Asthma inhalers: how do I use my puffer?

There are a number of different devices for delivering asthma medicine into your lungs. One of the most commonly used is the pressurised metered dose inhaler (pMDI) or puffer.

The medicine contained in the inhaler is in a fine mist. When you press the canister this mist is released, and you breathe in to deliver the medicine to your airways. It is important that you use your inhaler correctly, so that you receive the correct dosage.

How to use your inhaler

To make sure you are using your inhaler properly, follow these steps:

  1. Remove the cap from the mouthpiece, ensuring that the mouthpiece is free from dust and grit.
  2. Hold the inhaler upright and give it a good shake.
  3. Breathe out gently.
  4. Tilt your head slightly back.
  5. Put the mouthpiece in your mouth, and close your lips around it. (Do not bite the mouthpiece).
  6. Start to breathe in slowly and deeply through your mouth, and at the same time press down firmly on the canister to fire one puff of the medicine (use both hands if you cannot manage with one). Continue to breathe in slowly and deeply.
  7. Remove the inhaler from your mouth, continuing to hold your breath for about 5 seconds.
  8. Breathe out gently through your nose.
  9. Replace the cap.
  10. If you need to take a second puff, wait about a minute before repeating steps 2-8.

Because your inhaler technique can deteriorate over time, it’s a good idea to check your technique with your pharmacist or doctor from time to time.

If you have problems coordinating drug release and inhalation, you may be better using the puffer in conjunction with a spacer. Alternatively, you may be better off using a breath-activated device (such as Autohaler, Turbuhaler or Accuhaler), which may also be more appropriate for people who have arthritis of the hands and find pressing the device difficult.

Using a spacer device with your puffer will improve the amount of medicine that reaches your small airways. You should use a spacer when using your reliever inhaler for an asthma flare-up, or asthma attack. It is also recommended that you use a spacer with preventer puffers that contain inhaled corticosteroids, to reduce side effects such as oral thrush (a fungal infection of the lining of the mouth or throat) and hoarse voice.

Don't forget to wash your inhaler regularly. Some inhalers need daily washing and air drying. Your doctor or pharmacist can advise you and show you how to do this properly.

Last Reviewed: 21 September 2015
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References

1. National Asthma Council Australia. Australian Asthma Handbook, Version 1.1. National Asthma Council Australia, Melbourne, 2015. Website. Available from: http://www.asthmahandbook.org.au (accessed Sep 2015).
2. National Asthma Council Australia. Australian Asthma Handbook – Quick Reference Guide, Version 1.1. National Asthma Council Australia, Melbourne, 2015. Available from: http://www.asthmahandbook.org.au (accessed Sep 2015).
3. National Asthma Council Australia. Standard MDI (updated Jun 2015). http://www.nationalasthma.org.au/how-to-videos/using-your-inhaler/standard-mdi (accessed Sep 2015).
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