How to use an inhaler

This guide will show you step by step guide on how to use an inhaler. There are various types of inhalers in the market and this is not an exhaustive list. We have done the step to step guide on how to use some of the most common inhalers. Read to the end to get the checklist on how to use an inhaler. To jump straight to how to use a specific inhaler, click on the link in the table of content.

What is the importance of knowing how to use an inhaler?

It is important that people who have Asthma and chronic obstructive pulmonary disease (COPD) know how to use their inhaler as having a good inhaler technique have been shown to maximize the benefits of asthma medications and improved outcomes for the patient. Poor inhaler technique, in contrast, lowers the amount of drugs that reach the lungs, increases wastes of asthma medications, and may lead to poorly controlled asthma or COPD, reduced quality of life and increased incidence of emergency hospital admissions due to asthma attacks.

Knowing how to use an inhaler means you get the best out of that inhaler.

Inhaler Devices

An inhaler device is a container that holds the medicines which treat asthma. There are different types of inhaler. This page gives information about the different inhaler devices and how to use the inhaler devices. It also tells you the type of asthma medicines in the inhalers.  The image of different inhaler devices use is for illustration and to aid identification. Some of the images used are that of placebo and training inhalers which contain no medicines. The inhalers prescribed by your doctor should have the medicine in it. Please note that different strengths or brands may be different colours from those illustrated.

Common inhaler technique errors and suggestions solutions

This article on the pharmaceutical journal lists the most common errors patient make while using their inhalers. These errors could be because the patients do not know how to use the inhaler prescribed or because over time their inhaler technique deteriorates. So not only is it important that you know how to use an inhaler, but it is also important to refresh that knowledge regularly.

ErrorInhaler deviceExplanationSuggested solution
Not shaking before useAerosolNot shaking the aerosol before use may lead to inconsistent dosing.Shake all Aerosol inhalers before use.
Not priming the inhaler device before use.AerosolPriming is checking that the spray is working as it should. If not done, you may not get the required dose in.Prime your inhaler if using it for the first time or if using it after you have not used it for a while.
Not breathing out before inhalingAllWhen you breath out fully or as much as you comfortably can, you reduce the amount of air in your airways and creates space for the air containing your medicine with the next breath. This means deeper inhalation with greater opportunity of carrying the drug to where it does its job.Breath out fully or as much as you comfortably can.
Not positioning your inhaler device correctly.DPIHolding your inhaler pointing downwards during or after loading the dose may cause some of the powder to escape.Hold your inhaler horizontally or pointing upright.
Incorrectly coordinating pressured metered dose inhaler (pMDI) actuation during inhalationpressured metered dose inhaler (pMDI)Not correctly coordinating breathing in with pressing the canister could mean the medication is not delivered to the lung as supposed.Press the canister while breathing in the dose.
Using the wrong inspiration flow. Too fast or too slow.AllExperts believe that the total amount of inhaled drugs deposited in your lungs is strongly affected by the speed of inhalation.  For Aerosol devices, such as pMDIs, you should do a slow and steady inhalation.

For DPIs you should do a quick and deep inhalation
Using an empty inhaler AllWhen you use an empty inhaler, no dose will be delivered.Ensure your inhaler is not empty before using it.
Not holding your breath after inhalationAllHolding your breath increases lung deposition by sedimentation. When the air is kept still for a few seconds, more particles of the inhaled drug will sediment on to the receptor sites.Hold your breath for between 5-10 seconds or as long as you comfortably can.
Having multiple doses without waiting between doses.AllTaking another dose immediately can reduce the dose delivered per dose.If you require a second dose, wait 30 seconds
Not maintaining your spacer device.SpacerSpacers that are not maintained may be cracked and cause drugs to escape.Replace your spacers every 6 to 12 months.

How to use an inhaler

How to use an Accuhaler®

  1. Open the Accuhaler® by holding the outer case in one hand and using the thumb of your other hand to push the thumb grip away until you hear a click. You should now see the mouthpiece.
  2.  Hold the mouthpiece of the Accuhaler® towards you and slide the lever beside the mouthpiece away from you until you hear a click.  The makes the dose available to be inhaled.
  3. Breathe out away from the Accuhaler®. Wrap the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full as much as you comfortably can. 
  4. Remove the Accuhaler® from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  5.  Close the Accuhaler® by sliding the thumb grip back towards you until you hear a click. This will also cover the mouthpiece and lever.
  6. If you have to take a second dose, wait 30 seconds and repeat steps above.
how to use an accuhaler
Accuhaler

How to use the Aerolizer® (Dry powder inhaler)

  1. Remove the cover of the Aerolizer®
  2. Open it by turning the mouthpiece in the direction of the arrow.
  3. Insert the capsule in the base chamber of the Aerolizer® and rotate the mouthpiece to close it.
  4.  Press both buttons once. You should hear a click.
  5. Hold the inhaler horizontally while Keeping your head upright.
  6. Breathe out away from the Aerolizer®
  7. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  8. Remove the Aerolizer® from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  9.  Remove the used capsule from the chamber and close the Aerolizer®
how to use an aerolizer
Aerolizer

How to use the Autohaler®(Breath actuated aerosol)

  1. Hold the Autohaler® upright and pull down the lip at the back to remove the cover of the mouthpiece.
  2. Shake the Autohaler®. Push the lever at the top of the Autohaler® up and leave it up. Ensure your hand does not cover the air vent at the bottom of the Autohaler®.
  3. Breathe out away from the Autohaler®.
  4. Wrap the mouthpiece with your lips and breathe in steadily and slowly as much you can until your lungs are full or as much as you comfortably can. Continue breathing in even after the Autohaler® clicks as that is the dose being released.
  5. Remove the Autohaler® and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  6. Put the device off by pushing the lever on top of the Autohaler®.
  7. Put the cover of the mouthpiece back on.
  8. If you have to take a second dose, wait 30 seconds and repeat steps above.
Autohaler rotated
Autohaler rotated
Open Autohaler
Open Autohaler

How to use the Breezhaler® (Dry powder inhaler)

  1. Pull off the cover of the mouthpiece.
  2. Open the capsule chamber by holding the base of the inhaler and tilting the mouthpiece backwards.
  3. Open the blister pack and remove one capsule. Then put the capsule into the capsule chamber. Close the mouthpiece. You should hear a ‘click’.
  4. Hold the inhaler up such that the mouthpiece is pointing up and pierce the capsule by pressing the two side buttons at the same time. This should be done once only. You should hear a ‘click’.
  5. Release the two side buttons.
  6. Breathe out away from the Breezhaler®. Wrap the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full as much as you comfortably can. 
  7. Remove the Breezhaler® and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  8.  Check the capsule chamber to see if there is any powder remaining. If there are some powder remaining, then repeat the steps 6 and 7
  9. Remove the empty capsule and close the inhaler.

How to use the Clickhaler® (Dry powder inhaler)

  1. Hold the Clickhaler upright.
  2. Remove the cover of the mouthpiece.
  3. Shake the inhaler.
  4. Holding the inhaler upright with your thumb at the base and your forefinger on the push button on top of the Clickhaler, press the push button down firmly once until you hear a click.
  5. Breathe out away from the Clickhaler®. Wrap and seal the mouthpiece with your lips and breathe in steadily and deeply until your lungs are full or as much as you comfortably can. 
  6. Remove the Clickhaler®  and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  7. If you have to take a second dose, wait 30 seconds and repeat steps above.
  8. Replace the cover.
how to use a clickhaler
Clickhaler

How to use the Diskhaler® (Dry powder inhaler)

  1. Remove the cover of the mouthpiece. Check inside and outside of the mouthpiece to make sure it is clean and clear.
  2. Pull out the white tray gently with the edges of the white mouthpiece until you can see the ridges on each side of the tray.
  3. Press both sides of the ridges at the same time and pull the white tray completely out of the Diskhaler® body.
  4. Place one silver medicine disk on the wheel with the flat side facing up. The four blisters of the disk should fit neatly into the four holes in the wheel.
  5. Slide back the white tray fully as far as it will go into the Diskhaler® body.
  6. Life the lid (shaped like a half-circle) at the top of the Diskhaler® as far as it will go into a completely upright position. This lid must be in a straight upright position for the needle to pierce both the top and bottom of the medicine disk inside.
  7. Click the lid down into position.
  8. Breathe out away from the Diskhaler®. Keep the Diskhaler® at a level so the medicine does not spill out. Wrap and seal the mouthpiece with your lips without covering the air vents.
  9. Breathe in steadily as strongly and deeply as you can until your lungs are full as much as you comfortably can. 
  10. Remove the Diskhaler® from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  11. Rotate the Diskhaler® to the next blister by gently pulling the white tray out and in again. Only piece the blister when you are ready to take the next inhalation.
  12. Replace the mouthpiece cover.

Important notes about Diskhaler®

The Diskhaler® pierces one blister of medicine at a time

Store at 25°C (77°F)

Always check the inside and outside of the mouthpiece to make sure it is clean and clear. Any foreign object in the mouthpiece could be inhaled and cause serious harm.

How to use the diskhaler
How to use the diskhaler

How to use the Easi-breathe® (Breath actuated aerosol)

  1. Hold the Easi-Breathe® inhaler upright without using your fingers to cover the air holes at the top of the inhaler device.
  2. Shake the Easi-breathe® inhaler
  3. Open the mouthpiece by removing the cap covering it.
  4. Breathe out away from the Easi-Breathe® inhaler
  5. Wrap and seal the mouthpiece with your lips and breathe in steadily and slowly as much you can until your lungs are full or as much as you comfortably can. Continue breathing in even after the dose is released.
  6. Remove the Easi-Breathe® inhaler and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  7. Put the cover of the mouthpiece back on.
  8. If you have to take a second dose, wait 30 seconds and repeat steps above.
how to use the Easi breathe inhaler
how to use the Easi breathe inhaler

How to use the Easyhaler® (Dry powder inhaler)

  1. Open the Easyhaler® by holding it in one hand and using the other hand to remove the cover of the mouthpiece.
  2.  Shake the device
  3. Hold the Easyhaler® upright with your thumb on the bottom and index finger on the top. Press down once until you hear a click to release the dose.
  4. Breathe out away from the Easyhaler®. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  5. Remove the Easyhaler® and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  6.  Close the Easyhaler®
  7. If you have to take a second dose, wait 30 seconds and repeat steps above.
how to use the Easyhaler
how to use the Easyhaler

How to use the Ellipta® (Dry powder inhaler)

  1. Open the Ellipta® inhaler by sliding the cover down until you hear a ‘click’.
  2. Breathe out away from the Ellipta® device.
  3. Wrap the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  4. Remove the Ellipta® device and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  5.  Close the Ellipta® device.
  6. If you have to take a second dose, wait 30 seconds and repeat steps above.
  7. Discard your Ellipta® inhaler six weeks after opening.
Ellipta white
Ellipta white
Ellipta showing counter
Ellipta showing counter

How to use the Airflusal® Forspiro® inhaler

  1. Hold the inhaler horizontally with the protective cap facing towards you.
  2. Open the protective cap downwards. This will reveal the mouthpiece.
  3. Ensure the side chamber is closed, lift up the edge of the white lever to prepare the dose.
  4. Make sure the side chamber is closed and then prepare the dose by lifting up the edge of the white lever. Move this white lever completely until you hear a click. This puts a dose in place.
  5. Close the white lever completely so that it clicks back to its original position. The Airflusal Forspiro® inhaler is now ready for use straight away.
  6. Breathe out away from the Forspiro®
  7. Wrap and seal the mouthpiece with your lips without covering the air vent and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as is you comfortably can. 
  8. Remove the Forspiro® inhaler from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  9. Close the Forspiro®
Fospiro
Fospiro
Fospiro inhaler
Fospiro inhaler

How to use the flutiform® inhaler

  1. Shake the inhaler very well and remove the cap
  2. Breathe out, away from your inhaler
  3. Wrap and seal the mouthpiece with your lips and breathe in steadily and slowly.
  4. Press the top of the canister down completely to release a dose as soon as you start breathing in. Continue to breathe in slowly but steadily and as deeply as much you can until your lungs are full or as much as you comfortably can.
  5. Remove the flutiform®inhaler from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  6. Put the cover of the mouthpiece back on.
  7. If you have to take a second dose, wait 30 seconds and repeat steps above.
Flutiform inhaler
Flutiform inhaler
Flutiform
Flutiform

How to use the Genuair® (Dry powder inhaler)

  1. Open the Genuair®, by gently squeezing the arrows marked on each side of the mouthpiece cover and pull off.
  2. Hold the Genuair® device towards you with the mouthpiece ensuring and the coloured button is facing up.
  3.  Press the coloured button until it reaches down and then release.
  4. Ensure the coloured window found at the front of the Genuair® device is green.
  5. Breathe out away from the Genuair® device.
  6. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full as much as you comfortably can.  You will know your dose is released when you hear a click. Keep breathing in after you hear the click.
  7. Remove the Genuair® device and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  8. Ensure the coloured window is now red as that confirms that you have inhaled the appropriate dose correctly. If it shows green, then you need to repeat step 5-5
  9.  Close the Genuair® device by replacing the mouthpiece cover.
Genuair inhaler

How to use the HandiHaler® (Inhalation powder, hard capsule)

  1. Release the dust cap of the HandiHaler by pressing the green button on the side once. You then have to fully open the dust cap by pulling it upwards. You will see a chamber where the capsule gets placed. Open this chamber by pulling the mouthpiece upwards.
  2. Take one capsule, remove it from the blister pack and place it into the chamber.
  3. Cover the mouthpiece firmly until you hear a click.
  4.  Holding the HandiHaler® upright, press the green button on the side of the inhaler once only and then release it.
  5. Breathe out away from the HandiHaler®
  6. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  7. Remove the HandiHaler® from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  8.  Remove the used capsule from the chamber and close the HandiHaler®.
Handihaler when open
Handihaler when open
Handihaler rotated
Handihaler

How to use the NEXThaler® (Dry powder inhaler)

  1. Open the NEXThaler® by holding it upright and fully opening the cover of the mouthpiece.
  2. Breathe out away from the NEXThaler®
  3. Wrap and seal the mouthpiece with your lips without covering the air vent and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  4. Remove the NEXThaler® from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  5. Close the NEXThaler®
  6. If you have to take a second dose, wait 30 seconds and repeat steps above.
Nexthaler when open rotated
Nexthaler when open
Nexthaler
Nexthaler

How to use the Novolizer® (Dry powder inhaler)

  1. Open the Novolizer®, by gently squeezing the arrows marked on each side of the mouthpiece cover and pull off.
  2. Hold the device towards you with the mouthpiece ensuring that the coloured button is facing up.
  3. Press the coloured button until it reaches down and then release. You should hear a double click and the control window should change from red to green.
  4. Confirm that this window is green.
  5. Breathe out away from the Novolizer® device.
  6. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can.  You will know your dose is released when you hear a click. Keep breathing in after you hear the click.
  7. Remove the Novolizer® device from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  8. Ensure the coloured window is now red as that confirms that you have inhaled the appropriate dose correctly. If it shows green, then you need to repeat step 5-7
  9. Close the Novolizer® device by replacing the mouthpiece cover.
  10. If you have to take a second dose, wait 30 seconds and repeat steps above.
how to use the Novolizer inhaler
how to use the Novolizer inhaler

How to use the Metered-dose inhaler® (MDI, aerosol)

  1. Shake the inhaler very well and remove the cap
  2. Breathe out, away from your inhaler
  3. Wrap and seal the mouthpiece with your lips and breathe in steadily and slowly.
  4. Press the top of the canister down completely to release a dose as soon as you start breathing in. Continue to breathe in slowly but steadily and as deeply as much you can until your lungs are full or as much as you comfortably can.
  5. Remove the MDI inhaler from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  6. Put the cover of the mouthpiece back on.
  7. If you have to take a second dose, wait 30 seconds and repeat steps above.
How to Use the Metered Dose Inhaler MDI
How to Use the Metered Dose Inhaler MDI

How to use the Respimat ® (Solution for inhalation)

  1. Check that the Respimat® inhaler has a cartridge inserted. Hold the Respimat® inhaler upright with its mouthpiece cover closed.
  2. Turn the clear base in the direction of the arrows on the label until it clicks
  3. Open the cover of the mouthpiece until it fully snaps open.
  4. Breathe out, away from your inhaler
  5. Wrap and seal the mouthpiece with your lips without covering the vent and breathe in steadily and slowly.
  6. Press the dose-release button while breathing in slowly but steadily and as deeply as much you can until your lungs are full or as much as you comfortably can.
  7. Remove the Respimat® inhaler from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  8. Put the cover of the mouthpiece back on.
  9. If you have to take a second dose, wait 30 seconds and repeat steps above.
Respimat when open
Respimat when open
Respimat
Respimat

How to use the Spiromax® (Dry powder inhaler)

  1. Open the inhaler by folding the mouthpiece down until a click is heard.
  2. Breathe out away from the Spiromax®
  3. Wrap and seal the mouthpiece with your lips without covering the air vent and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can.  You may sense a taste as you take a dose.
  4. Remove the Spiromax® from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  5. Close the Spiromax®
  6. If you have to take a second dose, wait 30 seconds and repeat the steps above.

How to use the Turbohaler® (Dry powder inhaler)

  1. Open the Turbohaler® by unscrewing and lifting off the mouthpiece cover.
  2. Holding the Turbohaler® upright and with the aid of the grip at the bottom, twist the grip as far possible in one direction then twist it back again until you hear a click which means the dose is ready.
  3. Breathe out away from the Turbohaler®.
  4. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  5. Remove the Turbohaler® and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  6.  Close the Turbohaler®.
  7. If you have to take a second dose, wait 30 seconds and repeat the steps above.
Turbohaler when open rotated
Turbohaler when open
Turbohaler 1 rotated
Turbohaler

How to use the Zonda® Braltus® inhaler (Dry powder inhaler)

  1. Pull the cap upwards.
  2. To open the mouthpiece, Hold the base of the Zonda® device firmly and pull the mouthpiece upwards.
  3. Take one capsule from the bottle, close the bottle tightly and put the removed capsule into the capsule-shaped compartment at the base of the inhaler. You should only remove this capsule immediately before use.
  4. Do not store the capsule in your inhaler and never place a capsule directly on the mouthpiece.
  5. Close the mouthpiece until you hear a click. Leave the cap open.
  6. While holding the inhaler with the mouthpiece pointing upwards, Press the button fully once to release it. This should pierce the capsule and release a dose ready to inhale.
  7. Wrap and seal the mouthpiece with your lips and breathe in steadily as strongly and deeply as you can until your lungs are full or as much as you comfortably can. 
  8. Remove the Zonda® inhaler from your mouth and hold your breath for 5 to 10 seconds or as long as you comfortably can and then breathe out slowly.
  9. Repeat steps 7 and 8 if required to ensure the capsule is completely emptied.
  10.  Remove the used capsule from the chamber and close the inhaler
Zonda
Zonda when open rotated
Zonda
Zonda rotated

How to use an inhaler with chambers like Aerochamber

  1. Remove the mouthpiece cover of the inhaler and the Aerochamber® Spacer.
  2. Shake the inhaler 4 to 5 times while holding it upright and insert into the flat end of the Aerochamber® Spacer.
  3. Breathe out fully as you comfortable can
  4. Wrap the mouthpiece of the spacer between your teeth without biting it and seal it with your lips.
  5. Press the top of the inhaler once to release the dose into the spacer then breath normally five times.
  6. Remove the Aerochamber® Spacer.from your mouth.
  7. If you have to take a second dose, wait 30 seconds and repeat the steps above.
  8. Remove the inhaler from the spacer and replace the inhaler mouthpiece cover

How to use an inhaler with a volumatic spacers.

  1. Put the two parts of the spacer device together.
  2. Remove the mouthpiece cover of the inhaler.
  3. Shake the inhaler 4 to 5 times while holding it upright and insert into the flat end of the Volumatic® spacer.
  4. Breathe out fully as you comfortable can
  5. Wrap the mouthpiece of the spacer between your teeth without biting it and seal it with your lips.
  6. Press the top of the inhaler once to release the dose into the spacer then breath normally five times.
  7. Remove the spacer from your mouth.
  8. If you have to take a second dose, wait 30 seconds and repeat the steps above.
  9. Remove the inhaler from the spacer and replace the inhaler mouthpiece cover

Useful tips on using spacers

  1. Use the spacer that correctly fits your inhaler.
  2. Ensure your spacers are washed regularly preferably every fortnight.  Follow the instruction on leaflet that comes with the spacers.
  3. Replace your spacers every 6 to 12 months.

Checklist on how to use an inhaler

  1. I have prepared the inhaler device. This means removing the mouthpiece cover, opening the device, and holding the inhaler device upright.
  2. I have prepared the dose. This means shaking the inhaler if it is an aerosol or loading the dose if it is a dry powder inhaler.
  3. I will breathe out gently as far as I comfortably can away from the inhaler.
  4. I Will wrap and seal the mouthpiece with my lips.
  5. I will breathe in and co-ordinate inhalation according to the type of inhaler For dry Powder Inhalers, do a strong and deep inhalation (forceful). For aerosols and MDI including when using a spacer, use slow and steady inhalation (gentle)
  6. I will remove the inhaler from my mouth and hold my breath for 5 to 10 seconds
  7. I will repeat dose if required after waiting 30 secs then close the mouthpiece of the device.

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