age
• which medicine you need
• how well your lungs work
• which device you find easiest to use

Who can use an inhaler?

Adults and most children over 7 years of age can learn to use an inhaler device. However, it’s best for children to use a spacer.

Most children over 4 years of age can use an inhaler with a spacer. Babies and children under age 4 may need a face mask attached to the spacer to use an inhaler effectively.

How do I use a metered dose inhaler (MDI)?

A metered dose inhaler, often called a puffer, is the most common type of inhaler. It can be used with a spacer. Some of the medicines available in an MDI include Ventolin, Flixotide, Seretide and Atrovent.

How to use an MDI:

1. Remove the cap.
2. Hold the inhaler upright and shake it before use.
3. Breathe out fully.
4. Hold the mouthpiece between your teeth and close your lips around it.
5. Breathe in deeply as you press the canister down to deliver the dose.
6. Hold your breath for 5 to 10 seconds, then breathe out.
7. If you need to take another dose, repeat from step 2.
8. Replace the cap.

Video from National Asthma Council Australia

How do I use a spacer?

Some inhalers can be used together with a spacer. A spacer is a plastic chamber with an opening at one end, where the inhaler is attached, and a mouthpiece at the other end for you to breathe through. A spacer helps more of the medicine to reach your lungs, instead of it settling in your mouth or throat.

1. Put the spacer together (if necessary) by following the instructions supplied.
2. Remove the inhaler’s protective cap.
3. Shake the inhaler well.
4. Insert the inhaler firmly into the end of the spacer, while keeping the inhaler upright.
5. Place the mouthpiece between your teeth and close your lips to form a seal.
6. Breath out gently into the spacer.
7. Keep the spacer horizontal while you press the inhaler once to release a dose into the spacer. Do not remove the inhaler.
8. Breathe in slowly and deeply and hold your breath for about 5 seconds or as long as comfortable. Or breathe in and out normally for 3 or 4 breaths.
9. Remove the spacer from your mouth and breath out gently.
10. Remove the inhaler from the spacer.
11. If more than one dose is needed, repeat all steps starting at step 3.
12. Replace inhaler cap.

Children may benefit from a using a face mask that covers the mouth and nose. Check with your pharmacist or doctor to see if a face mask is needed.

Visit the National Asthma council Australia website for information on how to look after your spacer properly.

Video from National Asthma Council Australia

Video from National Asthma Council Australia

How do I use an Autohaler?

An Autohaler is activated by breathing in. It is easier to use than an MDI, because you don’t need to time your breathing with pressing the canister. Medicines available in an Autohaler include Airomir and Qvar.

1. Remove the cap.
2. Hold the inhaler upright and shake it before use.
3. Push the lever up.
4. Breathe out fully.
5. Hold the mouthpiece between your teeth and close your lips around it.
6. Breathe in deeply. Keep breathing in after you hear a click.
7. Hold your breath for 5 to 10 seconds, then breathe out.
8. Push the lever down.
9. If you need to take another dose, repeat from step 2.
10. Replace the cap.

Video from National Asthma Council Australia

How do I use an Accuhaler?

An Accuhaler is a round device that contains dry powder. Some of the medicines available in an Accuhaler include Flixotide and Seretide.

1. Open the cover.
2. Hold the inhaler horizontally and slide the lever until you hear a click. Don’t shake the inhaler.
3. Breathe out fully.
4. Close your lips around the mouthpiece while keeping the inhaler horizontal.
5. Breathe in deeply.
6. Hold your breath for 5 to 10 seconds, then breathe out.
7. Close the cover.
8. If you need to take another dose, repeat from step 1.

Video from National Asthma Council Australia

How do I use a Turbuhaler?

A Turbuhaler is an inhaler device with a base that twists. The first time you use the device, you need to prime it (make it ready for use). Some of the medicines available in a Turbuhaler include Bricanyl and Symbicort.

1. The first time you use the device, prime it by turning the base around and back again until you hear a click. Do this twice.
2. Remove the cover.
3. Holding the inhaler upright, turn the base around and back again until you hear a click but don’t shake the inhaler.
4. Breathe out fully.
5. Hold the mouthpiece between your teeth and close your lips around it.
6. Breathe in deeply.
7. Hold your breath for 5 to 10 seconds, then breathe out.
8. If you need to take another dose, repeat from step 3.
9. Replace the cover.

Video from National Asthma Council Australia

How do I use a HandiHaler?

A HandiHaler is an inhaler device used together with a capsule. It requires 2 breaths for each dose. It is used for the medicine Spiriva.

1. Open the cover and mouthpiece.
2. Remove the capsule from the foil pack and insert it into the inhaler.
3. Close the mouthpiece until it clicks into place.
4. Press the button on the side once to pierce the capsule.
5. Breathe out fully.
6. Hold the mouthpiece between your teeth and close your lips around it.
7. Breathe in deeply — you will hear the capsule vibrate while you breathe in.
8. Hold your breath and take the inhaler out of your mouth, then breathe out.
9. Repeat steps 6 to 8 to take a second breath.
10. Open the mouthpiece, tip out the capsule and throw it away.
11. Replace the mouthpiece and cover.

Video from National Asthma Council Australia

How do I use a Breezhaler?

A Breezhaler is an inhaler device used together with a capsule. Some of the medicines available in a Breezhaler include Onbrez and Seebri.

1. Remove the cover and open the mouthpiece.
2. Remove a capsule from the pack and insert it into the inhaler.
3. Close the mouthpiece until it clicks into place.
4. Press both side buttons once to pierce the capsule.
5. Breathe out fully.
6. Hold the mouthpiece between your teeth and close your lips around it.
7. Breathe in deeply — you will hear the capsule vibrate while you breathe in.
8. Hold your breath for 5 to 10 seconds, then breathe out.
9. Open the mouthpiece and look at the capsule. If it’s empty, remove it and throw it away. If there is still powder left inside, close and repeat steps 5 to 8 to take another breath.
10. Close the mouthpiece and replace the cover.

Video from National Asthma Council Australia

How do I use a Ellipta?

Ellipta inhalers contain different medicines and combination of medicines. These are designed to work slowly over 24 hours and generally only need to be used once a day. Some of the medicines available in an Ellipta include Anoro, Incruse and Trelegy.

If your inhaler contains a steroid (such as Trelegy), rinse your mouth with water or brush your teeth after use to prevent infections such as oral thrush.

As this inhaler works slowly, it is sometimes difficult to tell if it is helping you. if you are not sure please discuss with your doctor, nurse or pharmacist before stopping it.

1. Hold the Ellipta inhaler upright.
2. Slide the cover down so you can see the mouthpiece. You should hear a click. (Don’t shake the inhaler.)
3. Breathe out fully.
4. Hold the mouthpiece between your teeth and close your lips around it. (Don’t block air vents with your fingers.)
5. Breathe in deeply through your mouth.
6. Hold your breath for 5 to 10 seconds, then breathe out.
7. Slide the cover up to close the inhaler.

Video from National Asthma Council Australia

Resources and support

Check out the following websites for more information and videos to help you use your inhaler properly:

• The National Asthma Council Australia
• Asthma Australia
• NPS MedicineWise YouTube page
• Lung Foundation Australia

The National Asthma Council offers advice and tips on getting the most out of your inhaler and common errors when using an inhaler/puffer.

The Sydney Children’s Hospitals Network provides:

• a fact sheet on the use of spacer devices and other inhalers suitable for children
• an Asthma and your child resource pack for parents and carers